166 From 341 to 474: Isabella’s 133‑Point PANCE Comeback

Hello and welcome to a very special episode of the Physician Assistant Exam Review Podcast. This is episode 166 and we’re going to have an interview today with Isabella who went from a 341 to a 474 on her PANCE. This is a very special episode today and I’m bringing it to you because tomorrow Thursday, May 21st, is going to be open registration for the June cohort of 33 Days to Pass the PANCE. You can find out more at physicianassistantexamreview.com/33. Also, I’m going to be offering a 100% free workshop tomorrow on the backbone of what we do in the 33 Days program. We’re going to go through what’s holding students back. And it might be content and we’ll talk about that, but there are six areas of focus that I talk about, six disciplines that are important for doing well in PA school and doing well in the PANCE.

And most programs, most schools focus on one to two of those six areas. And most review courses only focus on one of those and maybe give a little bit of time to one of the others. We focus on all six tomorrow night, point them out to you, give you ways to figure out which one is holding you back and drills and techniques for how to fix it. So that’s going to be Thursday the 21st at 8pm, Eastern time and also I’m going to be doing another live version of that on May 26th Tuesday at 8pm. And if you go to physicianassistantexamreview.com/workshop, you’ll get all the information to register and attend those events, and they’re going to be really, really powerful. So I’m hoping that you will join us. If you’ve been struggling, if you’re saying, you know what, I’ve tried everything, I’ve done everything, and I’m still not really seeing my score jump.

I’m living along that 78, 82 mark, and I need to have an 80, you’re going to want to attend this without a doubt. Anyway, that’s enough from me. I want to jump right into the interview with Isabella ’cause she has a fantastic story.

All right, well for starters, I wanted just to welcome you. I haven’t talked to you since you completed 33 Days. We’ve emailed back and forth a little bit, but I’m super excited to have you on the show. Can you start a little bit with the beginning of your story, not all the way back to kindergarten perhaps, but maybe to you’re in clinical, you’re in didactic, you’re maybe struggling a little bit, trying to put pieces together. Can you start us off there and then we’ll walk through sort of the rest of the story?

Yeah, so going from undergrad to PA school was like a huge jump scare to some regards to the workload that you give. It’s like pretty dramatic. So my first semester of PA school like really hit me hard where it hit all of us hard, but yeah, like the testing, everything, the content I was being thrown at you was insane. So it was definitely a shock to try and overcome, but it’s hard to overcome that when you never went through something like that. So you have to, like, you’re getting all these study materials and then you’re just overwhelmed with all those study materials. So I survived the first semester, but I think it was just mainly because of the study groups and everything that I found my study group and that really is what, like, was a game changer for me. But kind of my third and fourth semester were like a little smooth sailing into clinicals.

But I ended up like my surgical clinical was my first one. I ended up failing that EOR and that was my first EOR. And I was like… That’s kind of a big hit. But I was like, oh my god. Like, is this how clinicals is going to start for me? And it was the new surgical blueprint too.

So I was like, wow, I really need to change this up a little bit. So that was the shock in clinical and then clinical honestly kind of went by really fast. I got used to the PAEA like blueprint and like the way the questions were pretty fast. I just want to interrupt you for one second, just back up. I like how you said you survived your first semester and got through didactic year. Found a couple of techniques in a study group and changed some things. It’s hard and overwhelming.

One of the things I always think about is just that you’re getting caught up that next wave hits of the next set of exams and you have to figure out to do next. But I want to pause for a second. You get into clinicals and you fail that first exam. What happens to your head at that point? I’ve spoken with students who had never failed an exam before. Literally were straight A students through undergrad, failed an exam either in didactic or clinical. And it really just spiraled them mentally for a little bit for a while as they tried to regroup and figure out who they were with.

A little bit, the person they thought they were who was always perfect, suddenly wasn’t perfect anymore. Definitely. Like I remember failing, I failed it. It was literally like, it was two points, but I was just like, oh my God, I went back to the surgical blueprint. I was like, what can I do differently? And I was asking like, you know, my professors and all of this, they’re giving me resources. And I studied, I was given two weeks to retake it.

I do UWorld, I do the whole nine, I go back into PANCE Prep. That was like my main book that I was using at the time. And I still only, I increased the score by five points. I ended up passing. That was like two weeks of studying, only increased my score by five points. I was like, wow, so grateful that went well. And the other ones went smooth sailing after that.

