Looking to stand out? NCCPA offers the Certificate of Added Qualifications (CAQ) in ten specialties.

Certificates of Added Qualifications (CAQs)

What are CAQs?

The CAQ is a voluntary credential that Certified PAs can earn in the following specialties: Cardiovascular & Thoracic Surgery, Dermatology, Emergency Medicine, Hospital Medicine, Nephrology, Obstetrics and Gynecology (Coming in late 2023), Orthopaedic Surgery, Palliative Medicine and Hospice Care, Pediatrics and Psychiatry.

CAQ Specialties

“As a PA 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, CAQ-CVTS, FAPACVS

Cardiovascular and Thoracic Surgery (CVTS) CAQ

Earn a Certificate of Added Qualifications (CAQ) in Cardiovascular and Thoracic Surgery (CVTS) 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 Cardiovascular and 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 and 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 and 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 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, PAs must earn a minimum of 75 credits of Category I 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 and 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:

PA 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.

Experience Requirement

PAs seeking the Cardiovascular and 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 PA, or physician/PA 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:

Anesthesia

• 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

Resuscitation

• Cardiopulmonary

The Cardiovascular and Thoracic Surgery Specialty Exam

Once PAs have satisfied other requirements for the Cardiovascular and 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.

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 Cardiovascular and Thoracic Surgery CAQ

The Cardiovascular and 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 I CME focused on the specialty. The same 125 credits may also be logged to maintain 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 PA Disciplinary Matters

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 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 PA Disciplinary Matters

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 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.

Dermatology CAQ

Be among the first to earn a Certificate of Added Qualifications in Dermatology and demonstrate your knowledge and expertise in your specialty! Registration for this new CAQ will begin in 2022 and the first CAQs will be issued in 2023 for the inaugural group of PAs who pass the CAQ exam.

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? Read more about the requirements below.

Introduction and Prerequisites

PAs who work in dermatology and wish to earn the Dermatology CAQ must demonstrate they have knowledge and experience in dermatology, above and beyond that expected of entry-level PAs or experienced PAs who are new to this specialty. The CAQ designation provides an objective measure of knowledge and expertise for the PA practicing in dermatology. Earning this credential demonstrates a commitment to the specialty and supports the concept of progressively enhanced scope of practice which has been a tradition in the PA profession. It may increase employability, respect among peers and open doors for career advancement, and increase patients’ confidence in the dermatology PA’s qualifications.

PAs seeking the Dermatology CAQ must 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 addition to these prerequisites, PAs must have specialty-specific CME, experience in the field, and pass a Dermatology CAQ exam. 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. Beginning in July 2022, PAs can begin the Dermatology CAQ process by submitting at least one of the non-exam components and the $100 administrative fee and then will have six years to complete all requirements for earning the CAQ, including passing the specialty exam. More detailed policy information is available here.

 

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 I CME focused on dermatology, with a minimum of 25 of those credits having been earned within two years prior to the date of exam application. The 75 credits CME credits must include successful completion of a dermoscopy course for a minimum of 5 credits. The CME credits used for earning a CAQ may also be used for maintaining the PA-C credential.

Recommendations for CME Activities:

Other than the required CME activity listed above, it is recommended that PAs complete a comprehensive CME program in dermatology

How do you know if CME activities are related to dermatology? 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.

Experience Requirement

PAs seeking the Dermatology CAQ must document a minimum of 4,000 hours of experience (the equivalent of two years of full-time practice) working in the dermatology specialty within six years of the date they provide their attestation to NCCPA. If selected for an audit, documentation substantiating that work experience will be required. Although not required by NCCPA, it may be beneficial for PAs to create a log of knowledge, skills, and patient management experiences.

