Nephrology Physician Assistants

Are you a physician assistant (PA) with an interest in specializing in practice related to kidneys? Or are you an aspiring PA who already knows you want this to be your focus area? A Certificate of Added Qualifications (CAQ) in nephrology may be for you. This credential can help ensure that you learn the skills you need to specialize in nephrology, and can also ensure that others know you have expertise in this area as well. Because earning the CAQ requires a high level of commitment to the specialty (you must have at least two full years’ worth of practice under your belt) it is important to consider early on how you will go about meeting the requirements needed for this credential. This guide will help you figure out what you need so that you can get the experience and education needed to earn the CAQ.

What is a Certificate of Added Qualifications?

A CAQ from the National Commission on Certification of Physician Assistants (NCCPA) denotes that a PA has a certain level of knowledge and experience related to a specialty in the medical field. Physician assistants do not technically need a CAQ to specialize their focus, so this credential shows that the PAs who have earned it have gone above and beyond to demonstrate their commitment to a specialty. PAs will typically have gotten generalist training first, so specialization builds on that generalist foundation.

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

Looking to become a CAQ in nephrology? Here is what you need to do:

Step 1: Become a Certified Physician Assistant 

In order to specialize as a PA, you must first become a PA. This requires attending physician assistant school and becoming licensed to practice. PAs seeking a CAQ must have a license to practice in one or more jurisdictions, and any licenses held need to be valid and unrestricted. If you are not yet a physician assistant, you can learn more about how to become one in our guide to how to become a licensed PA.

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

Earning a CAQ in nephrology requires earning 75 credits related to nephrology within six years of starting your CAQ application, and 25 of the credits must be earned in the two years preceding your application to take the exam. What is considered a relevant credit? You will need to use your judgment to determine what available CME programs are related to nephrology. According to the NCCPA Nephrology CAQ requirements, “PAs should complete CME activities that encompass knowledge of the evaluation of the kidney function, urinalysis, radiological assessment of renal disease, the kidney in systemic disease, chronic kidney disease, peritoneal dialysis, hemodialysis, medications and the kidney, the kidney in special circumstances (i.e., pediatric patients, pregnancy, and/or aging), hypertension, billing and coding, and kidney transplantation.”

The credits, which need to be Category I credits, may be used towards general maintenance of your PA license. Make sure you can prove that you have enrolled in relevant CMEs as you may be audited during your CAQ application process.

Step 3: Earn Enough Experience Working in Nephrology as a PA

While you are working towards earning those nephrology related continuing medical education (CME) credits, you will also need to gain experience working in nephrology, according to NCCPA Nephrology CAQ requirements. You are required to work 4,000 hours over six years (the equivalent of two full years worth of work) in the nephrology specialty before you attest to the NCCPA. Make sure you are able to prove that you worked the required amount of hours in the specialty.

You will a qualifying professional to attest that you have the knowledge, understanding, and skills that you need to practice as a nephrology PA, so make sure your experience covers all of the areas you need to cover in order to have someone vouch for you: According to the NCCPA Nephrology CAQ requirements, those interested in the nephrology CAQ need experience and understanding in the diagnosis and management of  the following:

  • Acute dialytic therapy
  • Anemia
  • Catheter infections and malfunction
  • Catheter placement for peritoneal dialysis
  • Dialysis complications
  • GFR medication dosage adjustment
  • Hemodialysis complications
  • Hypertension
  • Kidney donor and recipient assessment, care, and management, both pre and post transplant
  • Medication management in cases where renal function is comprised
  • Metabolic bone disease
  • Nutrition management
  • Uremia
  • Urine specimen collection, examination, and interpretation
  • Vascular access management, prep, and placement
  • Volume management

Patient case management experience in either acute dialytic therapy hospitalist care, chronic kidney disease, end stage renal disease, or kidney transplant is also required,

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

Step 4: Take the Specialty Exam in Nephrology

Taking a 120 question multiple choice exam is required in order to earn your CAQ in nephrology. The exam is offered in both spring and fall at Pearson VUE test centers, and you can apply to take it once your other requirements for the CAQ have been completed. The exam costs $250 to take.

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

A physician, senior physician assistant, or physician or PA program post graduate director will need to attest that you have met all experience requirements listed in step 3, and that you are suitable to be credentialed. This attestation must be submitted within 90 days of learning your CAQ exam score.

Step 6: Start the Nephrology CAQ Application Process

Once you complete one of the necessary components (CME credits, experience, procedure and patient case attestation, or exam), you can start the CAQ application process, even if you do not have all of the requirements complete yet. You can also wait until you have everything that you need for submission. Once you start applying, you have six years to finish the nephrology CAQ application process, which includes a $100 fee.

Why Earn a CAQ in Nephrology?

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

Wider Scope

Six in ten PAs increase their responsibilities post certification.

Better Salary

One third of CAQ earners received a cash bonus, and most have gotten or expect a raise. 

Career Advancement

Three quarters of CAQs have found or believe they will find a new job. About 40% have earned promotions.


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

Last updated February 2022.