So kind of was like, that was good. But it was definitely a shock, the first surgical one. I was like, wow.

And that’s so funny that line that you’re talking about, ’cause you pass, but only went up five points, which is a little concerning. I have a lot of, not a lot. I have students who will email me and say, You know what, I went up 80 points, but I still failed. And I’m hard pressed to tell them that’s such a huge success story and we’re moving in the right direction. But it’s the other side of that coin is they move so far, you only moved a little bit. I was like, wow. Yeah.

But yeah, that kind of was, my last clinical is family med. So I was like kind of a good clinical to end on. And I think that also, in my head, I was like, that’s a great PANCE prep clinical to have because it really encompasses medicine really well. So that’s kind of what I had in theory in my head. I ended up doing well in that EOR graduated in December, PA school, and it was kind of difficult because it was around the holidays. I had my exam scheduled the end of January, so it was a little bit of time. So I told myself after the holidays, that’s when I’ll start studying.

Obviously things always happen and that really didn’t happen. As much as I wanted it to. But I felt like I had a good like graduating PA school. I was like, wow, I have that foundation in my head, or I thought I did, of what can help me pass the PANCE. But in the end, I think I had the realization like after taking my PANCE in January and I ended up failing that by nine points. I got a 341. It really wasn’t content.

It was a mindset issue. And that’s kind of what I had the realization after taking that exam, that exam is like a beast and nothing that I even went through or encompassed in PA school. And as much as you said that getting through, you know, surviving didactic and getting along was difficult. Like you said, nothing like what you were somewhat prepared for the PANCE, but still hadn’t seen anything like that. Yeah. Like my, I’ll talk a little like my PANCE prep really was PANCE Prep Pearls.

Okay. I don’t know why I did that because I stared at that book, like, through and through, through didactic and clinical, where there was just no new information that could jump out on the page for me. So I think I was just kind of passively studying, but I thought I was actively studying by reading it for the 50th time. And you would think me going through PA school for two and a half years, I would have realized that, but I didn’t, because I was in the environment of, I took the exams, I took the exams in the same seat for two and a half years, I was comfortable with that environment. I knew exactly who was to my left, who was to my right, who was proctoring my exam. So I felt comfortable taking those exams. But when I went into the PANCE, I did not have a game plan for if I wasn’t feeling okay during the exam, how was I going to manage that?

And that’s, I started like spiraling during the exam and it was hard to take me out of that mindset. So that’s kind of where I found you and your course.

You and I actually met before that though, right?

Yeah, so it was before clinicals you came in December before we started in January. You came to my school at Pace University in Pleasantville. You did a little course of like how to go through test questions ’cause our cohort, like we were just wondering how to go through and like kind of not stay in the weeds in questions. So you kind of went through a little course on that where I remember I was like, wait, Brian Wallace came to my school.

Right, ’cause usually that’s my next question, is how did you stumble across me? Where did you find the stuff?

Yeah.

And then, so you would, so let’s fast forward a little bit. So you failed your PANCE, but not by much. You’re back to that same EOC problem of like, you’re right there, but you also knew that you sort of spun out of control, and maybe didn’t study to the best of your ability. It’s a tough season, it’s a tough time. And I think a lot of people find that one, they have so much else going on, right? There’s so many students I talk to who, you know, you’re graduating. So you’re looking for a job.

You’re moving out of your apartment. Yeah, I moved out. Yeah, people are getting married. People are having babies. There’s always so much going on that everyone will say, like, okay, I’m going to sit down and do this. But with that open-ended time horizon, it gets hard to quantify what your days are supposed to look like. And I see that a lot with students.

Definitely. Yep. That was like, and also another thing is like, I scored well on the EOC. So that kind of gave me a little confidence boost where I was like, oh, like my school set up, I score well on this EOC. I’m prepared for the exam like the PANCE, you know what I mean? Well, it also is why, people always ask me to be able to predict for them based on their, you know, practice exam scores. Even, you know, EOC is high stress, right?

High stakes practice exams you take at home are not, you know, you could attest to this, are not the same as sitting in that chair. Not at all. On that day. They’re helpful, they’re directionally helpful, but they’re not predictive. You know, we had Helen who’s one of our coaches. I’m sure I told you the story. She was getting 95% on UWorld and failed her test, right?

