To maintain NCCPA certification, PA certificate holders must pass the Physician Assistant National Recertifying Examination (PANRE) before their certificate expires at the end of the sixth year (or tenth year) of their certification maintenance cycle. The examination is comprised of 240 multiple-choice questions designed to assess general medical and surgical knowledge. While 60% of the generalist exam covers the same content for all examinees, each person can select the remaining 40% content from one of three fields: adult medicine, surgery or primary care. See NCCPA for more Information.