Procedures/Patient Case Requirement

PAs applying for the Dermatology CAQ must be able to apply the appropriate knowledge and skills needed for practice in dermatology. In support of this requirement, candidates must provide an attestation from a collaborating physician, senior/lead PA, or physician/PA post graduate program director who works in the specialty and is familiar with the candidate’s practice and experience. The attestation may be submitted before taking the exam or no later than 90 days after NCCPA has notified the applicant that exam results have been released.

The attestation indicates that the PA has demonstrated the knowledge and skills that are relevant to their practice and/or understands how and when the knowledge and skills should be applied for appropriate patient management. The list of knowledge, procedures, and skills for the Dermatology CAQ attestation includes the following:

  • Administering local anesthesia
  • Applying Unna boot
  • Interpreting pathology reports
  • Performing:
    • bacterial/viral/fungal cultures
    • biopsies (shave, punch, excisional)
    • complete skin exams
    • cryosurgery
    • dermoscopy
    • electrodessication and curettage
    • I&D
    • intralesional, intramuscular injections
    • microscopy
    • patch testing
    • surgical excisions
    • Wood’s lamp evaluation
  • Understanding:
    • appropriate use of imaging studies
    • chemical peels
    • complications of dermatologic procedures
    • laser procedures
    • Mohs appropriate use criteria
    • narrow band UV therapy
    • suture techniques
    • principles of wound care

Exam Requirement 

Once PAs have satisfied other requirements for the Dermatology CAQ, they are eligible to apply for the Dermatology CAQ Exam. The inaugural administration of the Dermatology CAQ exam will be offered nationwide beginning the Spring of 2023 at Pearson VUE testing centers. This exam will consist of 120-multiple choice questions related to dermatology topics and targeted for PAs with two years of dermatology experience. It is based on the Content Blueprint.

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  document will be helpful to those preparing for this exam as well.

Maintaining the Dermatology CAQ

The Dermatology CAQ 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 Dermatology CAQ Exam 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. The same 125 credits may also be logged to maintain the PA-C credential.

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

PAs who lose eligibility for a CAQ after submitting the application and fee 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 forfeits all fees.

Exam Results

Results 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 results, the exam results 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 PA meets the licensure/federal privilege requirements for the CAQ program.

“The CAQ acknowledges the skills and years of experience I have in my area of medical practice. It lets others know that I have been formally reviewed and tested in this field and have passed those requirements to carry a CAQ in my specialty.”


– Stuart Richards, PA-C, CAQ-EM

Emergency Medicine CAQ

Earn a Certificate of Added Qualifications (CAQ) in Emergency Medicine 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 Emergency Medicine CAQ must demonstrate they have advanced knowledge and experience in emergency medicine, above and beyond that expected of entry-level PAs or PAs working in a generalist practice. PAs seeking eligibility for the Emergency Medicine 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 Emergency 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.

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 emergency medicine 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 emergency medicine, 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 emergency medicine leaders provided input in developing the following CME recommendations for PAs interested in pursuing a CAQ in that specialty.

Applicants should complete a comprehensive emergency medicine course that reflects the guidelines set forth in the most current version of Model of the Clinical Practice of Emergency Medicine. Applicants should also complete the following courses:

• Pediatric Advanced Life Support or Advanced Pediatric Life Support
• Advanced Trauma Life Support
• Airway course

Experience Requirement

PAs seeking the Emergency Medicine CAQ must have gained at least 3,000 hours of experience (the equivalent of 18 months of full-time practice) working as a PA in emergency medicine 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 the specialty, 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 a PA can satisfy the Specialty Procedures and Patient Case Requirement, consideration should be given to the following areas:

Airway Adjuncts: Invasive Airway Management

• Intubation
• Mechanical ventilation
• Capnometry
• Non-invasive ventilatory management

Anesthesia

• Local, digital
• Procedural anesthesia, conscious sedation

Advanced Wound Management

• Incision & drainage, wound debridement
• Superficial/deep wound closure

Diagnostic/Therapeutic Procedures

• Soft tissue and joint aspiration
• Lumbar puncture
• Slit lamp examination
• Thoracentesis, thoracostomy
• Tonometry
• Control of epistaxis
• Electrocardiographic interpretation
• Cardiac pacing
• Defibrillation/cardioversion
• Clearing a cervical spine
• Fracture/dislocation management