Because it’s not the same. It’s not the same as much as everybody wants that predictor. You’re never going to get it. And that’s hard. We can say most students who do this pass, most students who do this don’t pass. But we can’t tell you that statistics change when it gets down to one person. Right?

It’s never not real anymore. Definitely. Yeah.

Okay, so you got your scores back obviously you were devastated, but you sort of had an idea what had happened at least a little bit out of the gate you might not want to admit it to yourself. I did it. Yeah. But you sort of knew where you were and what you could make up for. So what brought you back to 33 Days to Pass the PANCE and my material at that point? Yeah, so I found out the news obviously it took a little bit like I think I took like a month off until I started researching some stuff, but I was reaching out to my school as well just to get some resources. So one of my professors was like, oh, I know like a really good, it was a course, and he sent me your 33 Days course.

And I knew I didn’t want one of those cram courses that was like a week long. I don’t do well with those. I’m really like, I love a schedule and I love structure and I wanted something a little longer that could like spread me to my exam. So then one of my professors sent me your course. I saw it didn’t have to deal, like it wasn’t dealing with like content. Like I liked how you went into the mind and that’s kind of what I was dealing with at the time and how to change your mindset. So when I was researching your course, I was like, you know, this actually seems like a great fit for me at the time.

And I was like, you know what, heck, like I need all the help. Like let’s just do this. And it turned out great. So that’s fantastic. You know, it’s one of the things I struggle with is I know to some people 33 Days seems like a long time to other people they actually like that length. But you know, from being on the other side, it would be very difficult to do what we do in a five day or a three-day course. It just doesn’t work, and basically we’re changing habits, we’re changing structures.

It takes time for some of the ideas to settle in some of the things that maybe didn’t quite get in the beginning sort of pan out in the end. And it’s just not something that and I’ve never really been interested in that kind of a cram course because I always feel like, you said you passed your EOC. You have the material. There’s no reason why that would be the problem. You know, maybe it’s possible that it’s a content issue, but I find it to be pretty rare that it’s a content issue. Yeah. I find more frequently the stories I get is exactly what you said where I didn’t have a plan for when things didn’t go well.

I didn’t have a plan for XYZ. I had one thing go in take the test and leave and that was sort of my the only thing I had to my structure. Yeah, had my snacks, my water, I was like, I’m set. And so building that I find it can be really, really helpful for some people. So what changed for you as you went through the program? What were some of the things that you, you know, without getting into too much detail, because we don’t have, you know, hours and hours here today. But what were some things that you picked up on that sort of shifted things for you?

Mm-hmm. So once I joined the course, I used your content calendar from start to finish, because my exam lined up, like it was your course ended on the third, my exam was the fourth. So it was like really great for me, like line up wise. So I, with the content calendar, I honestly, like I really used practice questions, like on end for me with UWorld, but I use them in a way of not like, not on tutor mode, always on exam mode. I, whatever content was for the day, I did UWorld questions before I started my content. And then I just, whatever, like, you know, with cardio, like it was three days, so like whatever was topic was that day, like I chose that on UWorld. And then whatever I got wrong, those are the topics I mainly spent my time that day because I knew, even though like I’m very grateful, like I really, I didn’t have to worry about like a part time job and like all that, so I was studying all day.

But I didn’t want to study for eight hours in the day I didn’t think I needed that mentally. So that’s kind of what I did. So I really did the questions. It showed what I’m like lacking in. And then that’s what I honed in on. I used a book off of Amazon. It’s like the research, Babcock book that you showed us.

I ended up getting that because I loved the bullet points that it provided. I love how she sets out the bullet points. She’s great to begin with, but I loved the way it’s structured. Yeah. So I didn’t even touch PANCE Prep, like that was my content book. And then if I needed to reach somewhere else, I reached either to your podcasts or Cram the PANCE podcasts. So those were like my three kind of rotation type things.

But that’s kind of like what I changed. And I think when I was going through the UWorld questions, like I really tried to understand why I’m getting this wrong. And also through each disease state, I’m like, what clinical manifestations are they adding for this disease and why? And then if I see those clinical manifestations, I see the answer choices. I’m like, oh, they’re adding those. It’s lining up here. Done.

