Preparing for the New PAEA Surgery End of Rotation™ Exam 

PAEA will be publishing a new Surgery End of Rotation™ exam in Q3 of 2024.

In 2021, PAEA Assessment formed the PAEA General Surgery End of Rotation Exam Blueprint Workgroup. This group was charged with reviewing PA program needs under the new ARC-PA B3.07 standard of the ARC-PA Accreditation Standards for Physician Assistant Education, 5th Edition, evaluating the appropriateness of the current PAEA General Surgery End of Rotation exam blueprint, and recommending any proposed changes to the existing blueprint and topic list.

The workgroup conducted a literature review, specifically looking at the Physician Assistant National Certifying Examination (PANCE) blueprint, Surgical Council on Resident Education (SCORE) competencies, and common surgery textbooks, to identify overlaps with and gaps in the current PAEA General Surgery End of Rotation exam blueprint and topic list.

The workgroup also conducted a qualitative survey of programs through interviews with program directors to discuss how they were managing the transition to the new ARC-PA 5th edition B3.07 standard. The final recommendations from the workgroup resulted in the plan to publish a new PAEA Surgery End of Rotation exam with an updated blueprint and topic list.  

The key modifications include:  

  • A new professional practice task area which replaces the health maintenance task area. An example of an exam item that falls within the professional practice task area may be an item related to informed consent before a surgical procedure. 
  • The addition of three new exam content areas:  breast surgery, pain medicine/anesthesia, and trauma/acute care.  
  • The designation of preoperative, intraoperative, and postoperative as cross-cutting targets. These new targets help to ensure the exam has questions across the perioperative settings. Each exam item will be coded to these targets and reported for both students and programs. 
  • The adjustment to exam item distributions by content and task areas on the blueprint with the most notable being the reduction in the overall number of gastrointestinal/nutritional questions on the exam. 

Members of the PAEA Emergency Medicine and General Surgery Exam Development Board and other volunteer item writers have already begun writing exam items to meet these modifications as we move closer to publishing a new PAEA Surgery End of Rotation exam.

To meet this timeline, we will begin pre-testing newly written exam items in January. Pretesting is an important step in PAEA’s rigorous exam development process and allows us to gather item performance statistics to evaluate an item’s inclusion on future exams.

This means that 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.”  

The new blueprint and topic list are available at We encourage you and your faculty to become familiar with the modifications as we prepare for the release of the new exam.

We anticipate offering both the current PAEA General Surgery End of Rotation exam and the new PAEA Surgery End of Rotation exam for one year following the publication of the new exam. This will allow programs time to appropriately map the new blueprint and topic list to program-specific learning outcomes and objectives and plan administration as it best aligns with your student cohorts and supervised clinical experience schedule. 

PAEA Assessment remains committed to its guiding principle, to educate and support programs to graduate knowledgeable and competent PAs who will improve health for all. We are excited to develop the new PAEA Surgery End of Rotation exam as we work to continue to support the needs of PA programs. If you have any questions, please contact us at