The PANCE blueprint, explained

The PANCE is 300 multiple-choice questions delivered in five 60-question blocks. Every question lives at the intersection of two NCCPA blueprint dimensions: an organ system (what the patient's problem is) and a task category (what you're being asked to do about it). Weighting below is approximate — always confirm against the official NCCPA blueprint.

Organ systems

Cardiology alone is roughly one question in eight. The top four systems together are about 40% of the exam — if your time is limited, spend it where the questions are.

Cardiovascular

~13%

Pulmonary

~10%

Genitourinary & Renal

~10%

Gastrointestinal & Nutrition

~9%

Musculoskeletal

~8%

Endocrine

~7%

Eyes, Ears, Nose & Throat

~7%

Neurologic

~7%

Reproductive

~7%

Infectious Diseases

~6%

Psychiatry & Behavioral Health

~6%

Dermatologic

~5%

Hematologic

~5%

Task categories

Task categories cut across every system: a cardiology question might test diagnosis, drug choice, or health maintenance. Diagnosis-type tasks (most likely diagnosis, H&PE findings, diagnostic studies) are roughly half the exam — the PANCE is above all a diagnosis test.

Formulating Most Likely Diagnosis

~18%

History Taking & Physical Exam

~17%

Clinical Intervention

~14%

Pharmaceutical Therapeutics

~14%

Using Diagnostic & Lab Studies

~12%

Health Maintenance & Prevention

~10%

Applying Basic Scientific Concepts

~10%

Professional Practice

~5%

How to use the blueprint

Weight your reps, not just your reading. Doing equal questions per system over-trains 5% systems and under-trains cardio.
Track mastery per blueprint cell. "I'm weak in MSK" is less useful than "I miss MSK pharmacotherapy questions."
Let the blueprint set your final month. High-weight, low-mastery cells first; low-weight, high-mastery cells last.

PA BoardLab tracks your mastery across every blueprint cell automatically.

A 13×8 heatmap of exactly where you stand — free to start, 5 questions a day.

Start studying free