Orthopaedic Surgery CAQ
Introduction and Basic Prerequisites
CME Requirement
Experience Requirement
Procedures/Patient Case Requirement
The Orthopaedic Surgery Specialty Exam
Maintaining the Orthopaedic Surgery CAQ
Other Policies

Interested in starting the process to gain a Orthopaedic Surgery CAQ? Read the Policies and Procedures for the Non-Exam Requirements of the Certificate of Added Qualifications Program before registering for the Orthopaedic Surgery CAQ.
Ready to apply for the exam? Read the Policies and Procedures for the Exam Requirements of the Certificate of Added Qualifications Program before applying for the Orthopaedic Surgery CAQ exam.
Registration for the 2013 CAQ exams will open in February 1, 2013.
The exam date for the Orthopaedic Surgery CAQ exam is Sept. 9, 2013. Schedule your CAQ exam early to improve the likelihood of a convenient testing location.
The final deadline for submitting the exam application is September 5, 2013.
Introduction and Basic Prerequisites
Physician assistants seeking the Orthopaedic Surgery CAQ must demonstrate they have advanced knowledge and experience in orthopaedic surgery, above and beyond that expected of entry-level PAs or PAs working in a generalist practice. PAs seeking eligibility for the Orthopaedic Surgery Specialty Examination must meet requirements of specialty-specific CME, experience in the field, and specific knowledge and/or experience in conducting procedures and being involved in patient cases that are deemed core to the specialty area of practice. After initiating the CAQ process by submitting the requirements for one of the components and the $100 administrative fee, PAs will have six years within which to complete all four components for the CAQ, including passing the specialty exam.
Physician assistants seeking the Orthopaedic Surgery CAQ must also first satisfy two basic pre-requisites: (1) current PA-C certification and (2) possession of a valid, unrestricted license to practice as a PA in at least one jurisdiction in the United States or its territories, or unrestricted privileges to practice as a PA for a government agency. (Note: If a PA holds licenses in multiple states, all of the licenses must be unrestricted.) The licensure prerequisite is addressed more fully here.
NCCPA's specialty CAQ process is predicated on a strong belief in the value and importance of the physician-PA team, and in support of the procedures and patient case requirement, each applicant must provide attestation from a supervising physician who works in the specialty and is familiar with the PA's practice and experience. PAs may find it helpful, however, to secure such a physician sponsor at the beginning of the process for the purpose of seeking guidance on the pursuit of the other requirements.
In the six years preceding the date of application for the specialty exam, candidates must earn a minimum of 150 credits of Category I CME focused on orthopaedic surgery practice with a minimum of 50 of those credits having been earned within the two years prior to the date of exam application. The 150 required CME credits must include completion of an Advanced Cardiac Life Support course. The same 150 credits may also be used for maintenance of the PA-C credential.
PAs are encouraged to use their best judgment when determining whether individual CME activities are related to orthopaedic surgery, understanding that those credits may be subject to a CME auditing process.
Upon fulfillment of all CME requirements, candidates will attest to their completion at NCCPA's Web site.
Recommendations for CME Activities:
Physician and PA orthopaedic surgery leaders provided input in developing the following CME recommendations for PAs interested in pursuing a CAQ in that specialty.
Applicants should complete CME activities that are focused in orthopaedic surgery and at the level appropriate for a PA practicing in the specialty.
Physician assistants seeking the Orthopaedic Surgery CAQ must have gained at least 4,000 hours of experience (the equivalent of two years of full-time practice) working as a PA in that specialty within six years of the date they attest to NCCPA that the experience requirement has been satisfied. If selected for an audit, documentation substantiating that work experience will be required.
Procedures/Patient Case Requirement
Candidates for the CAQ must be able to apply the appropriate knowledge and skills needed for practice in orthopaedic surgery, as described below. In support of this requirement, each candidate must provide attestation from a supervising physician who works in the specialty and is familiar with the PA's practice and experience. The physician attestation must indicate that the PA has performed the procedures and patient management relevant to the practice setting and/or understands how and when the procedures should be performed.
Again, the PA may not have experience with each procedure, but he or she must be knowledgeable of the basics of the procedures, in what situation the procedures should be done, and the associated management of patients.
