Nephrology CAQ

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 "I have worked in nephrology for my entire PA career, and I feel that the  CAQ program is an opportunity for me to gain recognition in my field." 
     Barbara L., PA-C

Read why one certified PA earned two CAQs!

Earn a Certificate of Added Qualifications (CAQ) in Nephrology 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, 2020 - Exam application registration opens for the Nephrology CAQ Exam

  • April 3, 2020 - Deadline to apply for an April CAQ Exam (Keep in mind if you wait to apply, there might not be any availability at the testing centers.)

  • April 6-11, 2020 - First exam window for the Nephrology CAQ Exam (Apply and schedule your CAQ Exam early to improve the likelihood of a convenient testing location.)

  • September 11, 2020 - Deadline to apply for a September CAQ Exam (Keep in mind if you wait to apply, there might not be any availability at the testing centers.)

  • September 14-19, 2020 - Second exam window for the Nephrology CAQ Exam (Apply and schedule your CAQ Exam early to improve the likelihood of a convenient testing location.)

Introduction and Basic Prerequisites

Physician assistants seeking the Nephrology CAQ must demonstrate they have advanced knowledge and experience in nephrology, above and beyond that expected of entry-level PAs or PAs working in a generalist practice. PAs seeking eligibility for the Nephrology Specialty Examination must meet requirements of specialty-specific CME and experience in the field. 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 Nephrology 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.s.

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 nephrology practice with a minimum of 25 of those credits having been earned within the two years prior to the date of exam application. The same 75 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 nephrology, 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 website.

Recommendations for CME Activities
Physician and PA nephrology leaders provided input in developing the following CME recommendations for PAs interested in pursuing a CAQ in that specialty.

PAs should complete CME activities that encompass knowledge of the evaluation of the kidney function, urinalysis, radiological assessment of renal disease, the kidney in systemic disease, chronic kidney disease, peritoneal dialysis, hemodialysis, medications and the kidney, the kidney in special circumstances (i.e., pediatric patients, pregnancy, and/or aging), hypertension, billing and coding, and kidney transplantation.

Experience Requirement

Physician assistants seeking the Nephrology CAQ must have gained at least 4,000 hours of experience (the equivalent of two years of full-time practice) working as a PA, including at least 2,000 hours (the equivalent of one year of full-time practice) in nephrology 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 nephrology, as described below. In support of this requirement, each candidate 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 PA’s practice and experience within 90 days after they receive their 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.

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:

Case Management of Patients in One of the Following Nephrology Subspecialties:

• End stage renal disease
• Chronic kidney disease
• Kidney transplantation
• Hospitalist care involving acute dialytic therapy

Diagnosis & Management of:

• Hypertension (primary & secondary)
• Anemia
• Volume management
• Complications of dialysis
• Metabolic bone disease
• Adjustment of medication doses to GFR
• Medication management in patients with compromised renal function
• Vascular access management/complications in hemodialysis
• Nutritional management
• Uremia
• Catheter infections/malfunction
• Vascular access preparation and placement
• Peritoneal dialysis catheter placement
• Acute dialytic therapy
• Assessment/care/management of kidney donors and recipients pre- and post-transplant
• Collection/examination/interpretation of urine specimen

The Nephrology Specialty Exam

Once PAs have satisfied other requirements for the Nephrology CAQ, they can  apply for the Nephrology Specialty Exam -- 120 multiple-choice questions related to nephrology 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 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 Nephrology 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 Nephrology CAQ

The Nephrology 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 Nephrology Specialty Exam before the expiration of the current CAQ, an -- 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.