Purpose To analyze the effectiveness of an independent commercial 3-day Physician Assistant National Certifying Examination (PANCE)–Physician Assistant National Recertifying Examination (PANRE) board review course to improve first-time pass rates on the PANCE. Methods Data were extracted from academic files at 2 universities over 2 years. In the first year (2014), the universities had not implemented a requirement for participation in a commercial board review course. In the second year (2015), both universities required participation in the course. There were 116 students at Idaho State University and 85 students at the University of Utah. Results Multiple regression analyses with PANCE score as the outcome variable were conducted with number of days to PANCE, number of practice tests, location of review course, Physician Assistant Clinical Knowledge Rating and Assessment Tool (PACKRAT) II performance, first-time PANCE pass rates, and first-time PANCE scores. After controlling for demographics, PACKRAT II scores, and students' home university, the study found that participation in the board certification course did not seem to affect student performance on the PANCE (R2 change = 0.000, p = .728). Post hoc analysis revealed a significant main effect for number of tests (F(3,94) = 3.35, p = .022, ηp2 = 0.097). Although not statistically significant, differences between on-site and off-site attendance may be of practical significance. Conclusions There were no significant differences in PANCE performance of PA students who participated in a program-sponsored board review course and the performance of those who did not participate the previous year. We offer suggestions for future research to maximize the utility of a board review course.