As I'm sure you noticed, the way they ask questions in the new version/revised PANCE seems deliberately done to make PPP less useful. It's still a helpful tool, but not as helpful as it was a few years ago. As one example buzzwords aren't helpful, they almost don't use them, unless you can recognize that they're saying the buzzword another way - you have to understand it not just basic pattern repitition.

And ROSH, while helpful, is not remotely broad enough. It's a base, but PANCE asks for more. Heme, for example, is an area little covered by ROSH or the PANCE expects a bunch of knowledge there that ROSH doesn't ask for.

At this point ROSH + PPP is like the absolute bare minimum, or in your case, it wasn't even enough. Tbh I felt like ROSH was more helpful building test question stamina, it's not broad enough.

It's fine if you want to go with some paid option. I used CME4Life and honestly it was meh. I think I got a small number of extra questions right because of it but eh it didn't feel hugely high yield to me.

For me, the single resource that I think gave me answers I would otherwise have missed, specifically in the weeks leading up to the PANCE, was the Goljan Step I/II prep course recorded lectures. Some student recorded them years ago and they've been shared around in medical schools from class to class, unfortunately you can't legally buy them even, just search goljan audio step prep. The series I listened to started with cell injury and inflammation, fluid and hemodynamics, nutrition, then neoplasia, two on hematology (these ones saved my butt), cardio, etc. 15 in total. If you find it, imo it's high yield. And I'm not even someone who typically learns all that well by listening, but listening to these I would pause and if I thought a point was important I'd make an anki flashcard, then review afterwards. 10/10 will relisten to again before taking the PANRE.