160 From 326 to 439: How Taylee Rebuilt Her PANCE Approach in 33 Days

Hello and welcome to the Physician Assistant Exam Review Podcast. This is episode 160 and I’ve got something really special for you today. I’ve got an interview with a student who went up 113 points on her second PANCE attempt. These stories are so much fun. There’s so much fun for me to see the turnaround in a student who was struggling, who was worried, who wasn’t trusting themselves, who didn’t have the skills that they needed to pass the exam. They had the content knowledge. They’d been through school.

They graduated. They passed their EORs. They passed their end of curriculum exam. But they couldn’t quite get over this final hurdle. And with a little time and effort and energy put into learning to trust themselves again, put into rebuilding some of that ego that gets beat up a little bit during PA school for all of us and learning some new skills and ways of approaching things like studying and test taking, as you’ll hear, how much distance they can make, how far you can go. And this is something I always talk about. If you can listen to the podcast and it’s great and I could work with you on cardiology or pulmonology and we could move scores a little bit.

A handful of points here, a handful of points there. Nothing is going to move scores like skills. Nothing is going to move scores like confidence. Nothing’s going to move scores like understanding what kind of test-taking you will, test-taker you are, and then leaning into that. We teach all of that inside of 33 Days to Pass the PANCE. And April cohort is right around the corner. In fact, March 19th, Thursday, is when registration opens for the April cohort.

If you’re considering this, listen to today’s interview, head over to physicianassistantexamreview.com/33, and see if it doesn’t make sense for you. See if you couldn’t use some of the skills that we’re going to talk about today. See if you couldn’t use them on your end of rotation exams, or in didactic year, or wherever you’re struggling. We focus mainly on the PANCE here, but the information is the same. The things we talk about are all transferable really when we talk about study techniques, we talk about confidence, And we talk about what kind of test-taker you are. That really can apply to any exam that you take for the rest of your life. It applies to my PANRE every time I sit down to take it.

It applies when I go to do my BLS or ACLS. It’s all the same skills. Anyway, I won’t take too much more time.

Let’s hop straight on into the interview.

Okay, hi. How are you? Hi. Good. How are you doing? I’m great. So you have exciting news.

Yeah, getting that I didn’t even get the email which is funny because it was still linked to my university account and they took that away from us like two weeks after graduating. So okay, so my name’s Tayleigh. I took the PANCE exam about six and a half weeks after graduating I prepped pretty quick and didn’t feel fully ready and that’s how I failed the first try and then I joined Brian’s 33 Days course about five, what was it, four months later to build up that confidence and then after those 33 Days I took it the following Monday and passed. Honestly 33 Days took me from being very anxious and uncertain not as confident to Less anxious, very secure confident in the content that I know. So for starters, what kind of student were you through PA school as you went through clinicals, as you’re getting ready for your end of curriculum exams and your EORs? Like how is that kind of going for you overall? Oh my gosh.

Yeah. Throughout PA school, I was scoring average like high 80s through my exams, unless it got to, you know, musculoskeletal or orthopedics, which is my bread and butter. And then I just passed with high 90s. So I was pretty average, I would say, compared to my classmates, and I was definitely one of those students that would walk in, not really reviewing, but at the end of the exam, I would be reviewing my answers on the test with my classmates just making myself more stressed. So when it came to the EORs, I was not scoring very high, whatsoever. I was barely skating by. I think women’s health was the only one that I had to retake and I passed it with flying colors the next time.

But yeah, nothing too impressive. I guess I’m lucky, but I guess I’m not surprised why I didn’t pass my PANCE the first attempt. So the EOC I passed, I think I got like, I barely made it pass that one to like a 1450. It wasn’t too impressive whatsoever. So. So then what did you do going into your PANCE? What did you do for prep work and what were you thinking as you were approaching that exam?

Yeah, so UW gave us Smarty PANCE to use, which I didn’t find to be the most valuable tool to take our practice tests on. And then we had Kaplan as well. So it was okay. I didn’t get the most value. I would say on that first attempt, that’s what I was using. And then the PANCE Prep Pearls was a big one for me. And then the Cram the PANCE podcast, Ninja Nerd, I’d watch it here and there.