Hemodynamic Techniques

• Peripheral venous access
• Arterial access for diagnostics and placement of arterial lines
• Central venous access
• Intraosseous infusion

Radiographic Interpretation

• Chest x-ray
• Plain films (bone, soft tissues, abdominal series, etc.)
• CT scans, MRIs

Resuscitation

• Cardiopulmonary
• Fluid

The Emergency Medicine Specialty Exam

Once PAs have satisfied other requirements for the Emergency Medicine CAQ, they can apply for the Emergency Medicine Specialty Exam — 120 multiple-choice questions related to emergency 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 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
  • May 14-15, 2023 – Administration window for SEMPA 2023
  • May 13, 2023 – Deadline to apply for SEMPA 2023
  • 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 Emergency Medicine CAQ

The Emergency 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 Emergency Medicine 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.

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 PA 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, CAQ-HM, MPAS

Hospital Medicine CAQ

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

Introduction and Prerequisites 

PAs 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 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 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.

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, PAs must earn a minimum of 75 credits of Category I CME focused on hospital medicine practice with a minimum of 25 of those credits having been earned within the two years prior to the date of exam application. The 75 required CME credits must include an activity related to risk management. 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 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

PAs 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 belowIn support of this 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 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 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

Once PAs have satisfied 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 2012-2015 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 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 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 beginning in January 2023.

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.

“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, CAQ-Neph

Nephrology CAQ

Earn a Certificate of Added Qualifications (CAQ) in Nephrology 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 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.

PAs 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 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, PAs must earn a minimum of 75 credits of Category I 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

PAs 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 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:

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.


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 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 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.

I have been promoted and given higher pay and more responsibility since earning a CAQ.

-Mark Wright, PA-C, CAQ-OS

Orthopaedic Surgery CAQ

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 belowIn 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.

“I feel having a CAQ in pediatrics is a testament to my commitment to the  field, my fellow physicians and patients I work with on a daily basis. I feel it is  important as a PA to show my interest and dedication in  pursuing my education in pediatrics and the Pediatrics CAQ is the perfect opportunity.”

-Lauren Donaldson, PA-C, CAQ-Peds

Pediatrics CAQ

Earn a Certificate of Added Qualifications (CAQ) in Pediatrics 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.

Introduction and Prerequisites

PAs seeking the Pediatrics CAQ must demonstrate they have advanced knowledge and experience in pediatrics, above and beyond that expected of entry-level PAs or PAs working in a generalist practice. PAs seeking eligibility for the Pediatrics 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 Pediatrics 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, PAs must earn a minimum of 75 credits of Category I CME focused on pediatric 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 pediatrics, 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

PAs seeking the Pediatrics 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 pediatrics, as described belowIn support of this 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 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 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:

  • history taking and physical examination appropriate for infants, children and adolescents
  • preventive health counseling
  • preoperative management
  • postoperative management
  • intravenous medication administration
  • lumbar puncture
  • venipuncture
  • endotracheal intubation
  • central line insertion
  • peripheral intravenous catheter placement
  • incision and drainage of an abscess
  • simple laceration repair
  • bladder catheterization
  • foreign body removal
  • tympanography
  • spirometry
  • hearing and vision screening
  • circumcision
  • splinting
  • casting
  • adolescent medicine, including gynecological exams and testicular exams
  • wound and burn care

The Pediatrics Specialty Exam

Once PAs have satisfied other requirements for the Pediatrics CAQ, they can apply for the Pediatrics Specialty Exam — 120 multiple-choice questions related to pediatrics 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 2012-2015 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 Pediatrics CAQ

The Pediatrics 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 Pediatrics 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 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 beginning in January 2023.

