🛡️ Annual plans are backed by our Pass Guarantee — full refund or 6 extra months free if you don't pass · Terms apply 🛡️ Annual Pass Guarantee · refund or 6 free months
Built for PA Students & Practicing PAs

Study smarter.
Show up ready.

FirstPassPA is an online board-exam prep platform for physician assistant (PA) students and practicing PAs — with 6,400+ board-quality questions, 4,800+ clinician-reviewed flashcards with smart spaced-repetition review, timed exam simulation, an AI tutor that explains every answer, and Clinical Sim: interactive AI standardized-patient encounters with OSCE-style feedback (beta) — all built for the PANCE and PANRE certification exams.

🛡️ Annual plan backed by our Pass Guarantee
Every new account gets 7 days of full access — no credit card required. After your trial, keep going free with 10 questions a day, or upgrade anytime.
Full bank + EOR + simulations
Streak saved automatically
No card required
Cancel anytime
6,400+
Board-Quality Questions
13
NCCPA Organ Systems
7
EOR Rotations
$10.83
Per month, billed annually
Trusted by PA students

From PA students and
practicing PAs.

Real reviews from people prepping with FirstPassPA.

★★★★★

“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.”

Mariam L., PA-C
★★★★★

“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!”

PAPrep7049
★★★★★

“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!”

NC — Western Michigan University · 2028
★★★★★

“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!”

PAPrep1578 — Grand Valley State University · 2016
★★★★★

“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.”

Nick R — GVSU · 2016
★★★★★

“Price was the biggest issue for me. I was stunned at the cost of other board review options. I struggled with quite a few questions on the PANRE after doing well in school and doing well on the PANCE. The questions were not only great, but the resources available through the site are fantastic. I'm a practicing PA-C for 10+ years and I've been using the Outlines and Mnemonics pages during my actual working days. Good Luck to all the soon to be practicing PA-Cs. FirstPassPA will help you for sure! Highly Recommended!”

MRichPAC
Why FirstPassPA

Everything you need.
Nothing you don't.

Most PA board prep is bloated, overpriced, or built for physicians. FirstPassPA is designed from the ground up for the way PA students actually study.

01
NCCPA Blueprint-Mapped

Every question is mapped to the official PANCE and PANRE content blueprints by organ system and difficulty — the same framework NCCPA uses to build the real exam.

02
Study Smarter, Not Longer

SM-2 spaced repetition surfaces questions you struggle with more often and backs off on ones you've mastered — so every study session is maximally efficient.

03
Understand, Don't Memorize

Every answer choice includes a reason why it's right or wrong. Our AI tutor can go deeper on any concept, mechanism, or clinical pearl — instantly.

04
Know Where You Stand

Live analytics show your accuracy by organ system, session trends, mastery progress, and blueprint coverage — so you always know what to study next.

Features

Every tool your
board prep needs.

From your first practice question to a full 300-question timed simulation — FirstPassPA adapts to where you are in your prep.

🤖
AI Clinical Tutor

Powered by Claude. Ask why an answer is correct, how a drug works, what differentiates two diagnoses, or drill deeper into any mechanism — without leaving the question. Like having a faculty member on call — AI tutoring built into every question.

Pro
🩺
Clinical Sim — AI Patient Encounters

Interview an AI standardized patient who answers in character, examine them to uncover real findings — some photographic — then write a SOAP note and get OSCE-style grading with a checklist of exactly what you hit and missed. 10 cases — one per chief complaint, chest pain to dizziness — with voice dictation, on your phone or laptop. Included in Pro — 2 encounters per day.

Beta Pro
🗺️
NCCPA Blueprint Tracker

Work through every one of the 514 board-relevant diagnoses on the NCCPA blueprint — grouped by organ system and weighted the way the exam scores them. Check each off as you master it and watch your exam-weighted coverage climb. Every diagnosis opens to a clinician-reviewed one-page outline (workup, treatment, pearls, flowcharts, ECGs), the exact questions that test it, and side-by-side comparisons of look-alike diagnoses.