But by the sound of it from a lot of my other classmates, they were very confident that they were like, you’ll be fine. You’ll pass the PANCE on the first attempt. Don’t even worry about it. And then how do you go into that? Oh, I think going into the exam. I had gotten bad news from a lot of my classmates that I studied with. So it was our own little group of four in the back corner of the classroom.

And so I had my friends. And so we got news from one of them. She didn’t pass. And then my next friend said she didn’t pass. And then I was up next. So I feel like I had this mentality of like, I don’t think I’m going to pass. Which is a tough place to be.

Yes. And then with your course, it makes me laugh because I felt good throughout the exam. I got my first break and I took those 15 minutes and I was like, “Screw it. I’m going to go through the other four sections straight.” And I did. And I just instant I regret it. I remember your lesson that you provided us and I was like, “Yep, I should have taken my breaks for sure.” Okay. So then you get your scores back.

And obviously they weren’t what you were hoping for. I think you said you had a 326. So in the neighborhood, but not where you wanted to be. So then what happens next? I took a month to kind of relax, help my parents around the house with just house keeping, you know, I keep my mind off of what I just crammed for. So I guess that first attempt came so much quicker than I expected, like six and a half weeks after graduation. And I had already, I had just received like an orthopedic scholarship and full ride trip to Vegas, which is where I’m at now.

They basically paid for my flight home. So that was a conference that I had to attend and that took like a week. So out of that six and a half weeks I already had multiple things like my grandma’s funeral and then the conference and everything and I’m like realistically I think I gave myself four weeks to really review and I don’t feel like that was enough. So then I took the exam I took a month break after that and then I got back to studying and reviewing cardiology for a good, I would say two and a half, three weeks, just focusing on cardiology, making sure that I understood murmurs inside out and backwards, especially with the congenital ones and knowing how those looked on an X-ray and why they looked that way and just the pathophys behind a lot of that. And then I took like a week break because I was like, cardio is so heavy and then I moved into the PANCE Prep Pearls and just reading through every single page. And I think I did that for the next two months. And I still didn’t feel very good.

So then I talked to my friend Alia and she’s like, “Honestly, look into a prep course.” And then I got an email from you and it was like, “I’m extending the deadline to add a few more students.” And I’m like, I’m taking this as a sign that I should join. So ultimately joined in last minute and then listen to your lessons every morning. And before you move into that, let me back you up just a little bit. This is so… There’s a lot that happened. Yeah, no, it is a lot. I love that you took the month off.

I think that that’s a fantastic move. A lot of people jump right. I literally get emails from people the day that they find that they failed saying, can you tutor me? What can we do? And I’m like, whoa, whoa. No, absolutely not. You need to step away.

Take a breath. It’s going to be okay. You’ve got 90 days. We don’t need to start today. Like you need to kind of mourn a little bit. You need to take a minute.

So I love that you did that. At what point then afterwards did you, so you said that you got that email from me talking about that I was going to host a cohort. At what point were you considering doing that, but you were kind of like, maybe I don’t really need this. I’m not sure if it’s for me. I’m not sure what this is about. For you coming across my material, I don’t know how much you used before, how much you didn’t use. But what was the transition from this is something I’m kind of thinking about doing, but I’m hesitant and these are the reasons why I’m not sure about it and what sort of walked you through that decision making.

Yeah, I think I signed up, I was just looking for prep courses that were at a decent cost and would be quick. So I think I signed up for some of your emails and then you do like the five question Friday And I’m like, I kind of like that he still has these emails going and it just was the one thing that stuck. And I’m like, what if I just did those 33 Days? And so I didn’t ever listen to your podcasts, unfortunately, but once I found them, like, where has this been my whole life? I was like, where was this all of PA school? Because I remember before, I think it was the day that I bought the 33 Days to join the cohort. I was listening to the dermatology review that you had just released and I’m like, where has this been?

So I was so glad that I joined. I think it was just my confidence level was not where I thought it should be. And I’m like, let’s just see what this 33 Days is all about. I’m like, okay. And this is one of my questions because and for people who are kind of on the fence or thinking about it or just think about what they should be looking into is with all the material out there. There’s so much prep material. There’s so many different things you have.