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.

Palliative Medicine and Hospice Care (PMHC) CAQ

Be among the first to earn a Certificate of Added Qualifications in Palliative Medicine and Hospice Care (PMHC) and demonstrate your knowledge and expertise in your specialty! Registration for this new CAQ will begin in 2022 and the first CAQs will be issued in 2023 for the inaugural group of PAs who pass the CAQ exam.

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? Read more about the requirements below.

Introduction and Prerequisites

Palliative medicine and hospice care focus on the physical, psycho-social, cultural, and spiritual aspects of serious illness. Palliative care is person/family-centered, aligning a person’s values to possible treatments and interventions with the goal to relieve suffering. Through early integration of service, an effort is made to improve quality of life, for the patient and their family.

The Palliative Medicine and Hospice Care (PMHC) CAQ program is applicable to all PAs who practice in diverse specialties such as palliative medicine and hospice care, critical care, emergency medicine, family medicine, general internal medicine, general pediatrics, geriatrics, hospital medicine, nephrology, neurology, oncology, etc. and in a wide range of settings, such as private practices, health systems medical groups, cancer centers, dialysis centers, hospitals, long-term care facilities, and hospices may routinely rely on palliative care skills and knowledge in caring for their patients.

PAs who wish to earn the Palliative Medicine and Hospice Care CAQ must demonstrate they have knowledge and experience in palliative medicine and hospice care, above and beyond that expected of entry-level PAs or experienced PAs who are new to this area of care. Earning a PMHC CAQ will help PAs who want to document their experience and knowledge and/or who are required to have such a credential for privileges or reimbursement in this specialty area.

PAs seeking the PMHC CAQ must 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 addition to these prerequisites, PAs must have specialty-specific CME, experience in the field, and pass a PMHC CAQ exam. 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. Beginning in July 2022, PAs can begin the PMHC CAQ process by submitting at least one of the non-exam components and the $100 administrative fee and then will have six years to complete all requirements for earning the CAQ, including passing the specialty exam. More detailed policy information is available here.

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 I CME focused on palliative medicine and hospice care, with a minimum of 25 of those credits having been earned within two years prior to the date of exam application. The 75 credits CME credits must include an activity related to the safe and effective prescribing of opioids, and the CME credits used for earning a CAQ may also be used for maintaining the PA-C credential.

Recommendations for CME Activities:

PA and physician leaders working in palliative medicine and hospice care provided input in developing the following recommendations for CME activities for PAs interested in pursuing the Palliative Medicine and Hospice Care CAQ:

 

  • Advanced Care Planning
  • CME sessions offered by palliative medicine and hospice care organizations
  • Certificate courses, graduate level courses, fellowship programs, etc.

 

How do you know if CME activities are related to palliative medicine and hospice care? 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.

Experience Requirement

PAs seeking the Palliative Medicine and Hospice Care CAQ must document a minimum of 2,000 hours of experience (the equivalent of one year of full-time practice) providing palliative medicine and/or hospice care to patients with serious and life-threatening illnesses and advanced/serious chronic health within six years of the date they provide their attestation to NCCPA. If selected for an audit, documentation substantiating that work experience will be required. Although not required by NCCPA, it may be beneficial for PAs to create a log of knowledge, skills, and patient management experiences.

Procedures/Patient Case Requirement

PAs must be able to apply the appropriate knowledge and skills needed for practice in the Palliative Medicine and Hospice Care, as described below. You will need to provide an attestation from a physician, lead/senior PA, or physician/PA post graduate program director who works in the specialty and is familiar with your practice and experience. You may provide this before the exam or within 90 days after NCCPA provides notification that exam results have been released. The attestation of knowledge and skills must indicate that the PA has demonstrated the knowledge and skills relevant to their practice and/or understands how and when the knowledge and skills should be applied for appropriate patient management:

