Hospital Medicine Physician Assistants

Interested in furthering your career in hospital medicine as a physician assistant (PA)? Or looking to become a physician assistant for the first time and eventually specialize in working in the hospital setting? A hospital medicine Certificate of Added Qualifications (CAQ) is one way that you can ensure that you gain the relevant skills you need to stand out in this area of the field. It takes time to gain the experience needed to earn your CAQ – two years worth of full time practice is just one of the requirements – so it is important that you start planning out how you will earn this certification as early as you can. This resource will help you understand what experience, education, and other standards you will need to meet in order to qualify for a CAQ in hospital medicine.

What is a Certificate of Added Qualifications?

A CAQ from the National Commission on Certification of Physician Assistants (NCCPA) is a credential signaling that a physician assistant has a certain level of practice and relevant education in a specialty related to the PA field. CAQs are not required for specialty practice, meaning that those who have earned this credential have gone above and beyond to demonstrate their experience and know-how. Because this credential is earned in addition to basic PA certification, it is known that the PA holding it also has a solid background in primary care or as a generalist.

How to Earn a Hospital Medicine Certificate of Added Qualifications as a Physician Assistant (PA)

Looking to become a CAQ in hospital medicine? Here are some common steps to earn the hospital medicine CAQ:

Step 1: Become a Certified Physician Assistant 

You can’t become specialized in the physician assistant field without first becoming a physician assistant. Not only do you need to have gone to PA school, you must also have a license to practice in at least one jurisdiction, and the licenses that you hold must be valid and unrestricted. Interested in becoming a physician assistant? You can learn more about how in our guide to how to become a licensed PA.

Step 2: Earn Continuing Medical Education (CME) Credits in Hospital Medicine

In order to get a CAQ in hospital medicine, you will need to earn 75 relevant credits within six years of submitting your application, 25 of which must be earned in the last two years. What qualifies as a relevant credit? For the most part you will need to use your best judgment to determine this. However, the NCCPA hospital medicine CAQ is specific in their requirement that some of the credits must be in risk management.

The credits must be Category I credits and can also be used towards PA license maintenance. You may be audited during the application process to ensure that the CMEs you have chosen to complete are relevant.

Step 3: Earn Enough Experience Working in Hospital Medicine as a PA

While you are racking up CME credits for the hospital medicine CAQ, you will also need to gain the relevant experience that you need in the hospital medicine specialty. The experience requirement is 4,000 hours over six years (the equivalent of two full years worth of work) before you make your attestation to the NCCPA. Make sure you can prove that you completed the relevant experience in the case of an audit

You will need to get an attestation that you have the knowledge, skills, and understanding needed to practice hospital medicine from a qualifying professional, so make sure you gain the experience that you need to gain so that that attestation can be made: According to the NCCPA, those interested in the hospital medicine CAQ need experience and understanding in the following:

Exposure to the following cases

  • Thoracentesis and paracentesis
  • Ultrasonography
  • Chest tube placement
  • Lumbar puncture
  • Intubation
  • Vascular access
  • Arthrocentesis
  • Cardiac Testing

Understanding of these principles

  • Care for adult hospitalized patients, including those who are older or vulnerable
  • Diagnostic decision making
  • Communication
  • Pharmacoeconomics, pharmacoepidemiology, and drug safety
  • Information management
  • Evidence-based practice
  • Management practices
  • Leadership

Check with the NCCPA to make sure you are best prepared to get all the relevant experience you need.

Step 4: Take the Hospital Medicine Specialty Exam

You will need to sit for a 120 question multiple choice exam in order to earn your CAQ in hospital medicine. You can sit for this exam in the spring and fall at a Pearson VUE test center, once your other requirements for the CAQ have been completed. There is a $250 exam fee associated with the specialty exam.

Step 5: Submit Attestation that You Meet the Procedures and Patient Case Requirement for Earning a Hospital Medicine CAQ

A physician, senior physician assistant, or post graduate director of a physician or PA program will need to offer an attestation on your behalf stating you have met the experience requirements listed in step 3 and that you have the necessary understanding required for the credential. This document must be submitted within 90 days of receiving your CAQ exam score.

Step 6: Start the Hospital Medicine CAQ Application Process

If you want, you can start applying for certification as soon as you complete one of the necessary components (CME credits, experience, procedure and patient case attestation, or exam), even if getting what you need for the rest of the components will take some time. You may prefer to wait to start this process once you have everything that you need for submission. You will need to finish the hospital medicine CAQ application process within six years once you begin the application and submit the $100 fee.

Why Earn a CAQ in Hospital Medicine?

PAs with CAQ qualifications report a variety of benefits, according to a survey by the NCCPA:

Broadened Scope

60% CAQs expect increased responsibility in their roles post certification.

Better Salary

One in three PAs received a cash bonus related to earning their CAQ. Most PAs with a CAQ believe they will get a raise or have gotten a raise. 

Career Advancement

About 75% of CAQs have found or expect to find a new job. About four in ten CAQs have gotten promoted.


CAQs find they are more respected by other professionals 75% of the time, and by patients 66% of the time.

Last updated January 2022.