PANCE (Physician Assistant National Certifying Exam) is taken once — after graduating from an accredited PA program — to become initially certified as a PA-C. PANRE (Physician Assistant National Recertifying Exam) is taken every 10 years to maintain PA-C certification. PANRE has 240 questions and is slightly shorter than PANCE. Both use the same organ system and task area framework. A newer option called PANRE-LA (Longitudinal Assessment) allows PAs to answer 25 questions quarterly online instead of one large exam; it is now the preferred recertification path for most practicing PAs. BlitzGrok's PANCE prep is appropriate for both initial certification candidates and PANRE candidates reviewing for recertification.