Our History


Demand for primary care services was vastly increased by the passage of Medicare and Medicaid. With a perceived need for a generalist health practitioner to complement the services of physicians in inner-city and rural populations and an awareness of the growing number of corpsmen being discharged from military service without opportunity to apply their skills in a civilian occupation, Dr. Eugene A. Stead, Jr. enrolled four ex-Navy corpsmen to a new program at Duke University to train “physician’s assistants.”

This intensive two-year program gained widespread attention throughout the country. Fueled by Federal and foundation funding, the concept was quickly emulated by other academic institutions, both public and private.  While many drew upon the pool of former corpsmen, candidates for training were also drawn from a variety of other backgrounds and proved to be equally successful.



Upon the recommendation of its Committee on Goals and Priorities, the National Board of Medical Examiners (NBME) approved the development of a certifying examination for “the assistant to the primary care physician.” It was the first time that the NBME had engaged in examining any health professional other than physicians. An advisory committee was appointed, a “role delineation study” undertaken, and task forces created to refine components, and construct a blueprint for test committees that created the substance of the examination.


The first certification examination is administered to 880 PA candidates.


Recognizing a need for an independent, broad-based organization to attest to the qualifications of PAs, the AMA and the NBME convene a meeting in of 14 national organizations to form the National Commission on Certification of Physician Assistants (NCCPA). While the NBME would continue to develop and administer a certifying examination, the NCCPA would assume the responsibility for the requirements for eligibility, the setting of a passing standard and other conditions for initial certification and periodic recertification. The NCCPA would issue certificates and become the conduit to state regulatory agencies.

Staff is recruited and NCCPA opens its first office in Atlanta.


Those who had passed the initial Physician Assistant National Certifying Examination (PANCE) in 1973 and 1974 are issued certificates, designating the successful candidates as “Physician Assistant – Certified” (PA-C). Recipients are required to fulfill continuing education requirements every two years, and be recertified by examination every six years.



The NCCPA Board of Directors approves the Pathway II as a take-at-home recertification alternative to the proctored PANRE.


As part of the conversion to the computerized test administration, the clinical skills component and the extended core examinations is eliminated from the PANCE and the “stand-alone” voluntary Surgery Examination was introduced.


PANCE is administered for the first time as a computerized-based test at multiple sites across the country.



The PANRE and Surgery Examinations are administered for the first time by computer. Also, a new web-based CME logging system is launched to provide secure online access for PAs to their certification maintenance record.


NCCPA initiates an effort with other PA organizations to establish a profession-wide definition of PA competencies throughout a PAs’ career.


The stand-alone surgery examination is eliminated.


Stemming from the effort to establish a profession-wide definition of PA competencies throughout a PA’s career, Competencies for the Physician Assistant Profession is published.

Subsequently, various NCCPA committees and staff evaluate NCCPA’s certification and certification maintenance processes to determine how those processes may be modified to assess, incorporate or foster a broader range of the identified PA competencies.


The NCCPA Board of Directors approves a motion to allow the NCCPA to launch a Certificate of Added Qualifications (“CAQ”) program to recognize PAs’ experience and knowledge in certain specialty areas. Today CAQs are offered in cardiovascular/thoracic surgery, emergency medicine, hospital medicine, nephrology, orthopedic surgery, pediatrics and psychiatry.


The Pathway II examination is administered for the last time.


The NCCPA Board of Directors approves the addition of new directed CME requirements related to self-assessment (“SA-CME”) and performance improvement activities (“PI-CME”) and an extension of the recertification cycle from six to 10 years with a rolling implementation that began in 2014 and will be completely transitioned in 2020.

The first specialty CAQ exams are administered.


NCCPA certifies its 100,000th PA.


PAs begin transitioning to the new recertification process. The PI-CME and SA-CME requirements are later eliminated based on feedback from the PA community.


NCCPA considers modifying the current PANRE model through the addition of a specialty section to test PAs in their specialty practice areas. The idea behind the model is to maintain the generalist PA-C credential and PA flexibility while providing the opportunity for PAs to select assessment content that more directly related to their individual practice areas. Based on feedback from the PA community, this model is not approved by the Board and a new model, the Alternative to PANRE: A Pilot Program (“Pilot Program”), is developed instead.


The PA-C Emeritus designation becomes available to eligible PAs.


The NCCPA Board of Directors approves the Alternative to PANRE Pilot Program. The Pilot allows PAs to answer 25 test questions each quarter for two years.

Later that year, the NCCPA Board of Directors also approves the new PA-C Emeritus designation for PAs who have demonstrated longstanding commitment to the professionalism and standards required of Certified PAs, but who are no longer clinically practicing and do not have the need to be certified any longer.


The NCCPA Board of Directors approves standard settings and the separation of the content blueprints for PANCE and PANRE.


The two distinct content blueprints for PANCE and PANRE begin utilization.

PAs begin taking the Alternative to PANRE Pilot exam.


The Alternative to PANRE Pilot program closes.



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