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THE PANCE WHISPERER: Interview with Erich Fogg, PA-C

ByShayne Foley PA-C

Passing the PANCE is the first major hurdle in the transition from PA program to practice. While there is a high first-time pass rate, this ominous certification exam stokes a lot of anxiety and often leaves us thinking that we did not pass it as we leave the testing center. Unfortunately, that premonition comes true for a relatively small percentage, which is frustrating and career-delaying at best, but even more anxiety provoking and costly at worst. Fortunately, there exists a PA-C named Erich Fogg who has developed the recipe for successful PANCE remediation! Given his success rate and all of the questions that we get about the legendary PANCE, we decided that we needed to interview Erich and pick his brain about it.


PABP:

I have “CV envy” when I look at your LinkedIn profile!  Please tell our audience about your PA journey, including some of your clinical and non-clinical roles, current role(s) and work with PANCE remediation, so that they can ALSO be impressed with your career.

Erich:

Thank you, Shayne. I believe my CV primarily reflects my 28 years as a Physician Assistant, which basically makes me old.  But it is also showcasing a journey I could not have predicted when I started in this profession. Embracing opportunities has been a key theme throughout my career—saying “yes” to pioneering roles, such as being the first PA in my initial job and later venturing into a different, unique opportunities.

The events of September 11, 2001, prompted a significant life change, leading my wife and me to relocate from Georgia back to Maine, where I engaged in various aspects of PA practice and educational opportunities. This included clinical practice at our largest teaching hospital, involvement in PA education, serving as a medical malpractice consultant and expert witness, participating in committees with our national PA organizations, assuming an MSL role in the biotech industry, and addressing PA practice and regulatory issues at both the state and national levels.

In the mid-2000s, a call from a colleague in Massachusetts inspired the creation of a PA CME company, organizing over 50 events in 11 years and teaching thousands of PAs and healthcare professionals emergency medicine, orthopedic, and critical care topics. For the past 15 years, I’ve worked at one of the few remaining independent, non-profit hospitals in Maine, where I’ve held roles as a clinical leader, director, administrator, and appointed member of the Board of Trustees.

My diverse roles and experiences are interconnected, emphasizing the synergy between each opportunity. Recently, leveraging my extensive clinical and academic background, I assisted a PA graduate who struggled with the PANCE. Identifying the root cause as test-taking skills rather than content knowledge, we worked together for 8 weeks, resulting in a remarkable improvement of over 170 points. Through word of mouth over the last 3 years, I’ve had the privilege of aiding 75 students in achieving PANCE success after initial setbacks. 

The journey persists, driven by the understanding that seizing one opportunity often paves the way for others. Notably, the skills honed through this process extend beyond enhancing performance solely on the PANCE. They prove invaluable for tackling a spectrum of standardized high-stakes exams, including PANRE, EORs, didactic assessments, and summative exams.

Currently, I collaborate with several programs, assisting first and second-year students facing challenges with high-stakes exams. Collectively, we’ve achieved success at the programmatic level by improving test scores, while also reducing instances of remediation, academic dismissals, and probation statuses. A recurring sentiment from students I’ve collaborated with is, “I wish I had developed these skills sooner.” This underscores the universal applicability and transformative impact of these skills across various academic assessments and reinforces the value of early skill development.

PABP:

Many of our audience have yet to take the PANCE, and are understandably anxious to do so, even despite high passing rates.  What advice do you have for these folks in terms of understanding the PANCE, how best to study, recommended resources, etc.?

Erich:

The PANCE is undoubtedly an intimidating challenge, evoking fear in all candidates due to its high-stakes nature. While classified as a minimal competency exam, boasting a high pass rate for first-time takers, a significant number of students find themselves grappling with the daunting reality of failure.

In my extensive experience, initial failure on the PANCE often triggers a cascade of emotions—disappointment, frustration, embarrassment, and a profound loss of confidence. Unfortunately, this can lead to a discouraging cycle, with students feeling compelled to repeat the exam without addressing the reason for failure, and potentially perpetuating suboptimal performance.

The common misconception among those who fail is to attribute the setback solely to content knowledge, adopting a mindset of “if I only study harder.” Consequently, they invest in new preparatory courses, acquire more study materials, and dedicate additional hours to review. To their surprise, incremental improvements or, in some cases, regression in performance occurs. This paradox confounds candidates, emphasizing the need to delve deeper into the underlying issues.

Drawing parallels to medicine, where treating symptoms without addressing the root cause yields limited results, I have found that lasting improvement in test-taking performance requires a holistic approach. Success hinges on three fundamental principles: robust content knowledge (indisputably crucial for navigating the exam), honed test-taking skills (often underestimated, particularly among struggling students), and a resilient mindset (essential for managing performance and test-taking anxiety).

While ample resources are available for mastering content, there is a notable scarcity of material focusing on refining test-taking skills and cultivating a positive mindset. Recognizing and addressing these facets are pivotal steps toward achieving success on the challenging journey of the PANCE.

PABP:

You’ve successfully worked with approx. 70 students to go from “FAIL” to “PASS” with your guidance: What are themes (if any) that you see in the students that you’ve worked with, such as personality types, common mistakes, etc.?  

Erich:

Commonly observed errors in PANCE performance often revolve around approach, mindset, and a deficiency in tools and strategies to effectively navigate the exam. Students frequently express frustration when reviewing missed questions, realizing that they were dealing with what seemed to be “easier” questions or items they were confident in answering, yet got wrong.

My continuous pursuit of understanding leads me to question the “why” behind these lapses. Why were these individuals unable to successfully apply their knowledge? The root causes frequently trace back to inadequate test-taking skills or anxiety that undermines their ability to execute, and in some cases, a combination of both. It becomes evident that addressing these foundational issues is essential for candidates to perform optimally on the PANCE.

PABP:

With your reproducible success, it’s clear that you’ve developed a reliable system for passing the PANCE.  Without giving away your “secret sauce” recipe, what are the basic principles of how you take someone from “FAIL” to “PASS”?

Erich:

I believe the initial crucial step is to guide the student in vocalizing and truly believing in their worthiness to pass the exam. Regardless of whether they have encountered one failure or multiple, a student’s confidence is often shattered, and this lack of confidence can significantly impede their path to success. Thus, the journey begins with rebuilding that confidence.

Subsequently, the focus shifts to crafting a comprehensive preparation plan, strategically working backward from the upcoming (and ideally perceived as the final) test date. Embracing the motto “Failing to plan is planning to fail,” we establish a robust framework for success. This involves incorporating effective preparation methods, emphasizing active learning strategies over passive ones, and utilizing high-stakes, quality test banks to both master skills and address content gaps.

The preparation plan extends beyond the basics, incorporating learning strategies that enhance execution efficiency. This includes techniques to navigate content blind spots, appreciate subtle cues provided by item writers, narrow down answer choices, and improve the ability to select the correct answer when options are reduced to two. Simultaneously, I emphasize the importance of proper time management and flagging strategies.

Taking a holistic approach, I address not only the academic aspect but also work towards mitigating performance anxiety. A key component is having a well-defined anxiety de-escalation plan in place, ensuring that the student is equipped to manage stress and anxiety effectively throughout the exam preparation and testing process. The ultimate goal is to provide a soup-to-nuts approach, leaving no aspect untouched in the pursuit of exam success.

PABP:

If someone is interested in working with you on PANCE remediation or other endeavors, what’s the best way for them to contact you?

Erich:

We’d like to again say “Thank you” to Erich for sharing his PANCE expertise with us and our audience.

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