Palliative Medicine and Hospice Care Physician Assistants

Are you a physician assistant (PA) or aspiring physician assistant with an interest in palliative medicine and hospice care? Starting in 2022, there is a new Certificate of Added Qualifications (CAQ) specifically designating specialization for PAs in the area of palliative care. This CAQ can help you stand out as you look to become more specialized in your practice, and get you on the path to gaining the experience and education you need in order to provide care in this area of medicine. Sound like something you want to pursue? This resource will help you understand what you need to do to earn your CAQ in hospice medicine and palliative care.

What is a Certificate of Added Qualifications?

A CAQ from the National Commission on Certification of Physician Assistants (NCCPA) is an indicator that a PA has specialized knowledge in an area of medicine. Since this credential is not required in order for a PA to specialize his or her practice, a CAQ shows that the person who earned it went above and beyond to be educated in the specialty and gain relevant experience. The typical PA program trains PAs as generalists, so any specialty supplements a foundation of primary care or generalist knowledge.

How to Earn a Palliative Medicine and Hospice Care Certificate of Added Qualifications as a Physician Assistant (PA)

Looking to become a CAQ in palliative medicine and hospice care? Here are some common steps to consider:

Step 1: Become a Certified Physician Assistant 

You need to be practicing in the PA field in order to gain the experience you need for specialization. Once you become licensed as a PA in at least one jurisdiction, you can begin earning your CAQ. In order to earn the CAQ, all of the licenses that you hold must be valid and unrestricted. If you are not yet a physician assistant but aspire to be, check out our guide on how to become a licensed PA.

Step 2: Earn Continuing Medical Education (CME) Credits in Palliative Medicine and Hospice Care

You must earn 75 relevant CME credits to qualify for the palliative and hospice care specialty within six years of beginning your CAQ application. Twenty-five of these 75 Category I credits need to be earned within two years of applying to take the CAQ exam. You will need to use your best judgment to select relevant CMEs for the specialty, but one specific requirement is a CME activity on safe and effective opioid prescribing. Other recommended CME topics for this specialty include advanced care planning and sessions offered by relevant organizations

According to the NCCPA Palliative Medicine and Hospice Care CAQ requirements, you can use any credits you earn towards your CAQ for your general PA license renewal. Make sure you have proof that you have completed all of your CMEs.

Step 3: Earn Enough Experience Working in Palliative Medicine and Hospice Care as a PA

As you complete the necessary continuing medical education (CME) credits, you can start getting the required experience working in palliative medicine and hospice care as a physician assistant – 2,000 hours of experience, according to the NCCPA Palliative Medicine and Hospice Care CAQ requirements. This is the equivalent of one years of practice, but can be earned over the course of as many as six years before attesting to the NCCPA. Make sure to have proof of your experience!

You will also need to identify a qualifying professional (explained later) who can attest that you have the knowledge and experience that you need to practice in the hospice and palliative care specialty. They will need to know that you meet all of the NCCPA Palliative Medicine and Hospice Care CAQ requirements. For the palliative/hospice specialty, the requirements are as follows:

  • Understanding the cultural, spiritual, psycho-social, and physical aspects of illness
  • Supporting quality of life through pain and symptom management
  • Providing care through interprofessional teams that focus on a patient’s overall wellbeing
  • Care for patient and family in preparation of death or anticipated death
  • Effective communication with patients and family
  • Working together with the patient to choose treatment plans
  • Supporting caregiver needs
  • Guiding advanced care planning with patients and families, including completion of required documents
  • Insurance aspects of hospice care – including as a benefit and eligibility requirements
  • Principles of system based practice, including risk management

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 Palliative Medicine and Hospice Care

A 120 question exam in palliative medicine and hospice care is also required for the CAQ. This multiple choice exam can be taken in spring or fall and is given at Pearson VUE test centers. You must complete your education, experience, and CME requirements before taking the CAQ, which costs $250.

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

A physician, senior physician assistant, or program director for a PA or MD program will need to attest that you meet the step 3 requirements, and that you have the knowledge, skills, and understanding you need to practice hospice medicine. This attestation must be made and submitted within 90 days of receiving your score on the CAQ exam.

Step 6: Start the Palliative Medicine and Hospice Care CAQ Application Process

Even if just one of the CAQ requirements is complete (CME credits, experience, procedure and patient case attestation, or exam), you can start applying for the CAQ. While not required that you have everything completed before applying, you may decide to wait until you have completed all your requirements. You will have six years to complete the application once you start it. You must pay a $100 application fee.

Why Earn a CAQ in Palliative Medicine and Hospice Care?

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

  • 60% report increased practice scope
  • 33% report earning a cash bonus, and most expect or have seen a salary increase 
  • 75% report finding or expect to find a new job
  • 40% report having earned promotions.
  • 75% report being more respected by other health professionals
  • 66% report being more respected by patients.

Last updated February 2022.