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So its a couple of months out since we took the CAQ. I am really interested in people's thoughts. I remember getting through the test and wondering, why was most of this stuff on the test clinically relevant? I was wondering what others though relative to their specialities.  

 

I took the psych CAQ and it would be difficult for me to recommend it as something that should be used to mark a provider's preparedness for the daily work in our field.

 

Thoughts?

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I took the EM CAQ in 2013. 

I thought it was a better test than the PANREs I have taken.

I would view the CAQ as a whole rather than focus on the test. The test is only one leg of the stool.

When I walked out of the EM CAQ, I could only focus on the OB questions since I work at a place that doesnt have OB and my experience over the years has become limited.

Funny, when I got the results that included feedback, there was nothing about OB, I guess I did OK.

I would remember that we are early in the CAQ process, I think less than 5% of PAs have pursued this designation so far. Test development is not a static process, always changes, never satisfies everyone. Just like the PANRE and PANCE, the NCCPA does not have a vested interest in failing any significant % of PAs. They need our numbers and our money to exist. 

G Brothers PA-C

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I took the EM CAQ in 2013. 

I thought it was a better test than the PANREs I have taken.

I would view the CAQ as a whole rather than focus on the test. The test is only one leg of the stool.

When I walked out of the EM CAQ, I could only focus on the OB questions since I work at a place that doesnt have OB and my experience over the years has become limited.

Funny, when I got the results that included feedback, there was nothing about OB, I guess I did OK.

I would remember that we are early in the CAQ process, I think less than 5% of PAs have pursued this designation so far. Test development is not a static process, always changes, never satisfies everyone. Just like the PANRE and PANCE, the NCCPA does not have a vested interest in failing any significant % of PAs. They need our numbers and our money to exist. 

G Brothers PA-C

 

I also took it the same day (provided you did it in September and not at SEMPA), and I thought it was pretty fair for those who have worked ER.  I haven't taken a PANRE yet (next year) so can't comment on how it compares

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I'm afraid that the Physician Assistant realm has slipped into the misguided notion that more testing equal more competence. As we all know, down deep, it does not. This is a manufactured "follow the leader" process that merely generates additional money for NCCPA. The testing realm of medicine is so very misguided in it's thinking and it's promotional rhetoric that it has begun to believe it's own contrived reasons for instituting CAQ.

 

Much like the useless PANRE, it proves nothing of the clinical knowledge and skills of the test taker. NCCPA will get richer, and the profession will continue it's path to follow other professions down the expensive education pathway thinking more is better. Next will be the doctorate.

 

Consider, are the PA's of today better clinicians than the PA's of the '60's? Has all of this additional testing and degree status made us better clinicians?

 

Recently took PANRE again and I was so dismayed at the format, and testing content. Beyond the $300+ I donated to NCCPA and Pearson Testing, it proves nothing to my employer who keeps me because I do a good job with patient care and the system I work with. The entire system of education, certification, recertification and CAQ is broken, but the one who would have to call in the repair have no incentive to do so.

 

The Commonwealth Fund survey of healthcare recently ranked the U.S. #10 of developed countries. If we continue to fuel the system with an inept system of education/training, testing, certification and recertification for doctors, nurses and physician assistants, we will continue to fall. Overall includes education and certification. CAQ is part of the problem not the solution to anything.

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I'm afraid that the Physician Assistant realm has slipped into the misguided notion that more testing equal more competence. As we all know, down deep, it does not. This is a manufactured "follow the leader" process that merely generates additional money for NCCPA. The testing realm of medicine is so very misguided in it's thinking and it's promotional rhetoric that it has begun to believe it's own contrived reasons for instituting CAQ.

 

Much like the useless PANRE, it proves nothing of the clinical knowledge and skills of the test taker. NCCPA will get richer, and the profession will continue it's path to follow other professions down the expensive education pathway thinking more is better. Next will be the doctorate.

 

Consider, are the PA's of today better clinicians than the PA's of the '60's? Has all of this additional testing and degree status made us better clinicians?

 

Recently took PANRE again and I was so dismayed at the format, and testing content. Beyond the $300+ I donated to NCCPA and Pearson Testing, it proves nothing to my employer who keeps me because I do a good job with patient care and the system I work with. The entire system of education, certification, recertification and CAQ is broken, but the one who would have to call in the repair have no incentive to do so.

 

The Commonwealth Fund survey of healthcare recently ranked the U.S. #10 of developed countries. If we continue to fuel the system with an inept system of education/training, testing, certification and recertification for doctors, nurses and physician assistants, we will continue to fall. Overall includes education and certification. CAQ is part of the problem not the solution to anything.