  • Caring for the physical, psycho-social, cultural, and spiritual aspects of serious illness
  • Providing pain and symptom management of serious illness to sustain comfort and function when possible and support quality of life
  • Providing care in the context of formal or informal interdisciplinary teams to focus on the overall well-being of the patient (including non-physical domains of care), recognizing and facilitating necessary referrals as indicated
  • Providing care for the patient and family in preparation for an anticipated death and in the management of the death event
  • Demonstrated communication skills in caring for patients with serious illness and their families/caregivers
  • Implementing a shared decision-making process with the patient to align current medical options for treatments and interventions with their values and preferences
  • Assessing and supporting caregiver needs and coordination of care
  • Assisting and guiding discussions with patients and their families in advance care planning and completing necessary documents
  • Demonstrating knowledge of hospice care as an insurance benefit, hospice eligibility requirements and services provided

In addition, the PA should demonstrate an understanding of the principles of system-based practice, to include risk management.

Exam Requirement 

Once PAs have satisfied other requirements for the Palliative Medicine and Hospice Care CAQ, they are eligible to apply for the PMHC CAQ exam. The inaugural administration of the PMHC CAQ exam will be offered nationwide beginning the Spring of 2023 at Pearson VUE testing centers. This exam will consist of 120-multiple-choice questions related to palliative medicine and hospice care and targeted for PAs with experience in this area.

The Content Blueprint for the PHMC CAQ exam can be found 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  document will be helpful to those preparing for this exam as well.

Maintaining the Palliative Medicine and Hospice Care CAQ

The Palliative Medicine and Hospice Care CAQ 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 PMHC CAQ Exam 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. The same 125 credits may also be logged to maintain the PA-C credential.

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

PAs who lose eligibility for a CAQ after submitting the application and fee 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 forfeits all fees.

Exam Results

Results 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 results, the exam results 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 PA meets the licensure/federal privilege requirements for the CAQ program

Psychiatry CAQ

Earn a Certificate of Added Qualifications (CAQ) in Psychiatry 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 Psychiatry CAQ must demonstrate they have advanced knowledge and experience in psychiatry, above and beyond that expected of entry-level PAs or PAs working in a generalist practice. PAs seeking eligibility for the Psychiatry 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 Psychiatry 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, PAs must earn a minimum of 75 credits of Category I CME focused on psychiatry 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 psychiatry, 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.

Recommendations for CME Activities:
Physician and PA psychiatry 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 psychiatry and at the level appropriate for a PA practicing in the specialty.

Experience Requirement

PAs seeking the Psychiatry CAQ must have gained at least 2,000 hours of experience (the equivalent of one year 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 psychiatry, as described belowIn support of this 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 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 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 psychiatrist-observed patient case management across a broad range of psychopathology and appropriate treatments that include the following elements of psychiatric patient care and disorders (as appropriate given the applicant’s practice setting and area of focus):

  • Psychiatric interview, differential diagnosis and treatment plan
    • Psychiatric pharmacology
    • Treatment implementation/intervention
    • Crisis intervention/risk management
    • Ethical & legal issues

Disorders:

• Mood disorders
• Psychotic disorders
• Substance-related disorders
• Anxiety disorders
• Personality disorders
• Delirium, dementia, and cognitive disorders
• Life cycle and adjustment disorders
• Childhood disorders that persist into adolescence and adulthood
• Somatoform and factitious disorders
• Eating disorders
• Sexual and gender identity disorders
• Dissociative disorders
• Impulse control disorders not elsewhere classified
• Sleep disorders
• Ethics and forensic issues

The Psychiatry Specialty Exam

Once PAs have satisfied other requirements for the Psychiatry CAQ, they can apply for the Psychiatry Specialty Exam — 120 multiple-choice questions related to psychiatry 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, 2023 – Administration window for Psych Congress 2023
  • September 8, 2023 – Deadline to apply for Psych Congress 2023
  • 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  document will be helpful to those preparing for this exam as well.

