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The purpose of this study was to apply confirmatory factor analysis (CFA) methodology to support the structure of the Physician Assistant National Recertifying Examination (PANRE) for both primary care and surgical physician assistant (PA) examinee populations.Examinee data from 950 first-time takers (680 primary care and 270 surgical PA examinees) of PANRE were selected. LISREL 8 software was used to determine whether one general ability factor (ie, ability to apply general, primary care knowledge) accounted for most of the variability in both the task and organ system scores.Results indicated that one general ability factor accounted for most of the variability in scores obtained from both the task and organ system dimensions of the test blueprint. Invariance tests indicated that the general ability factor structure was equivalent across the two populations, indicating that PANRE scores are interpretable in a way that is consistent with the specifications defined in the content blueprint. While the surgical PA examinees on average did not score as high on PANRE as the primary care PA examinees, the difference should not be attributed to the structural design or content specifications of the PANRE.The present study demonstrated the applicability of factor analysis for validating the structural design and scoring model for the PANRE across populations of specialized PA examinees; only a single general ability primarily explains variation in responses to individual test questions, and subsequently explains overall PANRE performance. Even though PANRE is designed to measure application of general medical knowledge in primary care, recertifying surgical PA examinees do not appear to be at a disadvantage when taking PANRE.