Choose it. It was, I kind of was like going backwards in a way and trying to kind of… I love the way that you’re talking about how you’re thinking. Because I’ve talked about this, or I’ve talked about a lot of places, that you can have two people sitting next to each other in the library. And one of them’s doing good work, and one of them’s doing terrible work. And looking at them, you can’t tell the difference. They’re both sitting in that chair.

And they both look like they’re doing the same thing. And even if you’re one of those two people, you don’t know what the other, the person next to you is doing. And what you’re describing is such a good way of working and a good way of thinking that I love that transition piece and that you’re bringing it up the way that you are.

Yeah. And then other than like studying, I think what really did it for me was like, I created a mindset for myself from the start of 33 Days to the end of 33 Days. Like those days, every single day was like what I needed and I’m still doing them, even though the course has ended. Like, I visualize myself taking that exam from the start to the end, and I was like, if I visualize myself doing something for 33 Days, I’m going to get that done. Like, you know what I mean? Like, it’s going to be positive. And…

I love that you’re still doing it. There’s a few things, and you know this, ’cause you obviously went through this. There’s a few things I get feedback on, ’cause we’re changing things, right? So whenever you change things, people are unhappy, but at the end, it’s so great to see the people who are like, you know what? I wasn’t sure at the start, but I jumped in and I did it. And after a little while, I could see the changes in myself. I could see it in the way that I was functioning and the way that I was moving into this next thing.

Yeah. I think it was really like making that game plan for myself that I didn’t have the first time I took my exam. I was like, “I need to create that game plan now for my second attempt.” And I honestly think, like, I’m proud of myself for the game plan like I created. And I didn’t let any sort of like emotion take over me during the exam. Like that was huge for me. Like I even visualized me doing like the palm vein scanner, like me walking in. Like I did everything because I was like, I have to mentally.

And even before the exam, my exam day, like I went the day before and I like did an active visualization outside of the Pearson center. Because I need to like really get into that mindset like game day, like with sports and stuff. Like I had my playlist going.

So it’s basically, so to summarize, it’s completely different from how you walked into your first exam.

100%. Like I was shocked when I went through the whole like check-in process and I sat down. I was like, why is my heart not beating? Why am I not sweating? I was like, why am I like not freaking out? Like I wrote, I’ve made myself have this mantra. Like I wrote like a little saying on my whiteboard and anytime, like I know you said you did a smiley face, like I was like, I need to do something like that.

And I did it on my confidence card and on my whiteboard and anytime, like I felt some sort of way, I was like, I’m confident, like I’m capable, I’m strong. Like I could do this. Like I kept…

You did the work, had a plan, and it executed really well for you. That’s amazing.

Yeah, yeah.

Again, and that’s what I find is people who do well do well and that’s fine and that’s great. But the problem is when you’re not expecting something to go wrong, when you’re not expecting that run of four or five questions in a row that you don’t know the answers to, that heart rate jumps up a little bit and then you don’t know the next one and that heart rate jumps up a little bit more and you just start to spiral. So having a plan for those situations I think is such a powerful thing we can share with everybody today. Yeah. And I think also like I was not hard on myself at all like knowing you’re going to get those questions that you don’t know and that are absolutely ridiculous. You’re like, oh my god, I didn’t study this. I was like, yeah, they’re nothing.

I just chose an answer at that point at the percent confidence score and I moved on, I was like the ones that I do know, I’m confident that I got them right. And that’s great.

So before we move on, I want to talk about that day a little bit, but before we move forward in time, back me up a little bit as you were going through the program. So you were executing at a high level throughout the program and you’re somebody who, you know, there’s always a handful of people who to me stand out a little bit ’cause they’re on every call. They show up to things. They make, they’re in the chats all the time, definitely one of those people. How helpful was it for you to have that as somebody who had failed your PANCE? So you were sort of out, I’m going to say on your own because everyone else has sort of moved along. You’re not in the structure of school anymore.

How helpful was having the community and having that, those additional features as opposed to just a, you know, a review course or whatever you might get on video. That’s something that I knew I wanted. I felt like obviously failing your PANCE, like you feel like a little lonely like you’re passing from PA school or like you see everyone else’s passing you’re like wow like it’s just me so I think having that environment and having like the Social Lair and being able to like reach out to people and like talk to the coaches and everything I think that was like really like beneficial for my studying to know that like I’m not alone people go through this people go through it and then come out the other end golden, like they were able to do it. So it did give me such a great mindset to keep going with studying.

