AI Clinical Tutor
Every answer explained. Then ask why.
Ask why a distractor is wrong, how a drug works, or what separates two diagnoses, without leaving the question.
PANCE · PANRE · EOR · Didactic year
Study smarter.
Study smarter.
Show up ready.
Board-style questions with every answer choice explained, weighted to the NCCPA blueprint.
- No credit card
- Clock starts when you study
- Then 10 free questions a day
Try a real bank question
A 35-year-old competitive athlete reports exertional lightheadedness. Cardiac examination reveals a harsh crescendo-decrescendo systolic murmur best heard at the left lower sternal border that does not radiate to the carotids. Which of the following maneuvers is most likely to increase the intensity of this murmur?
Pick an answer.
You’ll see why the right answer is right and why each of the others is wrong. Every question in the bank is explained this way.
Show the answer and explanation
Answer: C, Valsalva maneuver.
Why Valsalva maneuver is correct
- A harsh systolic murmur at the left lower sternal border that does not radiate to the carotids in a young athlete with exertional symptoms is characteristic of hypertrophic obstructive cardiomyopathy.
- The murmur arises from dynamic left ventricular outflow tract obstruction, which worsens when the ventricle is smaller.
- The Valsalva strain phase decreases preload and left ventricular volume, increasing the outflow gradient and intensifying the murmur.
Why the others are wrong
- Squatting — increases preload and afterload, enlarging the ventricle and widening the outflow tract, which softens the murmur (opposite-direction trap).
- Passive leg raise — augments venous return and preload, increasing ventricular volume and reducing the gradient (opposite-direction trap).
- Sustained handgrip — raises afterload, which increases ventricular volume and decreases the dynamic obstruction, softening the murmur (confused-with-fixed-obstruction trap).
One of 7,200+ board-style questions
Inside FirstPassPA
Everything you need.
Everything you need.
Nothing you don’t.
One plan covers PANCE, PANRE and all 7 EOR exams. Here is what is inside.
- board-style questions
- 7,200+
- flashcards
- 4,800+
- diagnosis outlines
- 514
- drug monographs
- 190+
Timed examsIllustrative
Rehearse test day.
Blueprint-weighted blocks, feedback held until you finish, then a score report by organ system.
NCCPA blueprint
Weighted like the real exam.
Draws follow the PANCE Content Blueprint (effective January 2025). PANRE mode switches to the PANRE/PANRE-LA weights.
- Cardiovascular11%
- Pulmonary9%
- Renal/
Urology9% - Gastrointestinal8%
- Musculoskeletal8%
- Neurology7%
- Reproductive7%
- Psychiatry/
Behavioral7% - Infectious Disease7%
- Endocrinology6%
- EENT6%
- Professional Practice6%
- Hematology5%
- Dermatology4%
Clinical SimBeta
Practice on a patient, not just questions.
Take the history, examine, write the SOAP note, and get OSCE-style grading. 10 AI patient cases, one per chief complaint, with 2 encounters a day on Pro.
AnalyticsIllustrative
Know your weak spots.
A readiness score from your accuracy, consistency and coverage, plus every organ system ranked by the exam points at risk.
Clinical year
All 7 EOR rotations.
A focused question set for each end-of-rotation exam. Study the rotation you’re on, between shifts.
Flashcards
Review on a schedule.
Grade each card Again, Hard, Good or Easy. Reviews tighten as exam day nears.
Also included
Compare plans- Module examsTimed exams for every organ-system module of PA school.
- PANRE modeEvery draw re-weighted to the PANRE/PANRE-LA blueprint.
- ECG rhythm library12-lead tracings with the features and pearls that get tested.
- Lab referenceSearchable lab values on every question screen. Free.
- 40 mnemonicsHigh-yield memory hooks, tagged by organ system.
- Your own decksBuild cards your way and share a deck with classmates.
- BookmarksStar any question, then practice from your list.
- Diagnosis libraryOne-page outlines linked to the questions that test them.
FirstPassPA is an online board-exam prep platform for physician assistant (PA) students and practicing PAs — with 7,200+ board-quality questions, 4,800+ clinician-reviewed flashcards with smart spaced-repetition review, timed exam simulation, didactic module exams for every organ system, an AI tutor that explains every answer, and Clinical Sim: interactive AI standardized-patient encounters with OSCE-style feedback (beta) — built for didactic year through the PANCE and PANRE certification exams.
How it works
Built around
Built around
your exam date.
- 01
Set your exam date.
PANCE, PANRE or your next EOR. Your countdown and review schedule key off it.
- 02
Study in short blocks.