So many things already that you already talked about going through. I mean hundreds and thousands of dollars worth of material. Yes. What made you sort of decide that maybe this would be the right thing to do? I think the course itself would have been the same cost as another exam. So I’m like, why not prep myself with that same cost and prep the best I can? And then if it doesn’t work, it’s the cost of another exam anyway if I would have done nothing.

So I was like, it seems pretty level.

Let’s just go for it.

And then where was the point? Usually it’s somewhere in the first week or so where you kind of thought to yourself, wait a minute, this might actually be different. This might actually work. This seemed kind of weird at first, but I’m starting to get it and it’s starting to make sense.

Yeah, it actually was that first week. I think it was like the third lesson that you provided And it was like one of your most, your one of your favorites. I can’t remember it off the top of my head, but I listen, I think you told us to listen to it twice and I’m like, I’m glad.

I think that was the staying out of the weeds would have been day three.

Yeah, yeah. I was like, okay, I’m going to listen to this twice, but also three times, four times. I really, I liked it. It resonated a lot. And I think the biggest one I would say was the cognitive brain versus like the subconscious. And you bringing sport analogies into it. I’m like, yeah, my athletic training brain understood pretty much every lesson that you provided.

So it really did make a huge impact into my studying and then some of the lessons you brought out later just happened to be what I was doing anyway, like going to a cafe and focusing for 20, 30 minutes and then taking like a five, 10 minute break and then resuming and then doing that for like four hours. So that’s what I was doing. And I’m like, it sounds like I’m on the right track. So my focus was definitely there. And it was just nice to have that reinforcement with your program.

Perfect. Were there things along the way, you know, not getting into too specific details ’cause we don’t have a ton of time, but just a generalized overview. Were there things along the way that you did change in your studying and the way that you approached things or in the way that you were looking at test questions?

Yes, absolutely. Oh my gosh, you did a couple of those episodes where you flashed to the blue screen and then dissect questions. Which is something that I definitely did not do last exam, the first attempt at my PANCE. So you’re like, look at their age. Why are they coming into the office? Like they’re asymptomatic, right? And I’m like, all of that made way too much sense.

And I remember a question came up on my most recent PANCE where it was like this patient had a, I believe a basilar skull fracture. So they’re basically describing raccoon eyes, what do you do next? And on there it said like order a CT but they came to the urgent care. And so I’m like, oh, I don’t have a CT scan here.

Yeah, I was like hold on. (laughing) So then I was like, oh, you get ’em on an ambulance and send ’em to the ER ’cause you’re going to treat it like an open fracture. And so that type of thinking really did stay with me was so huge to just pause when I got panicked in the exam. Look at the question, dissect that age. And what does their lab work look like? Like, why did they include the history of hypertension or whatever, but yeah, it was…

It’s funny. And on one of the recent coaches calls, I was reviewing, Stella was going over that with a student, which I don’t remember the exact question, but it was something, one of the answer choices that the student wanted to pick was cystoscopy. And Stella was like, wait a minute. I don’t know about your office, but my office doesn’t have a setup for a cystoscopy just to do that sitting right here. So that’s going to come off my list immediately. That’s like the first one. And I know that’s something you want to do, but you have to understand the setting.

And immediately she was like, “Oh, okay, yeah, that makes sense.”

It did 100%. I always looked for that extra little bit of information. I liked how you said you’ll find two answers that are correct, but look back into the vignette and find supporting material as to why one’s better than the other. Well, that’s why now you can see as well that the first questions that we get on the way in the door is always how many questions should I be doing a day? Right? Should I be doing 50? Should I be doing 100 and me and the rest of the coaches are like, well, well, that’s the wrong question.

It’s not about how many, right? It’s about what you’re talking about and processing them and working with them. Yep. Exactly. And I did. I improved from the first time. I wasn’t doing too many practice questions because I did think that I knew enough to pass, but when you’re approaching the test-taking strategy, I was like, “That’s a whole different ballgame other than the material that you know.” So, yeah, next, this upcoming, this last exam, I definitely did way more practice questions, just to get familiar with the vignettes and dissecting them based on kind of the lessons that that you were teaching us.

So that I did, I do feel like paid off a lot. It went so much smoother, but I will say there were some where my cognitive brain told me the wrong answer and I instantly regretted it. (laughs) But I would say my subconscious definitely took over most of the exam because I was flying through a lot of these sections and finishing with a lot more time than I expected. So obviously my brain was working for me, not against me.