 

The time for the debate on whether the CAQ should exist or not was 6-7 years ago when the concept was being explored.  It's a bit late now- the horse has long left the stable.  That being said, I don't think anyone here thinks that because someone took the CAQ they are so much better at their specialty than someone who doesn't- just the same as no one here thinks that a PA with a master's is a better clinician than one without.  The beefs you have with the test and how PA's are being evaluated in general are just reflective of our medical culture in general, and it won't change until a monumental seismic shift in how the US actually views and provides medical care to its citizens.  Until then, as PA's we are merely operating in the environment that fostered us which requires us to continue to "progress" as the other medical specialties are.  I'm not a huge fan of it, but I'm also a realist.  I took the CAQ because I knew I'd be looking for another job within the year after I took the exam and I wanted to max out my resume to potential employers.  And whether the CAQ made any difference or not, I had my pick of the jobs I wanted.

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The time for the debate on whether the CAQ should exist or not was 6-7 years ago when the concept was being explored.  It's a bit late now- the horse has long left the stable.  That being said, I don't think anyone here thinks that because someone took the CAQ they are so much better at their specialty than someone who doesn't- just the same as no one here thinks that a PA with a master's is a better clinician than one without.  The beefs you have with the test and how PA's are being evaluated in general are just reflective of our medical culture in general, and it won't change until a monumental seismic shift in how the US actually views and provides medical care to its citizens.  Until then, as PA's we are merely operating in the environment that fostered us which requires us to continue to "progress" as the other medical specialties are.  I'm not a huge fan of it, but I'm also a realist.  I took the CAQ because I knew I'd be looking for another job within the year after I took the exam and I wanted to max out my resume to potential employers.  And whether the CAQ made any difference or not, I had my pick of the jobs I wanted.

 

I appreciate your comments immensely. Unfortunately, there was never any debate about the CAQ issue. There rarely is such debate in the unilateral decisions that are the NCCPA. This is not the first, and likely, won't be the last. They are the "royals" and we put "it" there. It has a life of it's own now beyond the profession. Alas it may be "the environment", but I don't have to like it.

 

I agree though that CAQ is "in place" and individuals must decide whether to participate or not. I don't impugn you  or your choice to do so at all. I applaud the effort you individually made to make it work. I have participated in many venues to "enhance my resume" and thus have had a wonderful, enriching PA career. I applaud your effort to improve and continue to do so. I personally spent a ton of time and money getting my doctorate in that quest.

 

I would call for a boycott on CAQ and it's further creation, and I will refuse to participate in the sham, but I also know how far boycotts don't go in the PA profession of anything that is rational.  Shamefully a majority of policy and procedure decisions in our profession are made by collectives in institutions that claim to  have our best interests at heart but are merely following the lead of the other organizations that have taken into the morass we are in now...NBME, AMA, ACS, Boards of Specialty Med etc. Worse than that, NCCPA has written itself into state laws in many places thus leaving them without opposition or need to consult or debate. They are our credentials emperor. There is no debate. But I fully understand the market and the competition that helped to create what we have today.  It is, in my humble opinion, an environment gone sour.

 

So True, again, it was not meant as an attack on you or anyone who considers carefully the implications of participating in CAQ or any other process seen as improving one's credentials. Although I would ask everyone not to participate, but it is that free choice makes us individually great professionals working in all venues, all specialties and moving onward, steadfastly into other countries. We adapt and survive.

 

My comments maybe only stating the obvious in some ways, but sometimes it feels right to do so. It really won't affect me much. I'm closer to retirement, may never have to PANRE again, and hopefully not have to search for another job competing against the many qualified candidates willing to take much less money to do the job I do. But for the future, I hope new PAs around the world will consider the evils of following blindly down a path that yields little but more fees, more tuition, and richer more powerful institutions to control us. That, in fact, limits choice and freedom. It does nothing to enhance it. There is likely to much enthroned entropy to change much but I continue to hope for a miracle.

 

"We used to look up at the sky and wonder at our place in the stars, now we just look down and worry about our place in the dirt." - Cooper

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I appreciate your comments immensely. Unfortunately, there was never any debate about the CAQ issue. There rarely is such debate in the unilateral decisions that are the NCCPA. This is not the first, and likely, won't be the last. They are the "royals" and we put "it" there. It has a life of it's own now beyond the profession. Alas it may be "the environment", but I don't have to like it.

 

 

My comments maybe only stating the obvious in some ways, but sometimes it feels right to do so. It really won't affect me much. I'm closer to retirement, may never have to PANRE again, and hopefully not have to search for another job competing against the many qualified candidates willing to take much less money to do the job I do. But for the future, I hope new PAs around the world will consider the evils of following blindly down a path that yields little but more fees, more tuition, and richer more powerful institutions to control us. That, in fact, limits choice and freedom. It does nothing to enhance it. There is likely to much enthroned entropy to change much but I continue to hope for a miracle.

