PAM Pass Rate 2026: What the Data Shows

Two Pass-Rate Figures, Two Different Populations

Searching for the Patient Assessment & Management Exam (PAM) pass rate turns up more than one number, and that is where candidates often go wrong. The Part II PAM is the National Board of Examiners in Optometry (NBEO) examination that forms part of the entry-to-profession licensure pathway. Two credible figures circulate for the most recent period, and they answer different questions.

Both numbers are first-time pass rates, and both are high. But they are not interchangeable, and the difference between them is not a meaningful "drop" or "rise." They measure different people over different windows. For a broader look at how these rates connect to preparation difficulty, see How Hard Is the PAM Exam? Complete Difficulty Guide 2026.

Who Is Actually Counted in Each Rate

The 89.4% university-published rate

UC Berkeley and Ferris State each publish a national first-time Part II PAM pass rate of 89.4% for the 2025-2026 academic year. Their stated first-time population includes candidates regardless of graduation status. That means the pool is defined by attempt number, not by whether the candidate has already earned the degree. It also differs from the way ASCO graduate-cohort reporting is built. An important caveat: these are university publications of NBEO outcomes, not a national dataset hosted by NBEO itself that was retrieved for this article.

The 87.96% NBEO-authored graduate-cohort rate

The NBEO-authored Institutional Yearly Performance Report, publicly hosted by ASCO and covering October 1, 2024 through September 30, 2025, lists a U.S. row with an 87.96% Part II first-time pass rate for a cohort of 1,628 qualifying U.S. graduates. The cohort definition is narrow on purpose: it includes only graduates in the stated interval who attempted all three NBEO parts at least once. It is therefore not the population of all PAM first-time candidates, and it should be read as a measure of graduating-class performance rather than of the full national candidate pool.

If you want the one-page version of how this fits with the rest of exam planning, the dedicated explainer at PAM Pass Rate 2026: What the Data Shows collects the figures in one place.

How the 100-900 Scale Relates to Pass and Fail

NBEO's current Scoring & Reporting page uses a 100-900 scale and states that scores above 300 pass. That wording matters. It is not a raw percentage of questions answered correctly, and it should not be translated into one. This article also does not infer what happens at exactly 300, because the published boundary language is "above 300" and nothing beyond that is stated here.

Scores are equated across forms rather than curved. In practical terms, that means your result reflects performance against a fixed standard, not your rank relative to the other people who tested that week. A strong or weak cohort does not move the line. If you want the full scoring discussion, PAM Passing Score 2026: Exactly What You Need to Pass covers it in detail.

There is also a structural detail worth knowing: approximately 120 TMOD items are embedded within the 350 questions, not added on top of them. Overall PAM and TMOD receive separate pass/fail decisions. The matrix footnote says 120 while the outline and program description qualify the count as approximate, so treat "approximately 120" as the careful phrasing. A standalone TMOD is a separate registration pathway and is not the full PAM examination discussed here.

What the Pass Rate Is Measuring: The Exam Itself

A pass rate only means something once you understand the test behind it. The full PAM is a demanding single-day endurance event.

Several rules shape how you pace and recover. Session 1 cannot be revisited after the inter-session break, so any flagged items need to be resolved before you leave that session. Unscheduled breaks do not stop the clock. An on-screen basic calculator, a searchable generic/trade drug equivalence list, an abbreviation list and a supplied scratch booklet are available. The drug list is a convenience tool, not an exhaustive syllabus, so do not treat it as a boundary for what you need to know.

Question style

Image-intensive patient cases generally carry three to six associated items, with three to ten response options per item. Both single-answer and multiple-response formats are used. On multiple-response items, up to four correct selections can be required, and credit requires all and only the requested correct options. Partial selections do not earn partial credit, which makes careful reading of the stem as important as the clinical knowledge itself. Practice with this format through the PAM practice test so that the "select exactly N" mechanic feels routine on test day.

Registration and fee mechanics

You register and pay through NBEO, then schedule your appointment with Pearson VUE. The exam fee is $1,490 for administrations beginning August 2026, and late registration adds $400. Candidates must bring two current signed physical IDs, at least one of them a government photo ID, with names matching the registration. A full cost walkthrough, including optional preparation spending, is in PAM Certification Cost 2026: Complete Pricing Breakdown, and scheduling windows are covered in PAM Exam Dates 2026: Testing Windows, Deadlines & Scheduling.

Where the Points Live: Content Areas and Task Dimensions

The NBEO Part II PAM Content Outline organizes the exam into two top-level areas. Understanding them helps you interpret what a pass rate of this size is really rewarding: broad, clinically integrated competence rather than narrow specialization.

The separate Content Matrix cross-classifies the same material by task type: Clinical Correlation of Basic Science Principles (11-17%), Diagnosis (26-34%), Treatment / Management (40-57%), and Legal Issues / Ethics / Public Health (4-10%). Clinical Presentation (History, Signs, Symptoms) is assessed within cases and has no separate percentage. These are intersecting task dimensions, not four additional additive domains, and the ranges are preserved here as published rather than normalized to sum to 100. Treatment and management carries the heaviest range, which tells you the exam is more interested in what you do next than in recall of isolated facts. A full breakdown is in PAM Exam Domains 2026: Complete Guide to All 2 Content Areas.

Why We Do Not Draw a Historical Trend

It is tempting to line up older pass-rate numbers and announce a direction. This article deliberately does not. Older university national rows disagree with one another, and the two current figures above cover different populations and periods, so no combined historical trend is inferred. The 87.96% and 89.4% figures must not be pooled or presented as comparable points on a single line.

If you are comparing programs or evaluating a specific school's outcomes, look at that institution's own published results alongside the NBEO-authored report, and read the cohort definition each one uses before drawing conclusions.

Retakes, Attempt Limits and Score Validity

Because the headline figures are first-time rates, it helps to know what happens afterward. After six attempts, special approval and remediation are required. NBEO prohibits distribution of recalled items and does not allow superscoring, meaning results from separate attempts are not combined. NBEO says scores do not expire, but PAM is a licensure examination result rather than a separately renewable specialty certification, and individual state licensing boards can impose additional acceptance conditions. If you are weighing how this fits into licensure planning, PAM Requirements 2026: Eligibility, Prerequisites & How to Qualify explains who may sit for the exam.

On eligibility in brief: student eligibility begins in the academic year of graduation from an ACOE program with Accredited, Accredited with Conditions or Preliminary Approval status, with institutional confirmation. Other candidates need direct sponsorship from a qualifying optometric program or a state optometry licensure board.

Using the Numbers to Plan Your Preparation

A pass rate is context, not a study plan. The practical use of the data is to calibrate your effort to the exam's actual weighting. Because Normal Health / Disease / Trauma accounts for 60-70% of the content, and Treatment / Management carries the largest task range at 40-57%, a sensible sequencing places case-based disease and management practice early and revisits it often, while giving Refractive / Sensory Processes / Oculomotor Processes steady, scheduled attention rather than a last-minute cram.

NBEO offers an optional Part II PAM/TMOD Practice Databank containing NBEO-owned questions, administered by Test Run, an independent third-party organization. It costs $199 for one month, with a $149 additional-month renewal subject to examination-registration and administration-date conditions. These are preparation charges, not the exam fee, and purchase or completion does not guarantee passing. This article did not access the paid bank, so it makes no claims about its contents. For a structured approach to building your plan, see PAM Study Guide 2026: How to Pass on Your First Attempt, and use the PAM Exam Prep practice tests to rehearse the case-based format at volume.

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