Emergency Medicine


Below is information from NCCPA's website on the Specialty Certificates of Added Qualifications (CAQs) in Emergency Medicine.

Physician assistants seeking the Emergency Medicine CAQ must demonstrate they have advanced knowledge and experience in emergency medicine, above and beyond that expected of entry-level PAs or PAs working in a generalist practice. PAs seeking eligibility for the Emergency Medicine Specialty Examination must meet requirements of specialty-specific CME, experience in the field, and specific knowledge and/or experience in conducting procedures and being involved in patient cases that are deemed core to the specialty area of practice. After initiating the CAQ process by submitting the requirements for one of the components and the $100 administrative fee, PAs will have six years within which to complete all four components for the CAQ, including passing the specialty exam.

Physician assistants seeking the Emergency Medicine CAQ must also first satisfy two basic pre-requisites: (1) current PA-C certification and (2) possession of a valid, unrestricted license to practice as a PA in at least one jurisdiction in the United States or its territories, or unrestricted privileges to practice as a PA for a government agency. (Note: If a PA holds licenses in multiple states, all of the licenses must be unrestricted.)

NCCPA’s specialty CAQ process is predicated on a strong belief in the value and importance of the physician-PA team, and in support of the procedures and patient case requirement, each applicant must provide attestation from a supervising physician who works in the specialty and is familiar with the PA’s practice and experience. PAs may find it helpful, however, to secure such a physician sponsor at the beginning of the process for the purpose of seeking guidance on the pursuit of the otherIn the six years preceding the date of application for the specialty exam, candidates must earn a minimum of 150 hours of Category I CME focused on emergency medicine practice with a minimum of 50 of those hours having been earned within the two years prior to the date of exam application. The 150 required CME hours must include completion of an Advanced Cardiac Life Support course. The same 150 hours may also be used for maintenance of the PA-C credential.

PAs are encouraged to use their best judgment when determining whether individual CME activities are related to emergency medicine, understanding that those hours may be subject to a CME auditing process.

Upon fulfillment of all CME requirements, candidates will attest to their completion at NCCPA’s Web site.

Recommendations for CME Activities:
Physician and PA emergency medicine leaders provided input in developing the following CME recommendations for PAs interested in pursuing a CAQ in that specialty.

Applicants should complete a comprehensive emergency medicine course that reflects the guidelines set forth in the most current version of Model of the Clinical Practice of Emergency Medicine. Applicants should also complete the following courses:

  • Pediatric Advanced Life Support or Advanced Pediatric Life Support
  • Advanced Trauma Life Support
  • Airway course

Physician assistants seeking the Emergency Medicine CAQ must have gained at least 3,000 hours of experience (the equivalent of 18 months of full-time practice) working as a PA in emergency medicine within six years of the date they attest to NCCPA that the experience requirement has been satisfied. If selected for an audit, documentation substantiating that work experience will be required.

Candidates for the CAQ must be able to apply the appropriate knowledge and skills needed for practice in the specialty, as described below. In support of this requirement, each candidate must provide attestation from a supervising physician who works in the specialty and is familiar with the PA’s practice and experience. The physician attestation must indicate that the PA has performed the procedures and patient management relevant to the practice setting and/or understands how and when the procedures should be performed.

Again, the PA may not have experience with each procedure, but he or she must be knowledgeable of the basics of the procedures, in what situation the procedures should be done, and the associated management of patients.

In determining whether a PA can satisfy the Specialty Procedures and Patient Case Requirement, consideration should be given to the following areas:

Airway Adjuncts: Invasive Airway Management

  • Intubation
  • Mechanical ventilation
  • Capnometry
  • Non-invasive ventilatory management


  • Local, digital
  • Procedural anesthesia, conscious sedation

Advanced Wound Management

  • Incision & drainage, wound debridement
  • Superficial/deep wound closure

Diagnostic/Therapeutic Procedures

  • Soft tissue and joint aspiration
  • Lumbar puncture
  • Slit lamp examination
  • Thoracentesis, thoracostomy
  • Tonometry
  • Control of epistaxis
  • Electrocardiographic interpretation
  • Cardiac pacing
  • Defibrillation/cardioversion
  • Clearing a cervical spine
  • Fracture/dislocation management

Hemodynamic Techniques

  • Peripheral venous access
  • Arterial access for diagnostics and placement of arterial lines
  • Central venous access
  • Intraosseous infusion

Radiographic Interpretation

  • Chest x-ray
  • Plain films (bone, soft tissues, abdominal series, etc.)
  • CT scans, MRIs


  • Cardiopulmonary
  • Fluid

Physician assistants who have satisfied all other requirements for the Emergency Medicine CAQ will be eligible to register for the Emergency Medicine Specialty Exam. The examination consists of 120 multiple-choice questions related to emergency medicine and targeted for PAs who have experience in the practice of that specialty. It will be based on the Content Blueprint, developed using data gathered during the 2009-2010 PA Practice Analysis conducted by NCCPA.

The exam will be administered once a year at PearsonVUE testing centers. Exams are conducted in September of year (check with NCCPA for exact times) and, typically, in conjunction with SEMPA's annual conference in the spring.

The Emergency Medicine CAQ awarded to successful candidates will be valid for six years. To maintain the CAQ beyond that timeframe, PAs must continue to meet the same PA-C and licensure requirements required of those seeking the CAQ for the first time, pass the Emergency Medicine Specialty Examination before the expiration of the current CAQ, and -- during the 10-year CAQ cycle -- earn and log at least 75 hours of Category I CME focused on the specialty. Those CME hours may also be used to satisfy the CME requirement for maintenance of the PA-C credential.