 

"We used to look up at the sky and wonder at our place in the stars, now we just look down and worry about our place in the dirt." - Cooper

 

Thanks for your reply.  To be honest, I didn't take any of what you said personally- I understand it's more a frustration with our institutions as they are.  And you may be right- there was not wide-ranging debate as to the validity of additional objective testing before it started- certainly not on this forum as far as I remember.  Although it wasn't the NCCPA acting unilaterally- the different specialty organizations, along with the respective physician counterpart organizations, had some voice in this too.  My understanding is that the goal was not to just create some additional test but to respond to the request from the physician groups that we (the greater PA collective) demonstrate some sort of objective competency not just as a certified PA but within the specialty the PA operated- because physicians have to do something similar.  The NCCPA just happened to be the only organization that had a history of objectively testing PA's so they naturally were called upon when it was felt some sort of test was one way to pursue this.  If there was any group that really pushed for this additional metric to evaluate our knowledge, I'd point to the physician specialty organizations first.

 

But believe me, I hear you

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I can understand frustration but I can better understand frustration due to a situation or condition that directly affects someone. So I would agree with a statement the CAQ is crap, IF I have been practicing for 20 years successfully and IF I lost a job opportunity to someone with 3 years of experience IF they had a CAQ and I didnt. But I would suspect that reasons to hire are more complicated than that.

 

Anecdotally I went to a EM board review course a few years ago in preparation for taking the CAQ. This is a well known, well attended course in the midwest. There were well over a couple thousand physicians there......and 4 PAs including me. In conversation with other attendees over the 5 day course, I was asked multiple times why I was taking it, why were there not more PAs taking it, how they could go back and get their PAs to increase their knowledge base and what they could do about PAs they had to work with that were, for a lack of a better word, weak. So there is a groundlevel need apparently to improve specialty experience and training.

 

At least in EM it is very apparent that physicians want PAs to practice at the top of their license even if they are seeing fast track patients because it is well known that death can start in the fast track just as easliy as it can in radiology. How do you standardize and codify this? The best way would be a similar education and confirmation of skills track like residencies for physicians or the fellowship concept that is also widely used. In the developed world, we have decided to mark success with a passage of a test. It is a concept that translates across different parts of society and cultures. Everyone understands that it is an indication of competency to a certain extent and that is the best we can do. The fact that it adds monies to a nonprofit organization that serves our profession (it does regardless of your perspective, without us it ceases to exist) is the nature of our economic system rather than evidence of a money grab.

 

So in stark contrast to the 2 other posts, I wholeheartedly encourage and recommend every single PA to obtain a CAQ if they practice in a specialty other than Family practice or IM. We already have that CAQ, its called the PANCE and PANRE. If there is not a CAQ availabe in your specialty then strive to attend physician directed board review in your chosen specialty and lobby the NCCPA to develop a CAQ so you can be recognized through a combination of experience, verified skill and education that you are competent in your chosen field. 

 

If money is an option, hone your negotiating skills. This should be an easy sell to the decisionmakers to have them pay for preparation and the testing. It makes you individually a better provider and they can PR the fact you have reached this level of skill and training under their umbrella.

 

Last, there have been a few comments concerning newer PAs. We are a small profession and the last we should do is eat our young. To compare them to PAs decades ago is unrealistic, it is a different world including medicine. To complain that they are taking jobs for less money than someone experienced is likely true in some instances but this is likely not due to the individual. I would ask how can you fault a new grad with limited options due to lack of experience and also other life obligations for accepting what has been offered to them after they have tried to negotiate? The fact that they have looming loan payments that have to be made along with just keeping the lights on is unavoidable pressure to make a choice. Respect that to better themselves they had to dig a debt hole that will take time to climb out of in comparison to the cost of our educations that pale in comparison. This isnt their fault, it is the system that has been put in place concerning education in this country. We have chosen to mortgage the next generations futures on many levels. Baby boomers pending retirement are the driving economic force behind this. Spend time complaining about this system but YOUR generation is what has done this through a multitude of economic actions and entitlements that those left working may or may not be able to support.

 

So one can pull their suspenders up, retire comfortably, wash their hands of the matter while placing a shot across the bow as a last parting gift. I would say to you, keep your apologies and also keep your negativity to yourself. Constructive criticism is helpful, what was said above is not.

 

George Brothers PA-C

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I can understand frustration but I can better understand frustration due to a situation or condition that directly affects someone. So I would agree with a statement the CAQ is crap, IF I have been practicing for 20 years successfully and IF I lost a job opportunity to someone with 3 years of experience IF they had a CAQ and I didnt. But I would suspect that reasons to hire are more complicated than that.

