The Certificate of Added Qualifications (CAQ) - Worth the Investment for PAs?

Physician associates/ physician assistants (PAs) with significant work experience in a medical specialty have unique qualifications to provide care for their practiced patient population and area of medicine. However, the PA degree is one of generalist practice. For some PAs, demonstrating clearer recognition of their efforts in a specific field is a valuable way to promote their skill set and clarify their career identity. To standardize the process of recognizing PAs with advanced skills in specific specialties, the National Commission on Certification of Physician Assistants (NCCPA) created the Certificate of Added Qualifications (CAQ).

NCCPA offers a CAQ for each of the named specialties.

What is the CAQ?

The NCCPA created the CAQ in 2011 as a way to allow PAs to demonstrate advanced expertise in specific medical specialties and subspecialties. The CAQ helps identifies a PA's dedication to ongoing education, advanced training, and experienced care delivery in that specialty. While completely voluntary, approximately 3,220 PAs have opted to earn their CAQ. Per the 2023 NCCPA Statistical Profile, most PAs seek a CAQ in emergency medicine and psychiatry.

How Can I Qualify?

There are pre-requisites to earn the CAQ, which are standard for each PA. To take the CAQ examination, there are several requirements that must be met, and these requirements may differ slightly in each specialty. All PAs must be certified by the NCCPA and have a valid, unrestricted state license.

The pre-requisites to earn a CAQ include:

1. An online examination

   1. Each CAQ examination is comprised of 120 specialty-specific questions. The exam is proctored for two hours. NCCPA publishes a blueprint for study preparation. The examination is offered twice yearly.

2. A letter of attestation

3. Proof of specialty-specific CME

   1. Qualified PAs must have a minimum of 75 credits of Category I CME focused on their desired specialty. All CME credits must have been earned in the last 6 years, with 25 of those credits earned in the last 2 years.

4. Documentation of hours worked in that specialty

   1. Every CAQ specialty requires a minimum number of hours worked in that specialty, varying from 2,000-4,000 hours (about 1-2 years of full-time practice). For certain specialties, there may be specific procedures, skills, and/or competencies that must be verified by a physician, lead advanced practice provider (APP), or residency/ fellowship PA director.

5. A one-time fee

   1. The fees total $350.

Which Specialties Offer a CAQ?

Current CAQs are offered in a variety of specialties. Click the hyperlink to see CME, resources, top employers, and other information by specialty.

1. Cardiovascular and Thoracic Surgery

2. Dermatology

3. Emergency Medicine

4. Geriatric Medicine

5. Hospital Medicine

6. Nephrology

7. OB/GYN

8. Occupational Medicine

9. Orthopedic Surgery

10. Palliative Medicine and Hospice Care

11. Pediatrics

12. Psychiatry

Is It Worth It?

Once you obtain your hard-earned CAQ, it is valid for 10 years. To maintain the qualification, you must earn 125 credits of Category I CME over the next ten years. To learn more about each CAQ, and to see what the specific criteria is required for your preferred specialty, review the information on the NCCPA webpage: Specialty Certificates - NCCPA.

Why jump through all those hoops and pay more money for a voluntary certificate as a PA? It's not for everyone. But more than half of those who have received their CAQ report using the credentials to find a new job, facilitate external credentialing processes, receive a pay increase, and/ or report increased recognition or regard from physicians, colleagues, and patients (Specialty Certificates - NCCPA).

Over 50% of PAs who earn their CAQ say it's worth it.