Cardiovascular/Thoracic Surgery CAQ

Sign In and Register Now! "As a physician assistant who works in a specialty, it
  is truly an honor to achieve recognition for my advanced experience,
  knowledge and skills from the NCCPA. This program will help demonstrate to our medical colleagues, patients and community our extensive clinical experience, continued specialty CME and passion for our profession and patient care." 

         Michael Nowak, MPAS, PA-C, FAPACVS, CAQ in CVTS

Earn a Certificate of Added Qualifications (CAQ) in Cardiovascular/Thoracic Surgery to show your advanced expertise in your specialty. Read what your peers are experiencing after earning a CAQ!

CAQ recipients seeking the following benefits have really reaped reward for their achievement:

  • Over 75% found or anticipate finding a new job

  • Over 40% successfully sought a promotion

  • 60% achieved or expect to increase their job responsibilities

  • Over 50% received or anticipate receiving a pay increase, and 33% received a cash bonus

  • Over 75% found the CAQ useful in documenting qualifications required for external accreditation

  • Over 33% achieved or anticipate a broadening of their eligibility for reimbursement

  • Almost 75% have received greater recognition or regard from physicians or other health care professionals

  • 66% reported greater respect or acceptance from patients

Earning a CAQ shows your employers that you are committed to your specialty. It demonstrates your dedication and passion to healthcare and the well-being of your patients.

Still unsure? Get a feel for the exam by reviewing some sample questions. Then read more about the requirements below.

Key Dates:

    • January 1, 2021 – Exam application registration opens for PAs applying to earn a CAQ

    • April 2, 2021 – Deadline to apply for a Spring CAQ exam administration at a Pearson VUE Test Center

    • April 5-10, 2021 – Spring administration window for all CAQ exams administered at Pearson VUE Test Centers

    • October 1, 2021 – Deadline to apply for a Fall CAQ exam administration at a Pearson VUE Test Center

    • October 4-9, 2021 – Fall administration window for all CAQ exams administered at Pearson VUE Test Centers

Introduction and Basic Prerequisites

PAs seeking the Cardiovascular/Thoracic Surgery CAQ must show they have advanced knowledge and experience in either or both of these surgical subspecialties, above and beyond that expected of entry-level PAs or PAs working in a generalist practice. PAs applying for the Cardiovascular/Thoracic Surgery Specialty Examination must have specialty-specific CME and experience in the field. They can begin CAQ process by submitting at least one of the components and the $100 administrative fee. They'll have six years to complete all four components for the CAQ, including passing the specialty exam.

PAs seeking the Cardiovascular/Thoracic 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.

In support of the procedures and patient case requirement, each applicant must provide attestation from a physician, lead/senior physician assistant, or physician/physician assistant post graduate program director who works in the specialty and is familiar with the physician assistant's practice and experience. PAs may find it helpful, however, to secure such a sponsor at the beginning of the process for the purpose of seeking guidance on the pursuit of the other requirements.

CME Requirement

In the six years preceding the date of application for the specialty exam, PAs must earn a minimum of 75 credits of Category 1 CME focused on cardiovascular/thoracic surgery practice, including 25 credits earned within the last two years. The same 75 credits may also be used for maintenance of the PA-C credential.

How do you know if CME activities are related to cardiovascular/thoracic surgery? Use your best judgment. (Keep in mind that the credits may be subject to a CME auditing process.)

Once PAs have completed the CME requirements for the CAQ, they'll attest to this online at their personal certification record.

Recommendations for CME Activities:
Physician assistant cardiovascular/thoracic surgery leaders provided input in developing the following CME recommendations for PAs interested in pursuing a Cardiovascular/Thoracic Surgery CAQ.

PAs are encouraged to complete CME activities that include knowledge of post-op critical care management, and surgical management of coronary artery disease, congenital heart disease, thoracic disease, and central and peripheral vascular disease.


PAs seeking the Cardiovascular/Thoracic Surgery CAQ must have at least 4,000 hours of experience (the equivalent of two years of full-time practice) working as a PA in cardiovascular/thoracic surgery within six years of the date they attest to this. If selected for an audit, documentation substantiating that work experience will be required.

Procedures/Patient Case Requirement

PAs must be able to apply the appropriate knowledge and skills needed for practice in the specialty, as described below. You will need to provide an attestation from a physician, lead/senior physician assistant, or physician/physician assistant post graduate program director who works in the specialty and is familiar with your practice and experience within 90 days after you receive your CAQ score. The attestation of knowledge and skills 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.

In determining whether a PA can satisfy the Specialty Procedures and Patient Case Requirement, consider the following:


• Local anesthesia
• Procedural anesthesia, Conscious sedation
• Endotracheal intubation

Advanced Wound Management

• Wound debridement, incision and drainage
• Superficial/Deep wound closure

Diagnostic/Therapeutic Procedures

• Arterial line placement
• Swan-Ganz placement
• CVP line placement
• Chest tube placement/removal
• Thoracentesis
• Pleurodesis
• Transvenous pacer wire placement/removal
• Epicardial wire removal
• Transcutaneous pacing
• PIC/PICC line insertion
• Intravenous line placement
• Intra-aortic balloon (IABP) pump placement/removal
• Nasogastric tube/feeding tube placement
• Bronchoscopy and bronchoalveolar lavage
• Pericardiocentesis
• Epicardial pacemaker management

Diagnostic Radiographic/other modalities

• Chest x-ray, CT Scans, MRI interpretation
• Diagnostic ultrasonography
• Diagnostic echocardiography
• Diagnostic electrocardiography

Operative/Perioperative Care

• Preoperative consultation, evaluation
• Active bedside patient care management
• First/Second surgical assist
• Conduit vessel harvesting
• Sternal closure/thoracotomy closure
• Sternotomy/Sternal re-entry
• Decannulation and/or separation from cardiopulmonary bypass
• Organ procurement for transplantation
• Postoperative care, management


• Cardiopulmonary

The Cardiovascular/Thoracic Surgery Specialty Exam

Once PAs have satisfied other requirements for the Cardiovascular/Thoracic Surgery CAQ, they can apply for the Cardiovascular/Thoracic Surgery Specialty Exam -- 120 multiple-choice questions related to cardiovascular/thoracic surgery targeted for PAs with experience in the practice of those specialties. It is based on the Content Blueprint, developed using data gathered during the 2009-2015 PA Practice Analysis conducted by NCCPA.

To review sample questions, 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.

The Cardiovascular/Thoracic Surgery CAQ Exam will be offered nationwide on April 6-11, 2020 and September 14-19, 2020 at Pearson VUE testing centers. Application registration opens Jan. 1, 2020 and we encourage PAs to apply and schedule early to improve the likelihood of a convenient testing location. The last day to apply for the exam is April 3, 2020 and September 11, 2020 respectively. 

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 Cardiovascular/Thoracic Surgery CAQ

The Cardiovascular/Thoracic Surgery CAQ is 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 Cardiovascular/Thoracic Surgery Specialty Exam before the expiration of the current CAQ, and -- during the ten-year CAQ cycle -- earn and log at least 125 credits of Category 1 CME focused on the specialty. The same 125 credits may also be logged to maintain the PA-C credential.

Other Policies


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 submit any outstanding 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 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. PAs 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.

Regaining a Certificate of Added Qualifications

If you lose a CAQ for any reason, you must begin the CAQ process again by meeting all eligibility requirements, including passing the CAQ examination.