Tutor mode explains every choice. Questions you miss come back sooner; mastered ones wait until they’re due.
- 03
Rehearse test day.
Sit a timed block with feedback held until you finish, then read your score report by organ system.
From the founder
Built by a PA who’s
Built by a PA who’s
been in your seat.
“I created FirstPassPA because I wanted a study resource that combined high-yield board preparation, clinical reasoning, and modern learning tools into a single platform designed specifically for PA students — without the bloat or the price tag.”
Ryan Busch, PA-C
Read the full story
Reviews
From PA students and
From PA students and
practicing PAs.
Real reviews from people prepping with FirstPassPA. Students and PAs from Grand Valley, Western Michigan, Kettering and more.
Reviewers receive a free month of Pro for any honest review, including critical ones.
★★★★★
“It was an awesome tool -Recertifying after being in specialty for the past 20 years was unnerving - but Firstpass PA and a couple podcasts I used during my commute helped me get through. Awesome prep tool and highly recommend to assess strengths and weakness, practice, check progress and ultimately help you achieve positve results. I'm so glad I signed up.”
★★★★★
“I had a week between graduation and my boards, and I hadn't gotten any sort of Qbank prior, and many others were hundreds of dollars, and the free trials included like nothing. FirstPassPA gave all access to the Qbank, blueprints, tests and more. I used this all week, the blueprints were super helpful, and then you could do questions on just one topic, or just one system, or everything. 10/10, definitely recommend, and its affordable whether you do all year, or just a month!”
★★★★★
“FirstPassPA definitely helped me pass my PANRE. I took a few days off work — my husband helped take care of our four children so I could study and do as many practice questions as possible. I've already recommended it to a few coworkers who need to take their PANRE soon.”
★★★★★
“As a practicing PA that has taken both the PANCE and PANRE, I can confidently say that the questions included here are representative of what you will see on the PA certification exams. The platform is well thought out, easy to navigate, and the response explanations are really helpful. Would highly recommend to anyone looking for comprehensive exam prep!”
★★★★★
“Loving FirstPassPA! As a current student I find the explanations after the practice questions extremely helpful. The site is easy to navigate and has been an incredible resource to have in my pocket!”
★★★★★
“I signed up for a free trial and was very impressed. I found the site easy to navigate and user friendly. The questions with explanations and access to flash cards will definitely keep me coming back!”
★★★★★
“The explanations after the practice questions were very helpful because they not only explained why the correct choice was right, but they also explained why the other options were incorrect. This made it much easier to truly understand the underlying clinical concepts.”
★★★★★
“Loving it! These challenging/complex questions require second level thinking and have really pushed my understanding of the topics. Every question and every multiple choice option has an explanation which is extremely helpful. Will be recommending to my peers!”
★★★★★
“Questions are challenging, thought provoking and provide great feedback immediately upon answering to help me learn, review and progress my knowledge. Great, easy to use platform that is visually appealing. I wish this had been around when I was taking the PANCE the first time!”
Compare
One plan.
One plan.
Every exam.
Premium PA QBanks commonly start around $250–$300 per access window. Here is what one FirstPassPA plan covers. See how we compare
| What you get | FirstPassPA | Typical QBank |
|---|---|---|
| Cost for one exam cycle | $129.99/yr or $14.99/mo | Commonly $250–$300+ |
| PANCE, PANRE and 7 EOR exams | All in one plan | Varies by product |
| Free trial | 7 days, no credit card | Varies by product |
| After the trial | 10 free questions a day | Varies by product |
| AI tutor on every question | Included | Varies by product |
| AI patient encounters | Clinical Sim (beta), included | Varies by product |
“Typical” is a general market range, not any specific product. Check current terms before you buy.
Pricing
Simple pricing.
Simple pricing.
Cancel anytime.
Every account starts with 7 days of full access and no credit card. Your 7 days start when you start studying, not at signup.
Every Pro plan includes
- Every question, flashcard and outline
- AI tutor and Clinical Sim (beta)
- Timed, module and EOR exams
- Analytics and spaced review
Monthly
$14.99/month
Full Pro access, month to month.
- Everything in Pro
- Cancel renewal anytime
- Pass Guarantee not included
Annual
Best value$129.99/year
$10.83/month, billed annually
- Everything in Pro
- Cancel renewal anytime
- Pass Guarantee (first PANCE attempt)
Pass Guarantee
Annual plan · first PANCE attempt
Didn’t pass your first PANCE attempt? Choose six more months free or a full refund (refunds on web plans; App Store plans get the extension). Requires answering 35% of PANCE-track questions by exam day and claiming within 60 days of score release. Not a promise that you will pass. Terms apply
Or stay on Free: 10 questions a day, the lab reference and your exam countdown. No credit card needed. Start free
PA faculty? Program pricing
FAQ
Questions,
Questions,
answered.
