CME4Life Synapse 
What is a Certificate of Added Qualification (CAQ)?
The Certificate of Added Qualification is a recognition given by the NCCPA (National Commission on Certification of Physician Assistants) to a physician assistant for their specialty experience as well as skills and knowledge, which are proven when they complete their examination successfully.
Why should a Physician Assistant opt for an Internal Medicine Specialty certification?
One becomes a physician assistant after completing an accredited physician assistant program and thus obtaining a master’s degree. One must also clear the Physician Assistant National Certifying Examination (PANCE) administered by the NCCPA and obtain licensure in the state one wishes to practice.
The physician assistant who has opted to work in the Internal Medicine Specialty can, later on, pursue additional qualifications in this specialty by opting for the CAQ exam conducted by the NCCPA. This certification will establish that the physician assistant has obtained advanced clinical training and skills in this specialty and endorses the knowledge, training, and experience the physician assistant holds in the Internal Medicine Specialty. It assures the hiring physician that the physician assistant is highly competent in this specialty.
It must be noted that the NCCPA does not offer a CAQ in Internal Medicine specifically, and physician assistants practicing in Internal Medicine have to choose the Hospital Medicine CAQ for their certification.
What are the requirements for eligibility for the Internal Medicine/Hospital Medicine CAQ certification?
- In addition to having a current PA-C certification and being a licensed physician assistant, the physician assistant must have the following to be eligible for the Hospital Medicine CAQ certification:
- Possess 3000 hours of experience in the Internal Medicine Specialty, which includes managing hospitalized, adult patients.
- CME requirement: According to NCCPA,“ 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 to maintain the PA-C credential.”
- Experience in specialty procedures, patient care experience, and attestation from the supervising physician under whom they have worked in Internal Medicine regarding their skills and knowledge. The attestation 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.
- Pass the Hospital Medicine CAQ Exam. Once physician associates have the prerequisites for the Hospital Medicine CAQ, they can apply for the Hospital Medicine Specialty Exam.
What does the Hospital Medicine CAQ exam entail?
It is a 120 multiple-choice question paper administered in two blocks of 60 questions with 60 minutes to complete each block. It has questions related to Hospital Medicine and is targeted at physician associates with experience in the practice of that specialty. The paper must be completed in 2 hours.
What is covered on the Internal Medicine/Hospital Medicine CAQ exam?
Questions are based on the Content Blueprint, developed using data gathered during the 2012-2015 PA Practice Analysis conducted by NCCPA. The content areas and the percentages are given below.
Hospital Medicine CAQ Blueprint
| Content Area | % | |
| 1 | Cardiology | 18 |
| 2 | Pulmonology | 14 |
| 3 | Gastroenterology | 11 |
| 4 | Endocrinology | 5 |
| 5 | Nephrology | 14 |
| 6 | Hematology/Oncology | 8 |
| 7 | Neurology | 8 |
| 8 | Psychiatry | 3 |
| 9 | Infectious Diseases | 11 |
| 10 | Allergy/Immunology/Rheumatology | 3 |
| 11 | Perioperative Medical Management | 5 |
How do I study for the Hospital Medicine CAQ?
- Since you have already cleared your PANCE exam, you will have a basic idea of what study schedules the best suit you. Study the content blueprint and its breakdown, and identify the topics you need to focus on. You can take time out to see patients with such chief complaints and gain knowledge from specialists regarding the treatment of the disease process.
- Use a question bank and quiz yourself. This will give you an idea of which topics you do not grasp and what must be reviewed in depth. Repeat this process again and again until you are familiar with the answers and how different questions can be phrased in the exam.
- Take an Internal Medicine Board Review Course. Those who love lectures can go for a short review course. You could review the topic in detail, take down notes, and go back to the videos again and again. You can do review videos based on the CAQ content blueprint and cover every topic.
While studying for your CAQ exam can be daunting, it is also a great way to keep up with the latest literature, developments, and technologies in the Internal Medicine/Hospital Medicine field in which you have chosen to specialize. It is a recognition that will show your employers that you are committed to this field of specialization and have advanced expertise. It will also give patients the confidence that they are being treated by a skilled and competent professional. On the day of your exam, stay focused and calm, and you will surely do well.
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