What to Know About CAQs for Physician Assistants

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January 22, 2024
Certificates of Added Qualifications (CAQs) for physician assistants were developed in 2011, in the hope of providing added distinction for PAs in specialty areas. 
If you’re thinking about getting a CAQ, you probably have some questions about them. In this post, we’ll take a look at some basic information when it comes to getting a CAQ as a physician assistant, so you can decide if it makes sense for you to get one at this point in your career. Here are five things you need to know!

1. CAQ Specialties

Physician assistant CAQs are currently available in the following specialities:

  • Cardiovascular and thoracic surgery
  • Dermatology
  • Emergency medicine
  • Hospital medicine
  • Nephrology
  • Orthopedic surgery
  • Pediatrics
  • Palliative medicine and hospice care
  • Psychiatry
  • OB/GYN

Keep in mind, the specialties available have been increasing, with the newest being OB/GYN added in 2023 and occupational medicine coming in 2025. So if you’re disappointed there isn’t one for your specialty, be sure to keep an eye out for it to join the list!


2. CAQ Eligibility

Work Experience

Eligibility for obtaining a CAQ varies depending on the specialty, so be sure to visit the NCCPA website for clarification on exactly what you need. 

However, for most specialties you need at least 4,000 hours of experience in that specialty, which is two years of full-time work. Some specialties require less, such as palliative medicine and hospice care, as well as OB/GYN, which only require 2,000 hours, so if you’re in one of those specialties you may be eligible sooner than you think. 

In addition, for most specialities an attestation letter is required within 90 days of receiving your CAQ score. This letter should be from a provider that’s familiar with your practice (such as a lead APP or supervising physician) and it needs to attest to your knowledge and skill set in that specialty. The NCCPA provides specific recommendations on what procedural skills and knowledge should be discussed in the attestation letter for a given specialty.

CME Requirements 

Furthermore, there are CME requirements necessary to obtain your CAQ. 

For most specialities this includes a minimum of 75 Category 1 CME credits specific to that specialty obtained within the past six years, with at least 25 of those credits being earned within the last two years. The NCCPA does make it a point to mention these credits can also be used towards maintenance of your PA-C credential, which is very nice. 

It’s important to note these have specifications in certain specialties. For example, if pursuing a CAQ in palliative medicine and hospice care, the CME requirement needs to include an activity on safe opioid prescribing. 

With that, be sure to thoroughly review what’s needed in this regard for your specific specialty. 

CAQ Exam 

Lastly, there’s the requirement of completing your CAQ exam. You can apply to take the exam upon successful completion of the other requirements. 

Exams are administered at Pearson VUE testing centers, and the exam application window opens on January 1 for PAs applying to earn a CAQ. There are deadlines to apply for an exam in both the spring and fall. Be prepared, because missing a deadline would delay your ability to take the exam.

Each specialty requires you to pass a 120-question exam. Luckily, there are content blueprints available through the NCCPA for each specialty that can provide you with guidance on what to review. 

Given that you’ve been working in your specialty for at least one year before taking the exam, you should be prepared. However, you may see content on the blueprint that you don’t come across in your practice every day, so be sure to take a look at it.


3. CAQ Exam Prep

There are many ways to prepare for CAQs outside of traditional book studying and relying on what you pick up in your day-to-day work. One that I highly recommend utilizing is the Rosh Review CAQ Qbanks. These are currently available for the EM, hospital medicine, pediatrics, and psychiatry specialities. 

Not only do Rosh Qbanks provide you with hundreds of questions you can use to prepare for the exam, they also include 100 AMA PRA Category 1 CME credits related to your specialty, which can be utilized towards the CAQ CME requirements. If possible, it’d be beneficial to utilize CME funding provided by your employer to purchase these while preparing for your CAQ exam.


4. CAQ Maintenance 

Overall, there’s definitely a lot of work that goes into obtaining your CAQ from the NCCPA. 

In addition, there’s effort that goes into keeping it. For example, you’ll be expected to take another CAQ exam after ten years to maintain your certificate.

Remember, the CAQ was created to provide recognition for PAs with specialty experience. Without extensive requirements, it would be less of an accomplishment to obtain, so it makes sense there are many steps to receiving and maintaining this designation.


5. CAQ Financial Considerations 

Obtaining a CAQ in any specialty is definitely a personal decision. And of course, it costs money to obtain. There’s a $100 administrative fee to begin the application process, as well as a $250 fee to take the CAQ exam. This doesn’t include the cost of obtaining the required CME.

That said, there are (of course) many benefits to obtaining your CAQ. For starters, there’s the pure recognition of specialization. In addition, acquiring your CAQ can be used to negotiate salary at your current position and when applying for a new job. It can also be a designation that allows you to stand out compared to other candidates.

My Personal Experience

In my case, I’m looking to obtain my CAQ in the CVTS category. I’m hopeful that not only will this constitute an acknowledgement of the skills and knowledge I’ve gained in the specialty, I also anticipate it’ll be something I can use within my organization for leadership opportunities and salary increases.

I do hope to utilize a CME fund provided by the hospital I work for to help obtain the required CME, which I believe will lower any financial burden associated with the exam. With the PA title covering qualifications in any area of medicine, I’m eager for the opportunity to show my dedication and commitment to my specialty by obtaining a CAQ.


Further Reading

If you’re a PA and thinking about getting a CAQ, I hope you found this post useful. Keep in mind the eligibility requirements, CAQ exam prep, what goes into maintaining your certificate, and how getting a CAQ will impact your finances. If you feel like it’s the right thing for you to do, get after it! You’ll have greater expertise and be able to advance your career in exciting new ways. 

Whatever you choose, good luck on your journey. We’re rooting for you!

Looking for more (free!) content to help you with PA professional development? Check out these other posts on the Rosh Review blog:


Rosh Review is the leading Qbank provider for PA programs across the United States. Whether you’re a pre-PA student or PA-C, Rosh Review has something for you along your PA journey. Start a free trial today!

By Olivia Graham, PA-C


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