In determining whether an applicant can satisfy the Specialty Procedures and Patient Case Requirement, consideration should be given to the following areas:
Anesthesia
• Local anesthesia including digital block
• Procedural anesthesia, conscious sedation
• Regional anesthesia
Advanced Wound Management
• Superficial/deep wound closure
• Wound debridement, incision and drainage
• Placement/removal of wound vacs, drains
• Tendon repair
• K-wire removal, hardware removal
Compartment Pressure Measurement/ Management
Diagnostic/Therapeutic Needle Aspiration/ Injections
• Joints, tendons, trigger points, bursa, cysts
• Needle biopsy
Diagnostic Radiography/Other Modalities
• Proper positioning and techniques for skeletal radiographs
• Interpretation of skeletal, soft tissue radiographs
• Interpretation of CT scan, MRIs
• Electromyography interpretation
Fracture, Dislocation Management
• Universal hip, shoulder, etc. reduction and relocation
• Application of braces, splints, casts, appliances
• Application of skeletal traction, skin traction
• Percutaneous pinning of fractures
Operative /Perioperative Care
• Preoperative consultation, evaluation
• First surgical assist
• Postoperative care, management
Prevention, Recognition, Management of Common Orthopaedic Complications/Conditions
• Deep venous thrombosis
• Pulmonary embolization
• Osteoporosis
• Osteomyelitis
The Orthopaedic Surgery CAQ Exam
Physician assistants who have satisfied all other requirements for the Orthopaedic Surgery CAQ will be eligible to register for the Orthopaedic Surgery Specialty Exam. The examination consists of 120 multiple-choice questions related to orthopaedic surgery and targeted for PAs who have experience in the practice of that specialty. It will be based on the Content Blueprint, developed using data gathered during the 2009-2010 PA Practice Analysis conducted by NCCPA.
Registration for the 2013 CAQ exams will open in February 1, 2013.
The exam date for the Orthopaedic Surgery CAQ exam is Sept. 9, 2013. Schedule your CAQ exam early to improve the likelihood of a convenient testing location.
The final deadline for submitting the exam application is September 5, 2013.
The exam will be administered once a year at Pearson VUE testing centers.
To help PAs in preparing for the Orthopaedic Surgery Specialty Exam, we have taken items removed from the item pool and created a tool, which demonstrates how items are developed and should be answered. In the PDF document below, PAs can review sample NCCPA items and critiques written by NCCPA test committee members.
To review sample NCCPA questions and explanations regarding why the correct answer is correct and why the other answer choices are incorrect, please click here.
You'll need Adobe Acrobat Reader to open this file. If you do not have Acrobat Reader, you can download a free version by clicking here.
Though produced for PANCE and PANRE applicants, the short video on What to Expect on Test Day will be helpful to those preparing for this exam as well.
Maintaining the Orthopaedic Surgery CAQ
The Orthopaedic Surgery CAQ awarded to successful candidates will be valid for ten years. To maintain the CAQ beyond that timeframe, PAs must continue to meet the same PA-C and licensure requirements required of those seeking the CAQ for the first time, pass the Orthopaedic Surgery Specialty Examination before the expiration of the current CAQ, and -- during the ten-year CAQ cycle -- earn and log at least 125 credits of Category I CME focused on the specialty. Those CME credits may also be used to satisfy the CME requirement for maintenance of the PA-C credential.
Temporary Eligibility for the CAQ Exam
In the event that a physician assistant applying for a CAQ is under review by the NCCPA, but his or her current PA-C certification is still valid, the individual will be permitted to apply for and take the CAQ exam. However, the examination score will not be released, and the individual will not receive the CAQ, until a final decision has been reached and the matter has been resolved to the satisfaction of NCCPA.
Temporary Eligibility for CAQ Maintenance
In the event that a physician assistant applying for CAQ maintenance is under review by the NCCPA, but his or her current PA-C certification is still valid, the individual will be permitted to apply for and participate in the CAQ maintenance activities. However, the individual will not receive credit for CAQ maintenance until a final decision has been reached and the matter has been resolved to the satisfaction of NCCPA.
Auditing
To ensure the reliability and accuracy of the CAQ and maintenance processes, NCCPA may audit the requirements of physician assistants who have applied for a CAQ or have successfully completed the CAQ process. PAs who fail the audit or refuse to submit to an audit may be subject to loss of the CAQ and/or other disciplinary actions as deemed appropriate by NCCPA and in accordance with the Policy and Procedures for Disciplinary Review.
Loss of Eligibility
If a physician assistant loses eligibility for a CAQ after submitting the application and fee, he or she will be deemed ineligible and restricted from registering for the exam or from maintenance of CAQ activity, or will be withdrawn from the examination or maintenance activity if registration has already been processed.
Financial Requirements
PAs must fulfill all outstanding financial debts and any applicable fees to NCCPA prior to becoming eligible to apply for a CAQ or for CAQ maintenance.
If a PA loses eligibility for a CAQ or CAQ maintenance after submitting the respective application and fees or if, at any time, it is determined that a PA provided incorrect eligibility information on any NCCPA application, the PA shall forfeit all fees.
Exam Scores
Scores from the CAQ exams will be released to examinees after NCCPA has completed all scoring and validation processes. Physician assistants may not register to repeat an examination if they have scores pending from a previous administration of the same examination. If a PA is deemed ineligible for the CAQ after taking the exam but prior to the release of exam scores, the exam scores will be invalidated and not reported to the PA.
Disciplinary Review
Nothing in this policy shall limit or prevent NCCPA from imposing sanctions as set forth in its Policy and Procedures for Disciplinary Review.
Certificate of Added Qualifications Reinstatement
Physician assistants who lose a CAQ for any reason must begin the CAQ process anew by meeting all eligibility requirements for the CAQ, including passing the CAQ examination.

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