New Browse the diagnosis library →
📋
6,400+ Practice Questions

6,400+ high-yield, clinically accurate questions across 13 NCCPA organ systems plus the new Professional Practice domain — medical ethics, law, patient safety & evidence-based medicine — for PA students on the PANCE and practicing PAs recertifying for the PANRE. Every distractor includes "why it's wrong" reasoning.

Pro
🧠
SM-2 Spaced Repetition

A research-backed spaced repetition algorithm — questions you struggle with resurface sooner; mastered cards return only when review is due. Your study time goes where it matters most.

Pro
Timed Exam Simulation

Simulate real NCCPA exam conditions with 1–5 block sessions and blueprint-weighted question selection for PANCE or PANRE. Answers stay changeable within a block and feedback holds until you finish — like test day — with a 45-minute shared break pool between blocks. Afterward: a score report with per-system breakdown and question-by-question review. Prefer feedback as you go? Tutor mode explains every answer instantly.

Pro
🏥
End-of-Rotation (EOR) Mode

Rotation-specific question sets for all 7 PAEA EOR rotations — Family Medicine, Internal Medicine, Surgery, Pediatrics, Psychiatry, Emergency Medicine, and GSRH (formerly Women's Health). Prep for your EOR exams between shifts.

New
📊
Analytics Dashboard

Accuracy by organ system, 14-day activity trends, session history, mastery badges, blueprint coverage rings, and spaced repetition progress — all in one place. Know exactly what to study next.

Pro
Bookmarking

Star any question while studying to save it for later. Build a personal review list of questions you want to revisit, then practice from your bookmarks as a dedicated mode.

Pro
🃏
Flashcards & Mnemonics

4,800+ clinician-reviewed flashcards across all 13 organ systems — presentation, workup, first- and second-line treatment, complications, pharmacology, and pearls — with smart spaced-repetition review that tightens as your exam date nears and syncs across devices. Plus 40 high-yield mnemonics.

Pro
✍️
Build Your Own Decks

Make your own flashcards and group them your way — by organ system, EOR rotation, diagnosis, or any theme you like. Format cards with bold, color, and highlights, and study them with the same exam-aware spaced repetition that powers the clinician bank. Then share a deck with classmates with a link — they can study it free with an account.

New
📈
ECG Rhythm Library

25 textbook-quality 12-lead ECGs covering every rhythm the PANCE tests — STEMI, blocks, V-tach, A-fib, torsades, WPW, hyperkalemia and more. Tap to flip for the diagnosis, key features, and teaching pearls. Mark cards complete and hide what you've mastered.

New
🧪
NCCPA Lab Reference

Complete searchable lab reference values — CBC, BMP, LFTs, ABG, cardiac markers, CSF, and more — available on every question screen. No more tab-switching.

Free
New · Clinical SimBeta

Practice on a patient,
not just questions.

Clinical Sim puts an AI standardized patient in front of you — interview them, examine them, write the note, and get graded like it's an OSCE.

Clinical Sim: an illustrated standardized patient — a 58-year-old man — sitting on an exam table in an exam room, waiting to be interviewed
Robert Hale, 58 — “Pressure in my chest — probably just heartburn, but my wife made me come in.”
  1. Take the history. Ask anything in plain conversation — the AI patient answers in character, and the story unfolds the way real patients tell it.
  2. Examine. “I auscultate the lungs” returns real findings — and some cases reveal photographic findings, like a rash or an inflamed pharynx, for you to read yourself.
  3. Write the note. Document a full SOAP note — typed, or dictated with your voice.
  4. Get graded. OSCE-style scoring across History-taking (30%), Physical Exam (25%), Communication (15%), and Assessment & Plan (30%) — with a per-item checklist of what you hit and missed, dangerous-miss warnings, and an exemplar note to compare against.
10 cases · 10 chief complaints Voice dictation Works on your phone Best-score tracking Included in Pro · 2 encounters/day
Meet the patients — try it free →

Clinical Sim is in beta and included in every Pro plan (and the free trial) at no extra charge. It's an educational simulation for board and OSCE practice — not medical advice, and not a substitute for supervised clinical training.

See it in action

Built for how PA students
actually study.

