CAQ-PMHC - CAQ in Palliative Medicine and Hospice Care

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 Certificate of Added Qualifications in Palliative Medicine and Hospice (CAQ-PMHC) certifies PAs with advanced knowledge in palliative medicine and hospice care focusing on the physical, cultural, psychosocial, and spiritual elements of serious illness. Candidates must demonstrate they have knowledge and experience in palliative medicine and hospice care beyond the expectations of entry-level PAs or experienced PAs new to this area of care.

The CAQ-PHMC applies to PAs working in diverse specialties, including palliative medicine, hospice care, emergency medicine, critical care, family medicine, pediatrics, geriatrics, internal medicine, hospital medicine, neurology, oncology, and nephrology, among others.

Exam Format

The CAQ-PMHC exam includes 120 multiple-choice questions related to palliative medicine and hospice care and targeted for PAs with experience in this specialty. The Palliative Medicine and Hospice Care CAQ exam blueprint includes:

Task Categories

• Managing suffering and distress - 40%

• Whole patient assessment - 20%

• Prognostication and natural history of severe and complex illness - 10%

• Managing medical interventions - 7%

• Ethical and legal aspects of care - 5%

• Safety and risk management - 4%

• Grief, loss, bereavement - 3%

• Impending death and death event - 3%

• Interdisciplinary teamwork, quality, and professionalism - 3%

• Managing palliative care emergencies and refractory symptoms - 3%

• Communication skills - 2%

Medical Content Categories

• Cardiovascular system - 12%

• Gastrointestinal system and nutrition - 12%

• Genitourinary and reproductive systems, male and female - 12%

• Neurologic system - 12%

• Pulmonary system - 12%

• Infectious diseases - 10%

• Eyes, ears, nose, and throat - 5%

• Hematologic system - 5%

• Musculoskeletal system - 5%

• Psychiatry and behavioral science - 5%

• Renal system - 5%

• Traumatic injuries - 3%

• Dermatologic system - 2%

Pearson VUE administers the CAQ-PMHC 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-PMHC exam may apply to retest but must meet the CAQ eligibility requirements when reapplying.

• Completion Time: Candidates have 2 hours to complete the CAQ-PMHC 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-PMHC must demonstrate they have advanced knowledge and experience in palliative medicine and hospice care. 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-PMHC 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 palliative medicine and hospice care within the six years before applying for the exam.

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

  • Must include an activity related to the safe and effective prescribing of opioids

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

Specialty Experience Requirement

• Complete at least 2,000 hours of experience providing palliative medicine and/or hospice care to patients with life-threatening illnesses and advanced chronic health 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 palliative medicine and hospice care who’s familiar with the candidate’s knowledge and experience. Attestations must be submitted within 90 days of the candidate receiving their CAQ score.

Attestations must indicate that the PA has demonstrated the knowledge and skills relevant to palliative medicine and hospice care and/or understands how/when their knowledge and skills should be applied for appropriate patient management, including:

• Tending the physical, cultural, psychosocial, and spiritual elements of serious illnesses

• Providing pain and symptom management to support quality of life and promote comfort and function

• Providing care within formal or informal interdisciplinary teams to focus on the overall well-being of the patient

• Guiding discussions with patients and families in advance care planning

• Assisting with the completion of necessary documents

• Providing patient and family care in preparation for the anticipated death

• Managing the death event

• Demonstrating communication skills while caring for seriously ill patients

• Implementing a shared-decision making process to align medical treatments and intervention options with patients’ values and preferences

• Assessing and supporting caregiver needs and care coordination

• Demonstrating knowledge of hospice eligibility requirements, provided services, and hospice care as an insurance benefit

• Demonstrating an understanding of the principles of system-based practice, including risk management

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-PMHC exam. When they apply for the CAQ exam, they pay the $250 exam fee.

The CAQ-PMHC 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 CME related to palliative medicine and hospice care 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 palliative medicine and hospice care-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-PMHC candidates include:

• Advanced care planning

• Palliative medicine and hospice care organizations’ CME sessions

• Certificate and graduate level courses, fellowship programs, etc.

• Experimental training in advanced communication skills, including motivational interviewing

• Complex symptom management of patients with/without substance use disorder

Practice exams aren’t currently available for the CAQ-PMHC.

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)

• Orthopaedic Surgery (CAQ-OS)

• Hospital Medicine (CAQ-HM)

• Emergency Medicine (CAQ-EM)

• Dermatology (CAQ-Derm)

• Cardiovascular and Thoracic Surgery (CAQ-CVTS)