Orthopaedic Surgery Physician Assistants

Are you a physician assistant (PA) who would like to specialize in orthopaedic surgery? Or, are you planning on becoming a physician assistant and already know that you want to focus in that area? A Certificate of Added Qualifications (CAQ) in orthopaedic surgery may be a good idea for you. The orthopaedic surgery CAQ can help get you to learn the skills you need for orthopaedic surgery specialization, and can be a way to signify that you have demonstrated knowledge and experience in this specialty. Given that you must have two full years’ worth of experience in order to earn this credential, it takes time and planning to ensure that you meet all of the requirements. This resource will help you gain an understanding of what you need in order to earn the orthopaedic surgery CAQ.

What is a Certificate of Added Qualifications?

A CAQ from the National Commission on Certification of Physician Assistants (NCCPA) signifies that a PA has specialty knowledge in an area of the medical field. It is not required that PAs have a CAQ in order to specialize their practice, so the CAQ credential is a marker of a professional going above and beyond. While earning the PA degree, professionals also earn a generalist education, so this specialization is built upon a strong general foundation.

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

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

Step 1: Become a Certified Physician Assistant 

You need to become a PA in order to specialize within the field – while clinical experiences will vary by program and placement sites, the typical goal of a PA program is generalist or primary care education. Once you earn your degree, you will need to have a license to practice in at least one jurisdiction, and all your licenses will need to be valid and unrestricted. Not yet a PA but interested in becoming one? Check out our guide on how to become a licensed PA.

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

Earning a CAQ in orthopaedic surgery requires earning 75 orthopaedic surgery related CME credits within six years of beginning your CAQ application, 25 of which must be earned in the two years directly before you submit your application to take the exam. You will need to use your judgment to determine which CMEs are relevant to the study of orthopaedic surgery, according to the NCCPA Orthopaedic Surgery CAQ requirements.

Your credits need to be Category I credits, and can also be used towards PA license renewal. You may be audited while applying for the CAQ, so make sure you can provide proof that you have earned relevant credits.

Step 3: Earn Enough Experience Working in Orthopaedic Surgery as a PA

As you rack up relevant continuing medical education (CME) credits, you will want to be gaining experience working in orthopaedic surgery as a physician assistant, according to the NCCPA Orthopaedic Surgery CAQ requirements. You will need to have worked 4,000 hours over the course of six years (equal to two years of full time work) in the orthopaedic surgery specialty before attesting to the NCCPA. Make sure you have proof that you worked the required amount of hours in the orthopaedic surgery specialty.

You will need to have a qualifying professional provide an attestation that you have the skills, knowledge, and understanding needed to specialize in orthopaedic surgery, so make sure you meet all the necessary experience requirements: According to the NCCPA Orthopaedic Surgery CAQ requirements, those interested in the orthopaedic surgery CAQ need experience with the following:

  • Anesthesia (local, procedural, and regional)
  • Advanced wound management (including closure, debridement, incision, drainage, vac and drain placement and removal, tendon repair, and k-wire and hardware removal)
  • Compartment pressure measurement and management
  • Needle aspiration and injections (including bursa, cysts, joints, tendons, and trigger points, as well as needle biopsy)
  • Diagnostic radiography (including positioning and interpretation of radiographs, CT scans, MRI, and electromyography)
  • Fractures and dislocations (including reductions and relocations, brace/splint/cast/appliance application, skeletal and skin traction application, and percutaneous pinning of fractures)
  • Operative and perioperative care (including consultation, evaluation, surgical assist, and post op care/management)
  • Prevention, recognition, and management of the following: osteoporosis, osteomyelitis, pulmonary embolization, deep venous thrombosis

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 Orthopaedic Surgery

You will need to take a 120 question multiple choice exam in orthopaedic surgery as another requirement for earning your CAQ. The exam, offered both in spring and fall, is administered at Pearson VUE test centers. You must complete your education, experience, and CME requirements before taking the CAQ. The exam costs $250.

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

A qualifying professional (physician, senior physician assistant, or program director for a PA or MD program) must attest that you meet all experience requirements listed in step 3, and that you have the knowledge and skills required of a CAQ holder. This attestation must be submitted within 90 days of getting your CAQ exam score.

Step 6: Start the Orthopaedic Surgery CAQ Application Process

If any of the CAQ requirements are complete (CME credits, experience, procedure and patient case attestation, or exam), you may begin the CAQ application process. You do not need to have everything completed in order to start the process, but you may decide to wait until you have everything that you need for submission. You have six years to finish the process once you initiate the application, which includes a $100 fee.

Why Earn a CAQ in Orthopaedic Surgery?

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

Wider Scope

60% of PAs report increased responsibilities post certification.

Better Salary

33% of CAQ earners report receiving a cash bonus, and most did or expect to get a raise. 

Career Advancement

75% of CAQs report finding or believe they will find a new job. About 40% have earned promotions.


75% of CAQs find themselves more respected by other health professionals and 66% find themselves more respected by patients.

Last updated February 2022.