Did you find that you were a little faster on the second attempt than you were on the first attempt?

100% yes, absolutely.

Were you someone who was running out of time on the first attempt? I’m just curious for myself.

Yes, I was, I was definitely, I’m a little bit slower on the first attempt. And I think that was just because I was so torn between the two answers and I’m like, I don’t know which one’s better. And I would always choose the wrong of the two. And then maybe that was just because I wasn’t looking at the setting that they’re in or like why.

They have a history of hypertension, hyperlipidemia and diabetes.

No, like me. I’m very good at choosing the second best answer. The very good answer but not the best answer is my claim to fame.

Same. So I think you said that a lot in your lessons. And I was like, yeah, I resonate. I resonate.

So you found that you were finishing on time, then, which was different than the first time around?

Yes, definitely. I had like five minutes or up to like 10 minutes to spare, depending on the session. So that was a huge improvement. And I didn’t flag as many. So I mean, I still could have scored better, but it paid off.

Let’s talk a little bit about how you felt coming out of getting that score that you didn’t want, having a tough month or so with the things that you had to do during the month afterwards, and then prepping into your next exam. And the direction that you end up going, which sounds like it turned out really well for even just on the way walking through the door.

Yes, definitely. So the first exam I remember walking out and I just didn’t have a very solid gut feeling that I passed. I was like, “It’ll be close, but I genuinely don’t feel very good.” And I think that’s just because I had heard the news for my classmates that I studied with too. And I just had that in my mind where I was like, “I don’t think if they didn’t, I probably didn’t.” And then the second exam, going in, I could already tell that my, I got a Garmin watch. So like stress I was checking. Very mild. It was so mild walking into it and I was like that’s great.

I think that’s a good thing. And so then when I got done with every section I’m like okay that didn’t go as smoothly as I hope, but I know that I can tackle the next section and just do a little bit better and do a little bit better. And I just remember, I think you said like, I can’t remember what you said exactly. What a privilege it was to be taking that test and I, it’s true. I think I sat with that extra minute. They give you like a minute to prep on the little clock. And I would just sit there and I’m like, I’m lucky to be here.

I’m very fortunate to take this exam. Like, what a privilege to be in this seat. I deserve this. I deserve to be here. And then I’d click ready to go and then I’d tackle that next section and just keep doing that. And I took my breaks. I took each break.

That’s great. Yes. And then when I walked out, I felt very good. I was like, okay, I feel okay. I think I’m okay. But as the waiting period went on that Monday through Friday, I was like, I failed. I failed again.

It’s hard to do. I don’t know anybody who walked out the door thinking they did well. But I have heard from a lot of students that they don’t feel nearly as stressed, nearly as drained and exhausted and miserable as they did. Maybe before coming across the material that we cover. I agree. I agree. Yeah.

Even just talking with one of my classmates, Alia, it was so funny chatting with her the week leading up to my exam because she’s like, I can already tell in your voice, like, you sound so calm and so ready to take it. And I honestly think it’s your course because the stress that I had a month prior to entering your class. It was like, I was pretty stressed, and I don’t think I would have passed (laughs) if I had taken it on February 4th when I was supposed to take it. So I’m really glad I joined really last minute and made it happen. So I really do.

And some of that stress you don’t even know is there. It’s kind of the funny part. You can’t see it in yourself. I mean, you know your stress, but you can’t really see it. Yes, absolutely. No, I could tell it. I could tell in my own mental, I was like, “Oh, I wouldn’t have been ready then.” I don’t know.

And I know the coaches in particular love the transitions and the students, just their faces from week one to the end. And the way people are talking and the way that they’re moving and the way that they just look is completely different. Yeah. So you have exciting news. Yeah, getting that. I didn’t even get the email, which is funny, because it was still linked to my university account and they took that away from us like two weeks after graduating. So I ultimately just woke up on Friday morning and I was like, let me just check the verification website and I saw the green check mark and it said that I was board certified.

Then I just changed my email quickly on NCCPA and I was able to see my score. So yeah, very stoked. It was so good.

That’s amazing. That’s so funny. So were you, was it a couple of days in or were you wondering why you didn’t hear anything or were you just checking every day?