Maintaining the Psychiatry CAQ

The Psychiatry 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 Psychiatry 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 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.

Obstetrics and Gynecology (OBGYN) CAQ

Be among the first to earn a Certificate of Added Qualifications in Obstetrics and Gynecology and demonstrate your knowledge and expertise in your specialty! Registration for this new CAQ will begin in 2023 and the first CAQs will be issued in 2024 for the inaugural group of PAs who pass the CAQ exam.

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

  • Over 75% found or anticipated 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 for health care and the well-being of your patients.

Still unsure? Read more about the requirements below.

Introduction and Prerequisites

PAs seeking the Obstetrics and Gynecology CAQ must demonstrate they have knowledge and experience in obstetrics and gynecology, above and beyond that expected of entry-level PAs or experienced PAs who are new to this specialty. The CAQ designation provides an objective measure of knowledge and expertise for the PA practicing in obstetrics and gynecology. Earning this credential demonstrates a commitment to the specialty and supports the concept of progressively enhanced scope of practice which has been a tradition in the PA profession. It may increase employability, respect among peers and open doors for career advancement, and increase patients’ confidence in PA’s qualifications.

PAs seeking the Obstetrics and Gynecology CAQ must 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 the licenses must be unrestricted.) The licensure prerequisite is addressed more fully here.

In addition to these prerequisites, PAs must have specialty-specific CME, experience in the field, and pass an Obstetrics and Gynecology CAQ exam. 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 PA’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. Beginning in July 2023, PAs can begin the OBGYN CAQ process by submitting at least one of the non-exam components and the $100 administrative fee and then will have six years to complete all requirements for earning the CAQ, including passing the specialty exam. More detailed policy information is available here.

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 I CME focused on obstetrics and gynecology, with a minimum of 25 of those credits having been earned within two years prior to the date of exam application. The same 75 credits may also be used for maintenance of the PA-C credential.

Recommendations for CME Activities:

It is recommended that PAs choose a variety of CME activities that cover the breadth and depth of obstetrical and gynecological medical, surgery, and preventive practice throughout the lifespan.

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

Experience Requirement

PAs seeking the Obstetrics and Gynecology CAQ must document a minimum of 2,000 hours (the equivalent of one year of full-time experience) of practice providing obstetrical and gynecologic care.

Procedures/Patient Case Requirement

PAs must be able to apply the appropriate knowledge and skills needed for practice in Obstetrics and Gynecologic care, as described below. You will need to provide an attestation from a physician, lead/senior PA, or physician/PA post graduate program director who works in the specialty and is familiar with your practice and experience. You may provide this before the exam or within 90 days after NCCPA provides notification that exam results have been released. The attestation of knowledge and skills must indicate that the PA has demonstrated the knowledge and skills relevant to their practice and/or understands how and when the knowledge and skills should be applied for appropriate patient management:

Exam Requirement 

Once PAs have satisfied other requirements for the Obstetrics and Gynecology CAQ, they are eligible to apply for the OBGYN CAQ Exam. The inaugural administration of the OBGYN CAQ exam will be offered nationwide beginning the Spring of 2024 at Pearson VUE testing centers. This exam will consist of 120 multiple-choice questions related to obstetrics and gynecologic topics and targeted for PAs with one year of OBGYN experience. It is based on the Content Blueprint.

This What to Expect on Test Day  document will be helpful to those preparing for this exam as well.

Maintaining the Obstetrics and Gynecology CAQ

The Obstetrics and Gynecology CAQ 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 OBGYN CAQ Exam 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. The same 125 credits may also be logged to maintain the PA-C credential.

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

PAs who lose eligibility for a CAQ after submitting the application and fee 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 forfeits all fees.

Exam Results

Results 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 results, the exam results 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 PA meets the licensure/federal privilege requirements for the CAQ program.

Specialty Certificates Resources