Earn a Certificate of Added Qualifications (CAQ) in Orthopaedic Surgery to show your advanced expertise in your specialty.
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 health care 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.
Introduction and Prerequisites
PAs 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 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.
PAs 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.
In support of the procedures and patient case requirement, each applicant must provide attestation from a physician, lead/senior PA, or physician/PA post graduate program director who works in the specialty and is familiar with the PAs’ 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, candidates must earn a minimum of 75 credits of Category I CME focused on orthopaedic surgery 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 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 website.
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.
Experience Requirement
PAs 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 physician, lead/senior PA, or physician/PA 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:
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 Specialty Exam
Once PAs have satisfied other requirements for the Orthopaedic Surgery CAQ, they can apply for the Orthopaedic Surgery Specialty Exam — 120 multiple-choice questions related to orthopaedic surgery 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.
Key Dates for Earning a CAQ
All exams for earning the initial CAQ are administered at Pearson VUE Test Centers.
- January 1, 2023 – Exam application window opens for PAs applying to earn a CAQ
- April 3-8, 2023 – Spring administration window for all CAQ exams administered at Pearson VUE Test Centers
- April 6, 2023 – Deadline to apply for a Spring CAQ exam administration at a Pearson VUE Test Center
- September 11-16, 2023 – Fall administration window for all CAQ exams administered at Pearson VUE Test Centers
- September 14, 2023 – Deadline to apply for a Fall CAQ exam administration at a Pearson VUE Test Center
This document 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.
Key Dates for Maintaining a Currently Held CAQ
PAs who are registering to take a CAQ exam to maintain their CAQ may choose to take the exam at a Pearson VUE Test Center or may choose the online delivery option.
Pearson VUE Test Center Delivery Option
- January 1, 2023 – Exam application window opens for PAs applying to earn a CAQ
- April 3-8, 2023 – Spring administration window for all CAQ exams administered at Pearson VUE Test Centers
- April 6, 2023 – Deadline to apply for a Spring CAQ exam administration at a Pearson VUE Test Center
- September 11-16, 2023 – Fall administration window for all CAQ exams administered at Pearson VUE Test Centers
- September 14, 2023 – Deadline to apply for a Fall CAQ exam administration at a Pearson VUE Test Center
Online Delivery Option
- March 17, 2023 – Deadline to apply for the online maintenance exam
- February 13, 2023 – March 25, 2023 – Online maintenance exam administration
Other Policies
Auditing
To ensure the reliability and accuracy of the CAQ and maintenance processes, NCCPA may audit the requirements of PAs 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 PA 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. 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
PAs who lose a CAQ due to the expiration of their PA-C certification may reinstate their CAQ upon regaining their PA-C certification, as long as the original or most recent CAQ expiration date has not passed and the PA meets the licensure/federal privilege requirements for the CAQ program. The CAQ will be reinstated for the period of time remaining in the CAQ maintenance period. PAs who lose a CAQ for any other reason, including NCCPA disciplinary actions, must begin the CAQ process anew by meeting the eligibility requirements for initial CAQs, including passing the CAQ examination, or may seek a reinstatement of their CAQ when they regain certification by filing a request for an exception to policy, as long as the CAQ expiration date has not passed and the PAs meets the licensure/federal privilege requirements for the CAQ program.