The Physician Assistant National Recertifying Examination-Longitudinal Assessment (PANRE-LA) is an adaptive test owned by The National Commission on Certification of Physician Assistants (NCCPA), designed for the purpose of medical knowledge recertification for Physician Assistants (PAs). This paper investigates the effectiveness of PANRE-LA for the at-risk population, namely how it helps designated populations learn during the exam window (2-year period). Result shows that with the remediation strategy, the at-risk population can improve 0.04 logit per quarter on the Rasch ability scale (equivalent to 0.16 logit per year), which was considered large given PA spent at most three hours during each quarter. It also detailed the relationship between test motivation and learning gain, PA profiles and learning gain, as well as suggesting actionable strategies for future advancement of recertification tests.