Hospital Medicine CAQ

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"I feel that the CAQ will finally give me a way to quantify the level of skill and specialized knowledge that I have gained through my physician assistant career.It will also be an easily recognizable way that patients can tell that they are being cared for by a competent individual who has gone out of his-or-her way to prove themselves in their chosen career path.”
     Dimas J. Valentin, PA-C, MPAS

Read why one certified PA earned two CAQs!

Earn a Certificate of Added Qualifications (CAQ) in Hospital Medicine 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.

Key Dates:

You can register for either the Aug. or Sept. CAQ Exam window, but not both, for the same type of CAQ. 

  • Late November 2016 - CAQ exam scores will be available

Introduction and Basic Prerequisites

Physician assistants seeking the Hospital Medicine CAQ must demonstrate they have advanced knowledge and experience in hospital medicine, above and beyond that expected of entry-level PAs or PAs working in a generalist practice. PAs seeking eligibility for the Hospital Medicine Specialty Examination must meet requirements of specialty-specific CME, experience in the field, and specific knowledge and/or experience in 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 Hospital Medicine 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 physician assistant'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.

CME Requirement

In the six years preceding the date of application for the specialty exam, PAs must earn a minimum of 150 credits of Category 1 CME focused on hospital medicine 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 and a CME activity related to risk management. 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 hospital medicine, understanding that those hours may be subject to a CME auditing process.

Upon fulfillment of all CME requirements, candidates will attest to their completion at NCCPA's website.

Experience Requirement

Physician assistants seeking the Hospital Medicine CAQ must have gained at least 3,000 hours of experience (the equivalent of 18 months of full-time practice, primarily involving the management of hospitalized adult patients) 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 hospital medicine, as described below. In support of this 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. The physician attestation must indicate that the PA has performed the patient management relevant to the practice setting and/or understands how and when the appropriate techniques and methods should be applied.

Again, the PA may not have experience with each item, but must be knowledgeable of the basics of the item, in what situation various techniques and methods should be applied, and the associated management of patients.

In determining whether an applicant can satisfy the Patient Case Requirement, consideration should be given to the following areas:

• Paracentesis
• Thoracentesis
• Chest tube placement
• Lumbar puncture
• Ultrasonography
• Intubation
• Arthrocentesis
• Vascular access
• Cardiac testing (includes EKGs, stress)

In addition, the PA must demonstrate an understanding of the following principles of system-base practice in hospital medicine:

• Care of the hospitalized adult patient, including elderly and vulnerable populations
• Communication
• Diagnostic decision making
• Drug safety, pharmacoeconomics and pharmacoepidemiology
• Evidence-based medicine
• Information management
• Leadership
• Management practices

The Hospital Medicine Specialty Exam

The Hospital Medicine CAQ exam scores will be available in late Nov. 

Once PAs have satisfied all other requirements for the Hospital Medicine CAQ, they can apply for the Hospital Medicine Specialty Exam -- 120 multiple-choice questions related to hospital medicine targeted for PAs with experience in the practice of that specialty. It will be based on the Content Blueprint, developed using data gathered during the 2012 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.

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 Hospital Medicine CAQ

The Hospital Medicine 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 Hospital Medicine 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. Those CME credits may also be used to satisfy the CME requirement for maintenance of 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 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.

Regaining a Certificate of Added Qualifications

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.