The EOR exams at a glance
- exams, one for each core rotation
- 7
- multiple-choice questions, 100 of them scored
- 120
- scaled score range
- 300 to 500
- set time, with a 10-minute break between sections
- 2 hours
- passing score set by PAEA; your program sets one
- None
- forms of every exam, for retesting
- 2 or more
Checked against PAEA's End of Rotation pages on November 2, 2026.1,2 To see where a score stands nationally, use the EOR score percentile calculator.
Which version will you take?
| Exam | Versions available |
|---|---|
| Emergency Medicine, Family Medicine, Internal Medicine, Pediatrics, Psychiatry | Legacy or July 2026 |
| GSRH | Legacy (Women's Health) or July 2026 (GSRH) |
| Surgery | One current version |
On July 27, 2026, PAEA published new versions of six exams, written to updated blueprints and topic lists. Women's Health became Gynecologic, Sexual, and Reproductive Health (GSRH). The legacy versions, which follow blueprints dated 2018 and topic lists dated 2020, remain available through July 2027, so programs can move to the new versions with their next cohort.3
Surgery has one current version, built to a blueprint PAEA dated 2023, and did not change in July 2026. PAEA did publish updated national statistics for it on that date.3,4
Ask your clinical coordinator which version you will take before you plan your studying, because the content weights differ. The July 2026 blueprint changes guide compares the two versions of each exam area by area.
The seven exams at a glance
-
Emergency Medicine Mean 417
- Cardiovascular 18%
- Rheumatologic/MSK 12%
- Gastrointestinal 10%
- Pulmonary 10%
-
Family Medicine Mean 415
- Cardiovascular 14%
- EENOT 10%
- Gastrointestinal 10%
- Pulmonary 10%
-
Internal Medicine Mean 418
- Cardiovascular 20%
- Pulmonary 15%
- Gastrointestinal 12%
-
Pediatrics Mean 421
- EENOT 12%
- Pulmonary 12%
- 4 more areas 10% each
-
Psychiatric and Behavioral Health Mean 416
- Depressive and Bipolar 17%
- Substance-Related and Addictive 15%
- Trauma, Stress, Abuse and Neglect 13%
-
Surgery Mean 417
- Gastrointestinal 17%
- Cardiovascular 15%
- Pulmonary/Thoracic 13%
-
GSRH (formerly Women's Health) Mean 414
- Prenatal Care/Pregnancy 20%
- Uterine/Cervix 12%
- Fertility Management 10%
- Sexual Health/Development 10%
Every exam has 100 scored questions, so a content area's weight on the blueprint is also about how many questions it gets. On the current Emergency Medicine blueprint, for example, cardiovascular topics make up 18 percent, or about 18 of the 100 questions that count.3 Each blueprint also weights task areas, such as diagnosis, diagnostic studies and clinical therapeutics, and each exam has a topic list naming the conditions it can test.
The national means for the current versions range from 414 to 421.4 Because each specialty exam has its own scale, a 410 on one exam and a 410 on another do not mean the same thing,2 and the useful comparison is with the mean and standard deviation for your exam and version. PAEA also notes that students tend to score higher on exams later in the clinical year, whatever the specialty.2
Each rotation guide has that exam's topic list, blueprint weights by content and task area, national scores for both versions, and a four-week study plan. Pick the rotation you are on, or the one coming next, and start with its two or three largest areas.
How programs grade the exam, and what happens if you fail
Look up in your handbook
- The passing score for each exam, and whether it is tied to PAEA's national mean.
- How much the exam counts toward the rotation grade, and how the scaled score is converted.
- Which version your cohort takes, legacy or July 2026.
- The retake date, and whether remediation must come first.
- What a passed retake earns: the new score, or a capped grade.
- What follows a second failure, such as repeating the rotation, probation or a progress committee.