A clean, focused interface — question bank, Clinical Sim, AI tutor, analytics, flashcards, and timed exams, on desktop and mobile.

A board-style practice question with answer rationale
Practice question bank
6,400+ NCCPA-aligned questions with “why it’s wrong” reasoning on every choice.
The AI tutor explaining a clinical concept on a question
AI clinical tutor
Ask why an answer is right, how a drug works, or to compare two diagnoses — without leaving the question.
The analytics dashboard with accuracy by organ system
Analytics dashboard
Accuracy by organ system, activity trends, mastery, and blueprint coverage — so you know what to study next.
A spaced-repetition flashcard
Spaced-repetition flashcards
4,800+ clinician-reviewed cards with smart review that tightens as your exam date nears.
A timed exam simulation block
Timed exam simulation
1–5 block, blueprint-weighted sessions that mirror real PANCE/PANRE conditions.
A one-page diagnosis outline
Outlines
514 board-relevant diagnoses, each a clean one-page outline with pearls and linked questions.
A Clinical Sim encounter: an AI standardized patient answering interview questions in an exam room
Clinical Sim · beta
Interview an AI standardized patient, examine, write the SOAP note, and get OSCE-style grading.
A practice question on a phone
Practice questions · on mobile
The full question bank on your phone — study between classes, on rounds, anywhere.
The AI tutor on a phone
AI tutor · on mobile
Ask the AI tutor to explain any answer, right from your phone.
The analytics dashboard on a phone
Analytics · on mobile
Your readiness score and weak areas, on the go.
A flashcard on a phone
Flashcards · on mobile
Spaced-repetition flashcards in your pocket.
A timed exam on a phone
Timed exam · on mobile
Full timed simulations that work on any screen.
A diagnosis outline on a phone
Outlines · on mobile
514 one-page outlines, readable on any screen.

One board-style question
in your inbox, every morning.

A free PANCE-style question at 7am ET, explanation included — plus the printable 8-week study plan delivered instantly when you sign up. No spam, unsubscribe anytime.

Aligned to the official NCCPA exam blueprint.

Questions are distributed by organ system weight exactly as NCCPA specifies for the PANCE — so you spend the most time on the highest-yield material. Switch to PANRE mode for adjusted weights.

⚠ Important Disclaimer

FirstPassPA is an independent study tool. We are not affiliated with, endorsed by, or sponsored by NCCPA. PANCE® and PANRE® are registered trademarks of the National Commission on Certification of Physician Assistants.

PANCE Blueprint Distribution
♥ Cardiovascular
11%
◈ Pulmonary
9%
⬡ Gastrointestinal
8%
◆ Musculoskeletal
8%
⚗ Endocrinology
6%
◎ Neurology
7%
◉ Reproductive
7%
+ 7 more categories
44%
End-of-Rotation Mode

Prep for your EOR exams
between shifts.

Each clinical rotation has its own focused question set — so you can review the most tested concepts for your current rotation, not everything at once.

🏠
Family Medicine
Outpatient primary care
🏥
Internal Medicine
Inpatient medicine
🔪
Surgery
Surgical conditions
👶
Pediatrics
Peds-specific presentations
🧠
Psychiatry
Behavioral health
🚑
Emergency Med
Acute & emergency care
🤰
GSRH (Women's Health)
Obstetrics, gynecology & sexual/reproductive health

Meet the PA behind FirstPassPA

Ryan Busch, PA-C — founder of FirstPassPA
Ryan Busch, PA-C
Founder, FirstPassPA
9+ Years in Clinical Practice · Family Medicine · GVSU PA Graduate

Hi, I'm Ryan Busch, PA-C.

I've practiced family medicine for over nine years — the first six in Federally Qualified Health Centers, caring for underserved and medically complex patient populations. Along the way I've enjoyed teaching students, mentoring future healthcare providers, and finding better ways to simplify difficult medical concepts.

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. My goal is simple: help you build confidence, master the material, and walk into your EOR exams and the PANCE prepared to succeed.

Read the full story →

Why FirstPassPA

Why students choose
FirstPassPA.