Great, all right, so let’s move into the day of the exam. So it sounded like you had a really good plan heading in. You had everything sort of geared up. And one of the things I do hear back from people quite frequently is even before scores come back, it’s just what you said, which is, you know, I sat down and I started to worry because I wasn’t worried, right? I started to get scared because my heart rate wasn’t up. So you felt, you know, I’m not, I hesitate to say pretty good, you felt fairly confident and you were happy with your plan and the structure as you move through that day. Yeah, definitely.

I just kept telling myself, like, the visualizations, like, I visualized myself sitting in the same seat and that I’m going to get this done and trust me, like, there was times during the exam, like, I did feel that run of like V-tach and I’m like, oh my god, like, but I had that game plan of like taking myself back and then like just going back into the moment like in a game. So I definitely, I used my breaks this time. Like you said, my first time, I definitely rushed my breaks a little bit. So that was huge for me. Going outdoors during my breaks is great. I did a workout before as well because I think that was great for my mindset. The game plan definitely was way better this time.

Nice, okay, so fast forward just a little bit. So you’re waiting for your scores. Walk me through opening that email.

Yeah, so I was, I know I told you, but I’m visiting some family in Florida. So I knew I was like scared I was going to get the email during my plane flight and I was like, oh my gosh. I ended up getting the email on May 12th, which is like my dad, it’s my dad’s birthday. So I was like, oh my gosh, this better go well. It’s my dad’s birthday. I opened it up and then I see it says PA-C and I don’t think I’ve ever had an elephant come off of my chest. I felt on top of the world.

I was like, wow, I actually did that. That is crazy. It’s such a relieving feeling that all your hard work just paid off in that moment. It’s so hard to explain. Once I saw the PA-C and the pass, I was like, that’s awesome. I don’t, I’ve weirdly had people come back and say, you know, and it sounds like you may be one of those people who have said, you know, I’m not happy that I failed this thing, but I found so much to build from out of what I did to turn myself into to get through this thing, that it almost is going to turn out to be a better story, a better place for me to build from as a PA as the rest of my life goes on. Honestly, I have like my mom always says that she’s like, everything happens for a reason and I could like now looking back I can now say everything happens for a reason but when you’re going through it it’s hard to be like oh everything happens for a reason but not like it truly does like I built so many qualities and like traits for myself like through this course and like everything going through like it just makes you build thicker skin through life and like I look back and I wouldn’t want to go through it again but I’m glad that it worked out and looking I I know like I didn’t go through like the whole the dashboard or like the stats or whatever, but I saw like going from a 341 to a 474.

I was like, wow, I was like 100% I was going to ask you, but I didn’t want to. I was worried you’re going to tell me a 351 and be mad about it. That’s why I was scared. I was like, oh, please don’t be five points again, but I wouldn’t have cared anyway. What was the number that you wound up with?

474. So I was like, wow, everything that kind of like, I was preparing, worked toward that. So.

That’s fantastic. That’s absolutely amazing. An unbelievable score, a great story. I love, like I said, how you bought in and did the work. You know, and that’s the hardest part. You know, you heard me joke throughout the program about, you know, buying a Peloton and hanging your clothes on it. And then I get people who are frustrated and it’s so hard.

But I do outside that, like I said, when I see people who jump in, who do the work, 99% of the time, they wind up with them doing amazing things. Not always, unfortunately, it doesn’t always pan out for everyone. But that’s fantastic that you did all this. And again, you have such a strong platform to move forward from now with the habits you’ve built, talking about still doing the daily, talking about the things that got you to where you are with the game plan and taking that looking forward at your upcoming job at your job search at your first day of work. All of those things are transferable, which is kind of my secret message inside of there, which of course you’ve realized by now, I want you to pass the PANCE, but that’s not my ultimate goal, right? My ultimate goal is to create better humans, better practitioners, and I think you’ve seen all of that and built that, so that’s so much fun for me.

Definitely. I kept telling myself like this whole journey is just going to make me an even more amazing PA in the end. And I wouldn’t have changed it for anything, honestly.