PAEA does not set passing standards for End of Rotation exams and does not advise programs where to set them; each program sets its own, and the exam's weight in the rotation grade varies with the program's other assessments.2 PAEA's exam policies say EOR scores may be used to grade a student's knowledge of the specialty, together with other assessment tools, before the final rotation grade is set.5 Published program policies show the common approaches. These are examples, not national rules:
- A cutoff below the national mean. The University of North Carolina at Chapel Hill PA program describes its thresholds as one standard deviation below PAEA's national mean and lists the scaled score for each exam, such as 390 for Emergency Medicine.6 The PA program at Rowan-Virtua School of Osteopathic Medicine requires a score at or above 1.5 standard deviations below the national mean.7
- A converted percentage. Gardner-Webb University converts the scaled score to a percentage from its distance to the national mean, with the mean equal to 85 percent, and combines it with the rotation's other assignments and evaluations.8
After a failed exam, programs can retest: PAEA offers at least two forms of every exam so programs can retest students after remediation.2 Its policies let a student take every form once without restriction (3 for Family Medicine, 2 for the others); after that, another attempt must wait 21 days.5 The rest is your program's rule. At UNC, for example, a first failure brings a meeting with the director of clinical education, a remediation assignment and a retest on the second Monday of the next rotation; failing the retest fails the rotation.6
If your program uses a cutoff tied to the mean, the EOR exam scores guide shows how to turn the mean and standard deviation into a target score and an estimated percentile.
Studying across the clinical year
When rotations run back to back, the exam for one falls at its end and the next rotation starts right after, so a study plan has to repeat for each rotation without falling behind.
- Plan each rotation from its first day. Put the exam date on the calendar, split the weeks by the blueprint's largest areas and leave the last few days for review. The EOR study planner turns your rotation dates into a day-by-day plan you can print or add to your calendar.
- Study what you see. Read on the conditions your patients have that day, then answer a few questions on them.
- Take a full-length practice exam early. A timed exam in the first week shows which areas to spend the rotation on. Breeze Ed's Clinical plan ($39 a month) includes 14 EOR practice exams, two for each core rotation, each with 120 questions and a two-hour time limit. Through November 30, code NOV25 takes 25% off your first payment.
- Build sets for your weak areas. Breeze Ed's custom exam builder narrows from a system to its topics and down to individual conditions, in study mode with feedback after each question or a timed test mode.
- Track results by area. Breeze Ed's performance analytics break your practice results down by system, topic and condition, so the next set targets what you miss.
- Read every score report. Your EOR report gives a keyword for each question you miss, naming its content area, task area and diagnosis.2 Add those topics to your review list for the PANCE, and for a retake if you need one.
- Week 1 A full-length practice exam to find the weakest content areas.
- Week 2 The two weakest areas, with mixed questions every day.
- Week 3 A second practice exam, then the next areas on the blueprint.
- Week 4 Missed questions and the largest areas, then the exam.
Do EOR scores predict the PANCE?
Published studies find a moderate to strong relationship between EOR scores and later PANCE scores, all on exams given before the July 2026 versions:
- Three programs, 2015. In a pilot of 72 students, the correlation between the composite percentage across all seven EOR exams and PANCE score was 0.856.9
- Three programs, 2015. In a study led from the University of Iowa, with 134 students who took all seven exams, each exam's correlation with PANCE score ranged from 0.47 to 0.68, and the average of the seven explained 65 percent of the variance in PANCE scores.10
- An update, 2018. The average of all seven exams predicted certification exam performance, and so did the average of four: Emergency Medicine, Family Medicine, General Surgery and Internal Medicine.11
- A multicenter study, 2019. Each 10-point increase in an EOR scaled score was associated with a PANCE score 16.8 to 23.5 points higher, depending on the exam, and with 37 to 48 percent lower odds of poor PANCE performance.12
These are associations within the programs studied, not a forecast for one student, and PAEA states that its exams are not intended to predict PANCE performance.5 A low score is best read as a list of topics to close before the PANCE.