Something else? support@firstpasspa.com
How does the 7-day free trial work?
No credit card required. Your 7 days start when you start studying, not at signup. You get full access to everything (all 7,200+ questions, the AI tutor, Clinical Sim patient encounters (beta, 2/day), EOR modes, flashcards, timed exams, and analytics) for 7 days. When the trial ends, choose a monthly or annual plan to keep full access, or continue for free with 10 questions a day.
Is there a free version?
Yes. Free accounts get 10 practice questions per day, access to the lab reference tool on every question, and the ability to track your exam countdown. No credit card required to start.
Can I cancel my subscription?
Yes, cancel anytime. On the web, open My Account and choose Manage / Cancel Subscription. If you subscribed in the iPhone app, cancel in your iPhone’s Settings → Apple Account → Subscriptions. You keep Pro access until the end of your current billing period. Questions? Email support@firstpasspa.com.
Do you offer a pass guarantee?
Yes — on the annual plan. If you answer at least 35% of the PANCE-track questions in your account (about 1,500 unique questions today; EOR and pharmacology items don’t count) and don’t pass your first PANCE attempt taken after purchasing the annual plan, we’ll extend your access free for six months, or refund your annual subscription (refunds apply to plans billed on the web through Stripe; App Store subscriptions receive the extension). It covers a first PANCE attempt only (not PANRE or EOR exams), requires your official NCCPA score report, and must be claimed within 60 days of score release. See the full terms at firstpasspa.com/pass-guarantee.
How are the questions written?
All 7,200+ questions are written to mimic the style and difficulty of actual PANCE/PANRE questions — clinically grounded, mapped to the NCCPA blueprint (13 organ systems plus Professional Practice), and tagged by difficulty. The bank covers both PANCE (students) and PANRE (practicing PAs recertifying). Every answer choice includes clinical reasoning explaining why it is right or wrong.
What’s the difference between PANCE mode and PANRE mode?
PANRE mode re-weights every draw to NCCPA’s current PANRE/PANRE-LA blueprint (effective 2023) — Cardiovascular 12%, Pulmonary 10%, GI 10%, Endocrine 8%, EENT 8%, Musculoskeletal 8%, Psychiatry/Behavioral 7%, Infectious Disease 7%, Neurology 5%, Reproductive 5%, Dermatology 5%, Hematology 4%, and Renal/Urology 9% (NCCPA’s Genitourinary 5% plus Renal 4%), with the remaining 2% drawn from Professional Practice items. PANCE mode uses the PANCE blueprint weights. Toggle between modes at any time from the header.
What are EOR mode questions?
End-of-Rotation (EOR) mode gives you a focused set of questions for each of the 7 EOR rotations — Family Medicine, Internal Medicine, Surgery, Pediatrics, Psychiatry, Emergency Medicine, and Gynecologic, Sexual, and Reproductive Health (GSRH, formerly Women’s Health). Great for studying between shifts during your clinical year.
Can I use FirstPassPA during didactic year?
Yes. Module Exams give you timed practice exams for every organ-system module of PA school, plus pharmacology and professional practice, and you can choose a didactic mix that keeps the question depth closer to a module exam than to board day. The same question bank, flashcards, and blueprint tools carry you from your first semester through the PANCE.
What is Clinical Sim?
Clinical Sim (currently in beta) lets you practice a full patient encounter with an AI standardized patient: take a history in plain conversation, perform an exam that returns real findings — including photographic ones — then write a SOAP note and get OSCE-style grading with a per-item checklist across history-taking, physical exam, communication, and assessment & plan. There are 10 cases — one per chief complaint, from chest pain to dizziness — and it’s included in every Pro plan at no extra charge, with 2 patient encounters per day. Clinical Sim is an educational simulation — it isn’t medical advice and doesn’t replace supervised clinical training.
Does my progress save if I close the app?
Yes. All your progress — question history, accuracy by system, spaced repetition data, flashcard review progress, bookmarks, streak, and exam date — is saved locally and persists across sessions. Sign up for a free account to back it up and sync your flashcard progress and exam countdown across devices.
Is FirstPassPA affiliated with NCCPA?
No. FirstPassPA LLC is an independent study tool and is not affiliated with, endorsed by, or sponsored by the National Commission on Certification of Physician Assistants (NCCPA). PANCE® and PANRE® are registered trademarks of NCCPA.
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