So just as we wrap up, let’s talk for a second about this is going to be an interview and thank you so much for coming on that I want to share with the community with people who are either in clinical and have failed that EOR or on that 82 level and are like, you know what, I need to keep my 80 but I’m terrified or in their didactic year even, and they’re struggling, or who have failed their PANCE and they’re struggling. That’s where this is going to go out to. So I was wondering if you could just share with them, you know, who you’d recommend it to, why you would recommend it, when you think would be sort of a good timing to do this, that kind of thing. Honestly, I would recommend it for if you’re consistently struggling during clinical year on your EORs. I think this would be a great course for you just in general with the test taking strategies and also the lessons that are given to you with creating like your mindset. Like you don’t necessarily need to go through like the content calendar like for the PANCE, But I think that will be a great way for you to get some testing strategies that I definitely used on my PANCE exam that you could use on your EORs. But also, obviously, this is a great course for the PANCE exam in general because these exams aren’t just questions and content and all of that.

It’s really just getting yourself in the mind to take that exam. And that’s kind of what I used it for and the strategies that was given through the lessons each day, I think is very beneficial for you to tackle that exam. Great. The other question I get all the time, and I struggle to answer this myself, is how much, I mean, you’re a little different because you had all day to do this, but how much time does it take, how much time did it take for you to do the things that I asked to be part of the program, and even projecting that into if you looked back at your clinical year, and how that would fit in if you had done it then as far as that. Because I know it’s a major concern for people because it’s piling more on top of more on top of more. No, I know. Yeah.

I always did the lessons in the morning. So if I was in clinical year, I would probably do the lessons before I go to clinical. But the lessons, I think the longest lesson was honestly, it was like 35 minutes. Like that was probably the longest lesson I had. And then doing the dailies are a little like difficult, but like they’re manageable depending on like what clinical you have. But honestly, probably like an hour ish, like two hours with content and then go to sleep and do it again. Yeah.

Yeah. So that’s what I try to get across, is most people find it extremely manageable. You can fit it in somewhere within a half, somewhere around an hour a day, plus or minus. But that’s obviously like you said, the content you’re studying on top of that, this doesn’t include the studying part of your day. Yeah, exactly. It’s a whole different thing. But hopefully we can speed you up and structure that a little bit better to make that not take quite this long, but some people.

Definitely. Is there anything else you’d like to share? Because I think we’ve pretty much run through your story. I’m really excited to hear about what you did, what you’ve accomplished. I’m incredibly happy for you and the story that you’re going to be able to tell moving forward is so much fun. Yeah. No, thank you again for having me.

I’m glad I was able to speak onto your course and how much it helped me and kind of the story there. But everything that you guys do and it definitely helps many people, especially me. Oh great. Well congratulations. Thank you so much. Again, your score is phenomenal, but the work you put in is a testament to that. I mean, and I hope that you really walk away from this and say, there’s one reason why this happened.

It’s the work that you did and you can then build from that moving forward. So congratulations again. Thank you so much. Really appreciate it. And best of luck. Thank you so much. Well, that was fantastic.

I’m so excited to have had Isabella on. She was an absolute pleasure during the cohort. Some people don’t participate at all and do just fine on their own. I mean, I’ve had people in Alaska, I’ve had people in Germany, I’ve had people in Ireland, in Spain, in the United Kingdom, Hawaii. So there are certainly people who don’t join the live calls or people who don’t participate live on anything throughout the program. But Isabella wasn’t like that. She was on every single call.

She was active in the community, active in the discussions, an absolute pleasure. So I could not have been more thrilled to see her success and see all of that hard work pay off. And you could hear it in her voice, the transitions that she made. And that’s really what we’re looking for. We’re looking to make those changes in people, those small changes that can lead to huge, huge gains, like what happened for her. We’re going to start that 100% free on the 21st at 8 PM and on the 26th at 8 PM. I’m going to be holding workshops on the six areas of focus that are going to help you break through, figure out what your issue is, what might be holding you back how to fix it.

But if you want to work with us directly on an ongoing basis like Isabella did, then you’re going to want to join the June cohort of 33 Days to Pass the PANCE at physicianassistantexamreview.com/33.

Alright, I look forward to seeing you guys again next week. Registration is open from the 21st through the 27th for the June cohort. Then we’re going to have to get things running because June first is right around the corner.

Alright, take care.