Guide to Medical Certification Exams: PANCE and USMLE Registration, Costs, and Eligibility

Administered by the National Commission on Certification of Physician Assistants (NCCPA®), the Physician Assistant National Certifying Examination (PANCE) grants the PA-C designation to those who pass. This guide covers eligibility, registration, exam structure, and costs, ensuring you have the key information to successfully plan your path to certification. Explore our PANCE eligibility, registration, scoring, and cost guide to learn when to schedule your PANCE exam and what to expect before exam day.

PANCE Exam Eligibility and Requirements

Before taking the PANCE, you must graduate from a physician assistant program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). To fulfill this PANCE education requirement, your program must have been accredited at the time of matriculation. You have 6 years after graduating from an ARC-PA-accredited PA program to take the PANCE, with a maximum of 6 attempts. If you exceed either limit, you will lose eligibility and must complete another full, ARC-PA-accredited program to regain it.

PANCE Registration and Testing Windows

To register for the PANCE exam, submit your application and $550 payment through the NCCPA. You can apply for the PANCE up to 180 days before your expected program completion date, as confirmed by your program director. The earliest you can take the exam is 7 days after completing your program. Your exam application acknowledgment email will confirm this date and outline your 180-day window to take the exam. You can only take the PANCE once every 90 days and up to 3 times per calendar year. Make sure you submit all required materials, as if you're ineligible, you won’t receive a score or may have it rescinded.

USMLE Exam Fees and Requirements (2025 Updates)

USMLE (United States Medical Licensing Examination) is your gateway to live your dream of working as a registered doctor in the States. In 2025, testing fees have updated, and knowing what to expect financially can help you plan better. The USMLE path is an exciting but costly process where fixed costs include application fees, visa fees, exam fees, and ECFMG certification.

USMLE Step-by-Step Cost Breakdown

• Step 1: The Basic Sciences Test - Base Fee ($680) plus International Delivery Surcharge ($205) for a total of $885.
• Step 2: Clinical Knowledge - Base Fee ($680) plus International Delivery Surcharge ($230) for a total of $910.
• Step 3: Final License Gateway - Exam Fee (2025) of $925 (Only offered in the USA or Canada).
• ECFMG Certification - Fee (2025) of $160.

Regarding mandatory steps, ensure that you register at ECFMG (Educational Commission for Foreign Medical Graduates) before going for Step 1 and Step 2. It is quite helpful if you know in advance how much money you should be prepared with at various stages of the USMLE journey.

Summary of Certification and Licensing Fees

The following table summarizes the primary expenditures for both PANCE and USMLE candidates based on 2025 data:

If you experience an extenuating circumstance and need to extend your PANCE exam eligibility time frame, you can submit an Exception to Policy (ETP) request at any time through your online account. For USMLE candidates, keep in mind that fees are mostly non-refundable once you’ve registered, and unused funds in your ECFMG account expire after 2 years. Using an international credit card enabled for USD payments can help avoid transaction failures and excessive forex charges.