I’m sorry. It sucks, really really sucks.
Here’s the short answer: take a few days. Then figure out where your last attempt actually broke before you spend another hour or another dollar. Doing the same plan harder almost never moves the score. Failing the PANCE is not an IQ problem. It’s a skills problem, and skills can be fixed.
Brian Wallace, PA-C. I’ve worked with PA students for 15 years and I run 33 Days to Pass the PANCE. Updated October 2026.
Step 1 Sit in it for a few days
Step one is sitting in it for a little bit. Being angry, being sad, all of it. You’ve got to take that time.
Action isn’t always the right move. Sometimes it’s just weathering the storm. Give yourself a few days to a few weeks to get it back together. That’s normal.
You might be saying what a lot of students tell me:
“I never failed an exam in PA school. I did not think I failed when I walked out of there.”
“I knew the material which was why I couldn’t understand why I failed.”
Hold onto that second one. It’s a clue.
Here’s the part nobody says out loud. You’ve got to rebuild your ego. If your faith in yourself is shaken, no amount of studying will produce decent test results. When someone makes an error during a game on my baseball team, the coaches only ever say one thing: “the next play.” the next play
Step 2 Don’t do the same thing harder
The obvious move is to buy the next cram course. Then the next one. Then the next one. And the scores don’t move. If anything, they go down. Seems crazy until you think: maybe the problem isn’t content.
You’ve been trying to fix a skills problem with content. Driving faster in the wrong direction doesn’t work.
There’s an old saying: a man with two watches never knows what time it is. Another question bank and another review book give you more watches. They don’t tell you the time.
Step 3 Find where it actually broke
I treat this the same way I’d treat a patient who walks in with a sore throat. What’s the differential? same as clinic
Your score comes from six skills, not one. Content is only one of them. Go through these honestly. Short answers are fine.
- Pure content. Did you get through all of it, or did you run out of runway? Which areas did you walk in already uncomfortable with?
- Studying. What did the last few weeks before the exam actually look like? What did you do with the questions you missed?
- Clinical reasoning. How often were you down to two answers? When you missed, was it that you didn’t know it, or that you knew it and still chose wrong?
- Test taking. Did you have enough time in each block, or were you pushing at the end? Did you change answers? Were there easy questions, or did every question feel hard?
- Stress and anxiety. How did you feel walking in? 1 is a nervous wreck. 10 is “I did everything I could, now it’s showtime.”
- Peak performance. How did you sleep the night before? Did you use your breaks? Did you eat and drink enough?
If you knew the material and still failed, look hard at the other five.
What about my score report?
Everyone is worried about the sections they did poorly on. But you don’t know if it was a content problem or a test-taking problem or a stamina problem. You don’t know if you got lucky on the ones you got right.
Your report is helpful… sort of. Say you know derm cold, but there’s one thing you didn’t know, and that one thing happens to show up on your exam. Now the report says you’re weak in derm. You’re not.
I put much less weight on the reports than anyone else. Use it as one clue, not as the plan.
When can I retake the PANCE?
NCCPA lets you take the PANCE once in any 90-day period, and no more than three times in a calendar year, whichever is fewer. If you finished an accredited PA program in 2003 or later, you get six attempts within six years of finishing. Exceptions are rare. Check nccpa.net for the current details before you schedule.
If you were close, you’re not starting from zero. You may be most of the way there, and the fix may be small. If you were far off, give yourself enough time to change how you study, not just what you study.
Walking back in
The second attempt is usually scarier, not easier. You’ll hear a voice that says, “I already failed this. Maybe I shouldn’t be doing this again.” That voice needs to stop today. Build a plan, practice test day, and walk in doing something different than last time.
And don’t go back into your hole and do this alone.
We can’t fix it for you, but we can fix it with you.
People who were exactly where you are
- Carlyn went from a 296 to a 397.
- Stephen went from a 326 to a 430.
- Sarah went from a 321 to a 438.
- Isabella went from a 341 to a 474.
- Erica had failed three times. She passed with a 411.
“Thank you for the resources you have created for PA students like me who truly are capable but sometimes it’s our anxiety and fears that take over.” Stephen
“Your program really helped me realize it wasnt my content knowledge but the skills I just didn’t have yet.” Sina
Across everyone who comes through 33 Days, the average student moves their PANCE score about 78 points. That’s everybody. The ones who passed, the ones who missed, the handful whose score went down.
Want help finding where it broke?
That’s what the Stop Guessing Session is. One session on Zoom with me, plus a written plan in your inbox 24 to 48 hours later.
Not ready to book? Get my daily email instead. It’s free, and you get my Test-Taking Rescue Kit when you sign up.
How 33 Days to Pass the PANCE helps
33 Days is a live, 33-day cohort built around those six skills. It is not a content review course. Content is one skill out of six.
- A short daily lesson for 33 days, built to fit around work, rotations, and family.
- Live calls every week with me and our coaches. Some of our coaches failed the PANCE themselves before they passed.
- A community of students going through it with you, every day.
- A full-length mock PANCE as a dress rehearsal for test day.
- The dailies: small daily habits for your body and your head that carry you into test day.
Cohorts run every other month: February, April, June, August, October, and December.
Our guarantee: we work with you until you win. If you don’t pass, we sit down with you and figure out what happened, and you come back through the program at no extra cost. You keep access to the materials until you pass.
Over 800 students have come through 33 Days since 2022, including students on their second, third, and fourth attempts.
When you’re ready for the full program, here’s when the next cohort starts.
Questions students ask me
Is 33 Days only for people who failed?
No. Retakers, first-time test takers, and clinical-year students getting ready for their rotation exams (EORs) and end-of-curriculum exam all come through it.
Is it a content review course?
No. Content is one of the six skills. The other five are how you study, how you reason through a question, how you take the test, how you handle the pressure, and how you show up on test day.
Should I retake right away or wait?
It depends on where it broke and how close you were. If you were close, you may not need long. If you were far off, take enough time to change how you study. Either way, NCCPA won’t let you sit again for 90 days.
What if I don’t pass after 33 Days?
We keep working with you. We’ll figure out what happened, and you can come back through the program at no extra cost.