I think I just, I was checking every day. So I remember it took like three, I think it took three days last time to get my score back. And then I was like, we’re at day four. Let me just check and see. And then I had the good news. So yeah, I was very, very happy with all of that. I went from a, was it a 326 to a 439?

So, something else I wanted to talk about is, so you got your scores back, which you went up, what, over 100 points. A 113 points is absolutely crazy, right? That’s so good. You should be so proud of that. And you can see the numbers that you probably deserve the first time around, because I don’t know about you, but how much, you know, of the content, working things that you put together, like you were had to have been 90% of the way there, 95% of the way there.

Yeah, yeah, absolutely. And even looking at the, where they show you the graph where those different specialty question, where you place like on a scale of 200 to 800. Oh my gosh, everything shifted so far to the right that I was like, whoa, what? I only missed three cardiology questions.

Right, was that actually me? Was that just the wrong one I’m in? (laughs) Oh my gosh, oh my gosh, hematology and psych, not great, but other than that, just to see the drastic change, I was like, oh man, I don’t feel like I put that much more effort into content review, which I appreciated from your course too. I do feel like it was primarily confidence and looking at a question differently and finding the hints because once you were able to, once I was able to sit and be like, the exam writers are trying to point me toward the correct answer, I could see that. I could definitely see that. And it was very nice and refreshing to be, I guess, in on the secret. And it’s different.

Once you start to study with that in mind and start to see how that stuff’s built out, it is, I refer to it as being able to see through the questions and being able to see, and it’s amazing what a difference that is compared to that constant battle than the antagonistic view of how this whole thing goes.

They’re tricking me, which is what I thought the first time 100%. I remember walking out of there and I’m like, “What the hell was that?” They’re tricking us. They’re not.

So another question I have for you is, unfortunately, like you said, I tend to, this program is designed in the way, unfortunately the way it’s marketed. I find people after they fail their first exam, right? Somewhere in that zone. And my goal is to start moving this earlier in people’s careers. We had a student, I don’t know if you listened to last week’s podcast, I had Madison on as a didactic student who was in the February cohort. And he was like, I don’t know why we’re not doing this before we start PA school. Like this is so much valuable.

Can you speak a little bit to that about having, there’s someone who’s listening and is, and again, he’s either an early clinical and struggling a little on a EORs or even doing just fine. And in a position to say, like, do I need this? I’m kind of doing okay. I’m not sure that this is, you know, I have enough stuff. Yeah, I would absolutely give two thumbs up. Like you should absolutely be doing this so much sooner in didactic year. Do I wish I would have done it?

It’s just hindsight’s always 20/20 because the sooner that you can get into tackling questions from a different lens. The better you’re going to be when you actually get to the PANCE and can look at a harder, I guess a harder worded. Question, but still know what they’re asking because that was one of your lessons too is like, poke, you know, you can cross out a lot of the stuff and rephrase the question and I’m like, I think starting that sooner in didactic year would help so many more students and I think it would have helped me with my EORs when I was barely passing. So, couldn’t recommend it enough and I think it just, I think it would really help, didactic and then your understanding overall of of content.

That was so much fun again. I just can’t get over 113 points is insane. It’s a huge amount to move for anybody. And I see it quite frankly, I see it every single cohort. Every time I have results coming in from the February cohort now and I’m getting new score reports almost daily from students with 50 points, 100 points, 25 points. Amazing moves. And I’d love for you to be part of that.

If you’re struggling, if you’re having a hard time, if you think you’ve done everything you can, but it’s just not getting any better, if you feel alone, like you’re the only one, please join us for the April cohort. And you will find so many other students who are exactly like you, incredibly intelligent, deserve to be in your to be in school, deserve to graduate, but are missing a skill or tool, or a tool, that they don’t know exists. You can find out more at physicianassistantexamreview.com/33 and don’t think it’s too early. If you’re struggling any time is a good time. Last week we had an interview with Madison who was a didactic student. This week you heard our student today talk about earlier even. It’s never too early.

The skills will track with you throughout PA school.

Alright with that being said let’s call it a day. Hopefully we’ll see you within the cohort. Pass this along to a friend or to a classmate if you know that they’re struggling or having a problem or to a faculty member who may be able to pass this on to people who are struggling. I would really really appreciate that.

Alright take care.