BOD Position Statement on Proposed PANRE
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PAOS BOD position statement on proposed PANRE change

The PAOS BOD recently conducted a survey of members asking their opinions on topics such as if members agree or disagree with the proposed PANRE change, how much time and money is spent preparing for the PANRE, why they feel there is a need for a change or why they do not want it. We had over 640 responses to the survey. By a 2:1 margin, our members answered yes to the following question: “If there is a choice of a general orthopedic specialty component (in addition to the general med take home exam), would you be in favor of this change?”

The primary reason why most members desire a change is that the current generalist exam does not reflect the actual practice of orthopedic PAs. Additionally, by a 2:1 margin, our members support a PANRE as they feel it demonstrates a level of professional competence and helps to safeguard the public. There was a large group of respondents who would like to drop the PANRE after the PANCE and use CME alone as the recertification requirement.

There are concerns regarding the change. Most common are the objections to taking two exams to recertify, the time spent to prepare for two exams, and the additional costs involved. Other concerns include taking a general orthopedic exam for those practicing in a subspecialty, the loss of flexibility if insurers or hospitals require a specialty credential, and potentially adversely affecting state licensing requirements.  At the recent AAPA leadership advocacy summit (LAS) in Washington DC, the NCCPA formally stated that there would be no “specialty” recognition (other than the optional CAQ). This means that after successfully completing the general medicine take home exam, whether the proctored specialty exam is in orthopedics, emergency medicine, or family practice, it will be reported to third parties as pass/fail and the PA will maintain professional flexibility as a generalist PA-C.  They have also stated that with the general take home exam, the PA may consult outside resources including texts, MDs, and PA colleagues.

There is the issue of cost. The majority of respondents spent over $200 and greater than 20 hours of time to prepare for the current generalist PANRE. Many reported spending hundreds (some thousands) and spending weeks in preparation. Several report using CME time and money taking a state sponsored medicine or private PANRE review course to pass the current exam.

Other concerns regarding this proposal include the validity of taking a recertification exam at all, the impact of different types of CME versus examinations on provider behavior, and specialty certification creating obstructions to practice and reimbursement.  We encourage you to keep informed on this important issue and to also take the NCCPA survey on the topic to voice your opinion. The AAPA has a resource page devoted to the topic  We also encourage you to read the NCCPA position by following links on their main page

Based on the responses to our member survey, the PAOS BOD supports the current proposed change to the PANRE as opposed to keeping it in its current form. We would like the NCCPA to provide more clarity on the “periodic” nature of the take home exam. We would also like more color be provided on proposed costs to administer two exams. We will continue to monitor this proposal and provide updates as they become available. We also encourage you to take the NCCPA survey on the subject and voice your opinion at the end of the survey in the comment section.

Sam Dyer, MHS, PA-C

President PAOS