 

Anecdotally I went to a EM board review course a few years ago in preparation for taking the CAQ. This is a well known, well attended course in the midwest. There were well over a couple thousand physicians there......and 4 PAs including me. In conversation with other attendees over the 5 day course, I was asked multiple times why I was taking it, why were there not more PAs taking it, how they could go back and get their PAs to increase their knowledge base and what they could do about PAs they had to work with that were, for a lack of a better word, weak. So there is a groundlevel need apparently to improve specialty experience and training.

 

At least in EM it is very apparent that physicians want PAs to practice at the top of their license even if they are seeing fast track patients because it is well known that death can start in the fast track just as easliy as it can in radiology. How do you standardize and codify this? The best way would be a similar education and confirmation of skills track like residencies for physicians or the fellowship concept that is also widely used. In the developed world, we have decided to mark success with a passage of a test. It is a concept that translates across different parts of society and cultures. Everyone understands that it is an indication of competency to a certain extent and that is the best we can do. The fact that it adds monies to a nonprofit organization that serves our profession (it does regardless of your perspective, without us it ceases to exist) is the nature of our economic system rather than evidence of a money grab.

 

So in stark contrast to the 2 other posts, I wholeheartedly encourage and recommend every single PA to obtain a CAQ if they practice in a specialty other than Family practice or IM. We already have that CAQ, its called the PANCE and PANRE. If there is not a CAQ availabe in your specialty then strive to attend physician directed board review in your chosen specialty and lobby the NCCPA to develop a CAQ so you can be recognized through a combination of experience, verified skill and education that you are competent in your chosen field. 

 

If money is an option, hone your negotiating skills. This should be an easy sell to the decisionmakers to have them pay for preparation and the testing. It makes you individually a better provider and they can PR the fact you have reached this level of skill and training under their umbrella.

 

Last, there have been a few comments concerning newer PAs. We are a small profession and the last we should do is eat our young. To compare them to PAs decades ago is unrealistic, it is a different world including medicine. To complain that they are taking jobs for less money than someone experienced is likely true in some instances but this is likely not due to the individual. I would ask how can you fault a new grad with limited options due to lack of experience and also other life obligations for accepting what has been offered to them after they have tried to negotiate? The fact that they have looming loan payments that have to be made along with just keeping the lights on is unavoidable pressure to make a choice. Respect that to better themselves they had to dig a debt hole that will take time to climb out of in comparison to the cost of our educations that pale in comparison. This isnt their fault, it is the system that has been put in place concerning education in this country. We have chosen to mortgage the next generations futures on many levels. Baby boomers pending retirement are the driving economic force behind this. Spend time complaining about this system but YOUR generation is what has done this through a multitude of economic actions and entitlements that those left working may or may not be able to support.

 

So one can pull their suspenders up, retire comfortably, wash their hands of the matter while placing a shot across the bow as a last parting gift. I would say to you, keep your apologies and also keep your negativity to yourself. Constructive criticism is helpful, what was said above is not.

 

George Brothers PA-C

 

 

No complaint about new PA's at all. Thanks for misquoting and misreading my comments. I train PA, medical and nurse practitioner students daily and work diligently to elevate our profession. And PANCE and PANRE have nothing to do with family medicine CAQ knowledge. Was never meant to be. Another misguided idea you plant.

 

Thanks for your condescending comments George. I see I will leave the profession in the aggressive sharp tongue hands of lemmings such as yourself. I wish you well as you help move the profession steadfastly toward doctorates, more debt, longer training, more useless credential exams and the like that (according to educational research) prove absolutely nothing of medical knowledge or patient care skills. You keep listening to those doctors you go to meetings with. They certainly understand it all.

 

My parting shot? I work long hours, doing decent work. And I went to medical school and residency... Knowing, I didn't know as much as you know. I can only hope, pray to be as all knowing as you appear to be. You certainly aren't as constructive as you think you are. But thanks for reminding me of the destructive nature of opinion.

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SteveMC

Could you explain your own history a little more?

 

Are you a Doc, PA, educator? or something else?

 

Not sure I agree with your statement of PANCRE/PANRE is not related to FP - that sort of goes against everything......  doesn't seem like a logical statement at all - can you explain more?

 

 

I hate to point out the obvious, but you are brand new to the forum, and seem to be slamming everything about where PA is going, yet don't identify who, what, where you are or what your background is?  I am suspicious of trolls......

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 I wish you well as you help move the profession steadfastly toward doctorates, more debt, longer training, more useless credential exams and the like that (according to educational research) prove absolutely nothing of medical knowledge or patient care skills. 

 

 

I will say that some of us of the newer generation look forward to heading in that direction, with the exception of more debt.

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