A modern, all-in-one study platform — with tools most PA prep tools don’t bundle, at a price that fits a student budget.

FirstPassPA Typical PA prep
AI tutor on every question Powered by ClaudeRare
AI standardized patients (Clinical Sim) 10 cases · betaRare
Spaced repetition (SM-2) Research-backedVaries
514 clinical outlines Clinician-reviewedLimited
ECG rhythm library 25 12-lead ECGsRare
Exam-date-aware flashcards 4,800+ cardsVaries
End-of-Rotation (EOR) mode All 7 rotationsVaries
Pass Guarantee (annual plan)Rare
Built by a practicing PA YesNot always
Free to try — no card 10 questions/dayOften none
Monthly plan From $14.99/moOften annual-only

Simple, affordable pricing.

Less than a single review book. Cancel anytime. Full access from day one.

Built by a practicing PA · 6,400+ questions across 13 NCCPA organ systems + Professional Practice

Free
$0
forever
  • 10 questions per day
  • NCCPA lab reference on every question
  • Exam countdown timer
  • Track your accuracy
Start Free →
Monthly
$14.99
per month
  • All 6,400+ questions
  • Timed exam simulation
  • Spaced repetition (SM-2)
  • AI tutor on every question
  • Clinical Sim — 2 AI patient encounters/day (beta)
  • EOR rotation modes
  • Analytics dashboard
  • Bookmarks & 4,800+ spaced-repetition flashcards
  • Cancel anytime
Get Monthly →
⭐ Best Value
Annual
$129.99
per year
Save 28% — just $10.83/month
  • Everything in Monthly
  • 🎓 Pass Guarantee — pass or we extend free / refund
  • Our lowest effective price — $10.83/mo
  • Ideal for full PANCE prep cycle
  • Lock in before price increases
  • Cancel renewal anytime — access through your paid term
Get Annual — $129.99 →
🎓 The annual plan is backed by our Pass Guarantee
Study with us and if you don't pass the PANCE, we'll extend your access free for 6 months so you can retake — or refund you. See the terms →

Cancel renewal anytime  ·  No credit card required to start free  ·  Pricing is locked once you subscribe

🏛️ PA program faculty? Institutional per-seat licensing with a faculty Educator Portal is available — see program pricing →

⚠️

Not affiliated with NCCPA. FirstPassPA LLC is an independent study tool. PANCE® and PANRE® are registered trademarks of the National Commission on Certification of Physician Assistants. Use of our platform does not guarantee exam passage. Results depend on individual study effort and preparation.

Study with us. Pass —
or we've got your back.

On the annual plan, if you don't pass the PANCE, we'll extend your full access free for 6 months so you can retake — or refund your annual subscription. Your choice.

Annual plan
Available on the annual subscription (not monthly or free trial).
Purchased before your exam
You subscribed before your PANCE test date.
Answered ≥50% of the bank
You answered at least half of the PANCE question bank.
See full terms →
FAQ

Common questions.

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.
All 6,400+ 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.
The PANCE and PANRE use slightly different organ system weights. In PANRE mode, questions are weighted with heavier emphasis on Cardiovascular (18%) and Endocrinology (9%), reflecting the PANRE blueprint for PAs recertifying. Toggle between modes at any time from the header.
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.
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.
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.
Yes, cancel anytime. You'll keep Pro access until the end of your current billing period. Email support@firstpasspa.com and we'll handle it promptly.
Yes — on the annual plan. If you study with FirstPassPA (completing at least 50% of the PANCE question bank) and don't pass your first PANCE attempt, we'll extend your access free for six months, or refund your annual subscription. See the full terms at firstpasspa.com/pass-guarantee.
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.
Your trial starts instantly — no credit card required. You get full access to everything (all 6,400+ 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. Cancel anytime.

Start with one free question
a day — by email.

A board-style question with the full explanation, every morning — plus the printable 8-week study plan the moment you sign up. Unsubscribe anytime.

⚠ Not affiliated with NCCPA. FirstPassPA is an independent study tool. PANCE® and PANRE® are registered trademarks of the National Commission on Certification of Physician Assistants.

The boards reward preparation.
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