CAQ-OS - CAQ in Orthopaedic Surgery

The National Commission on Certification of Physician Assistants (NCCPA) is accredited by the National Commission for Certifying Agencies (NCCA) to offer Certificates of Added Qualifications (CAQ) in 7 specialty categories to qualifying Physician Assistants. Only PAs currently certified by the NCCPA with a PA-C designation qualify for CAQs. The Certificates of Added Qualifications in Orthopaedic Surgery (CAQ-OS) certifies PAs with advanced knowledge in orthopaedic surgery beyond the expectations of entry-level or general practice PAs.

Exam Format

The CAQ-OS exam includes 120 multiple-choice questions related to orthopaedic surgery and targeted for PAs with experience in this specialty. The Orthopaedic Surgery CAQ exam blueprint includes:

• Fractures and Dislocations - 25%

• Soft-Tissue Injuries and Disorders - 25%

• Joint Disorders - 20%

• Preoperative, Postoperative, and Complication Management - 7%

• Spine - 7%

• Benign and Malignant Bone Tumors - 5%

• Infectious Diseases and Connective Tissue Disorders - 5%

• Pediatric - 4%

• Trauma - 2%

Pearson VUE administers the CAQ-OS exam in two 60-question blocks. Candidates may answer the questions in any order and review or change responses during the allotted block time. Once finished with a block or the time expires, candidates can’t return to or review the questions.

Candidates who fail the CAQ-OS exam may apply to retest but must meet the CAQ eligibility requirements when reapplying.

• Completion Time: Candidates have 2 hours to complete the CAQ-OS exam, 60 minutes for each 60-question block

• Cost: $350 total, includes $100 registration fee and $250 exam fee / $250 exam retesting fee if still within the six-year eligibility period for completing the CAQ

Exam Scoring

Candidates receive their exam score after NCCPA completes all scoring and validation processes, approximately 8 to 10 weeks after exam administration. NCCPA notifies PAs via email when exam results post to their personal certification record. PAs may request NCCPA to mail a printed copy of their exam scores to their address on file.

Candidates who don’t pass the exam may reapply for the next exam administration. There’s no limit to the number of times PAs may attempt the exam, but they must pass the exam within 6 years of starting the CAQ process or must start the process over.

For more detailed information, review the CAQ Exam Policies and Procedures.

PAs seeking eligibility for CAQ-OS must demonstrate they have advanced knowledge and experience in orthopaedic surgery. They must meet specialty-specific CME and field experience requirements. Once they meet these requirements and initiate the certification process by submitting the $100 administrative fee, they must complete the CAQ process within six years. The process has four components, including passing the CAQ-OS exam.

Eligibility

Prerequisites

• Current PA-C certification

• Valid, unrestricted PA license in at least one U.S. jurisdiction

  • All PA licenses must be unrestricted if PA has multiple licenses

• Attestation from a physician, senior PA, or post graduate program director familiar with the PA’s practice and experience

Specialty CME Requirement

• Complete at least 75 credits of Category 1 Continuing Medical Education credits related to orthopaedic surgery within the six years before applying for the exam.

  • At least 25 CMEs must be earned within the two years before the application date

  • CME credits may also be used to maintain PA-C credential

Specialty Experience Requirement

• Complete at least 4,000 hours of PA experience in orthopaedic surgery within six years of the date they attested that they satisfied the experience requirement.

  • Candidates must provide documentation substantiating their work experience if selected for an audit

Specialty Procedure/Patient Case Requirement

Provide attestation from a physician, senior/lead PA, or post graduate program director in orthopaedic surgery who’s familiar with the candidate’s knowledge and experience. Attestations must be submitted within 90 days of the candidate receiving their CAQ score.

To determine whether candidates satisfy the Specialty Procedures and Patient Case Requirement, they must be knowledgeable of the basics in the following areas:

• Anesthesia

  • Local anesthesia, including digital block

  • Procedural anesthesia, conscious sedation

  • Regional anesthesia

• Advanced Wound Management

  • Superficial and deep wound closure

  • Wound debridement, incision, and drainage

  • Wound vac and drain placement and removal

  • Tendon repair

  • K-wire and hardware removal

• Measurement and Management of Compartment Pressure

• Diagnostic and Therapeutic Needle Aspiration/Injections

  • Joints, tendons, cysts, bursa, and trigger points

  • Needle biopsy

• Diagnostic Radiography and Other Modalities

  • Proper skeletal radiograph positioning and techniques

  • Skeletal and soft tissue radiography interpretation

  • CT scan and MRI interpretation

  • Electromyography interpretation

• Management of Fractures and Dislocation

  • Universal hip and shoulder reduction and relocation

  • Casts, braces, splints, and appliances application

  • Skeletal and skin traction application

  • Percutaneous pinning of fractures

• Operative and Perioperative Care

  • Preoperative consultation and evaluation

  • First surgical assist

  • Postoperative care and management

• Common Orthopaedic Complications and Conditions Prevention, Recognition, and Management

  • Pulmonary embolization

  • Deep venous thrombosis

  • Osteomyelitis

  • Osteoporosis

Once candidates satisfy the prerequisites, they may submit their $100 registration fee to begin the CAQ process. They have six years to submit documents, sign the attestation statement, and finish all requirements to sit for the CAQ-OS exam. When they apply for the CAQ exam, they pay the $250 exam fee.

The CAQ-OS certification is valid for 10 years. To maintain their CAQ, candidates must: 

• Hold a current, valid, unrestricted, and unencumbered PA-C certification

• Submit required information for any state licenses or governmental agency privileges

• Pass the CAQ-OS exam within three attempts before current certification expires

  • Renewal candidates who don’t pass after the third attempt must meet initial eligibility requirements and reapply to test as an initial candidate during the next exam administration

• Earn at least 125 credits of Category 1 orthopaedic surgery-based CME within the current 10-year cycle

Renewal Fee: $350 every 10 years

CAQ-certified PAs must earn and log at least 125 credits of Category 1 orthopaedic surgery-based CME over each 10-year certification period. These credits also satisfy PA-C certification requirements. PAs may submit their CME credits before or during their exam application. Recommended CME topics for CAQ-OS candidates include those focused in orthopaedic surgery at the level appropriate for a PA practicing in this specialty and the Advanced Cardiac Life Support (ACLS) course.

• The NCCPA offers sample questions to help PAs understand the exam question structure.

• NCCPA offers 60-question CAQ-OS practice exams. Each exam is available for 180-days and costs $50. PAs can only take the exam once but may repurchase practice exams as many times as they want.

To qualify for the CAQ-Neph, applicants must be Physician Assistant - Certified. Earning the  PA-C designation requires passing the NCCPA Physician Assistant National Certifying Examination (PANCE).

NCCPA also offers CAQ certifications in:

• Psychiatry (CAQ-Psy)

• Pediatrics (CAQ-Peds)

• Nephrology (CAQ-Neph)

• Hospital Medicine (CAQ-HM)

• Emergency Medicine (CAQ-EM)

• Dermatology (CAQ-Derm)

• Cardiovascular and Thoracic Surgery (CAQ-CVTS)

• Palliative Medicine and Hospice Care (CAQ-PMHC)