End of Rotation™: Content

PAEA End of Rotation exams are a set of objective, standardized evaluations intended to serve as one measure of the medical knowledge students gain during specific supervised clinical practice experiences.

These resources are used by exam development board members to guide the creation of exam content, and by the exam development staff when constructing exam forms. They will be useful to students when studying for the exam, and for faculty when determining which other SCPE evaluation components and program objectives may require additional assessment tools.

Emergency MedicineBlueprintTopic List
Family MedicineBlueprintTopic List
General SurgeryBlueprintTopic List
Surgery (for pre-test in Jan 2024 and publication Sept 4, 2024)*BlueprintTopic List
Internal MedicineBlueprintTopic List
PediatricsBlueprintTopic List
Psychiatry & Behavioral HealthBlueprintTopic List
Women’s HealthBlueprintTopic List
*Current students taking the PAEA General Surgery End of Rotation exam may begin to see exam items from the new content areas and task area starting in January. As a reminder, pretest items are not scored items and do not impact a student’s exam performance or score. Until Surgery exam publication, programs should continue using the General Surgery blueprint to prepare for an exam.

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Questions on the exams are considered only a sample of all that might be included for the clinical experience and may not reflect all content identified in the topic lists.


The  End of Rotation exam Topic Lists, Blueprints, and Core Tasks and Objectives are resources used by PAEA to guide the development of exam content and construction of exam forms.  Questions on the exam are considered only a sample of all that might be included for the clinical experience, they are not  intended  to be all-inclusive, and may not reflect all  content identified in the Topic Lists. These resources will be useful to faculty when  determining which other supervised clinical education experience objectives may require additional assessment tools. These resources may also be useful to students when studying for the exam;  however the Topic Lists are not a comprehensive list of all the exam question topics. PAEA’s goal is not to provide a list of all the topics that might be on the exams, but rather to provide students with a resource when preparing for the exams.  PAEA recommends that students review the Topic List, Blueprint, and Core Tasks and Objectives in conjunction when preparing for the exam.

Guiding Principles

Several cross-cutting criteria guide the development and delivery of the End of Rotation exams. The goal of these ideals is to assist the exam development team in ensuring that the exams, to the extent a multiple-choice exam can, evaluate a wide breadth of dimensions critical to a PA student’s preparation. This list has evolved as the End of Rotation exam program has matured.

  • The End of Rotation exam blueprints are two-dimensional, meaning that they are organized by task and content area. Each End of Rotation exam is built to blueprint and topic list specifications. Questions encompass a representative sample of content topics and may not reflect all content topics identified in the topic lists.
  • Questions developed for End of Rotation exams reflect the needs of a broad diversity of patients whom PAs will treat.
  • Questions developed for End of Rotation exams cover the lifespan and reflect a variety of patient care settings with some specifications in the seven core areas:
    • Emergency Medicine
      • Full lifespan
      • Emergency department, urgent care
    • Family Medicine
      • Full lifespan
      • Ambulatory, urgent care, and long-term care
    • General Surgery
      • Full lifespan
      • Ambulatory, emergency department, inpatient, and perioperative
    • Internal Medicine
      • Adult and geriatric
      • Ambulatory, inpatient, and long-term care
    • Pediatrics
      • Infants, children, and adolescents
      • Ambulatory, emergency department, and inpatient
    • Psychiatry and Behavioral Health
      • Full lifespan
      • Ambulatory, emergency department, and inpatient
    • Women’s Health
      • Adolescent and adult
      • Ambulatory, emergency department, inpatient, and perioperative
  • Questions are geared toward a PA student who has completed the relevant supervised clinical practice experience.

  • Questions are typically presented in vignette format so the exams can better assess problem-solving and critical thinking.
  • Each End of Rotation exam consists of 120 multiple-choice questions, 100 of which are scored. The other 20 questions are unscored pre-test questions used to gather statistics, which aid in future exam construction.
  • The End of Rotation exam contains two 60-question sections.
  • Each End of Rotation exam has at least two forms, providing the option for a re-test form should a student fail the first administration. Family medicine has three forms available for administration. This allows programs with two family medicine rotations to test twice with End of Rotation exams and still retain a third form for re-testing.

  • End of Rotation exams are intended to be used in conjunction with other evaluation modalities when assigning a student grade for a supervised clinical practice experience.
  • End of Rotation exams are delivered in the PAEA Assessment Center.
  • End of Rotation exams may be delivered proctored, unproctored, or with a third-party remote proctoring service, with a set time of two hours with a 10-minute break between sections. 
  • Items are randomized for each student administration, within each section of the exam, and form assignments are randomized within each cohort to ensure exam security.
  • Scores are reported in a way that allows students and programs to see where students fall compared to other PA students taking the same standardized exam nationwide.

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