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Would like some input about the CAQ exam....especially from the PA's that have passed the EM CAQ.

A little about myself: I did an Emergency Medicine residency at Cook County and have been practicing as a EM PA in the Midwest for 3 years. I don't plan on leaving my current job but I think it would be a positive to have a certificate that says I have substantial EM knowledge and "proof" that I can perform advanced procedures in case I decide to make a job change. Do you think it's a test worth taking? Does anyone see negatives in CAQ exams in general besides the "pigeon holed in a specialty argument" (I know SEMPA supports the idea). I had difficulty finding the actual total cost of registering for the CAQ exam. Does anyone know the bottom line price to take the exam?? I looked at the sample questions on the NCCPA website - they seem fairly basic. Is the actual exam more challenging? Thanks for the responses!

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The exam is not as difficult as the ABEM physician exam, but it does delve deeper into ER than the PANCE/PANRE, as you'd expect.  For myself, I saw no change in employment status, pay or scope of practice as a result of passing it, but others have- I took it when preparing to change jobs and wanted to max out my CV.  There might be jobs that will give preference to you as a CAQ recipient when all other things are equal in multiple people applying for the same job, even if it's not listed in their minimum requirements.  Even though so far there hasn't been any need to prove I passed the CAQ, I'm still glad I took it- maybe it's just human nature to want some sort of objective benchmark that you can show your prior training and experience means something on paper, beyond the day-to-day working in the ER.  

 

Maybe in another 5 years, you'll see far more places want their PA's to have the CAQ- at least, those places that are high-acuity, high-volume tertiary care centers that also only employ board-certified EM physicians.

 

BTW- I've moved this to the more appropriate EM subforum

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I took and passed it the first yr it was offered in 2011, I see this as only having positive value as an em pa. it has gotten me new jobs and I have been credentialed for things many other em pas I work with have not. I recently was cold called and asked to work part time at the first position in my state being developed for em pa solo coverage of a community hospital ED. when asked how they found my name the doc said he looked at the nccpa CAQ site and found me there(they list caq recipients by specialty and state). when I took the exam it cost $350 if I'm not mistaken. once you register and start sending them stuff to fulfill experience, course, and procedure requirements they will ask for your money.

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I passed it last year. The cost is still $350. $100 for registration and $250 for the test. I have not seen an increase in pay or scope.

Personally I can't see any negative side to taking it. How can being successfully evaluated for knowledge/skills specific to any specialty be bad?

IMO we will see more and more employers either require CAQ's as a condition of employment or as a required goal to work toward after hire.

And, all other things being equal it sure can't hurt to have it on your CV.

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For those who have families....how did you avoid any distractions while preparing for the CAQ?  

 

Thanks

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How prohibitive did everyone find getting the specialized certificates? Are they even *really* required?  The FAQ states applicants "SHOULD complete" the following courses:  PALS, ATLS and an airway course.  The attestation just discusses EM CME and ACLS.

 

Seems like a significant expense to get and maintain PALS, ATLS and an airway course. What airway course?  (I only know the Difficult Airway course, which runs >1000 dollars).

 

We are only ACLS and BLS trained in my shop.  Never felt the need for other certifications.  I work in a busy inner city ED for >10 years in Fast Track and ESI low 2's and 3's in the main ED.  We only see adults, so no PALS needed.  We don't participate in trauma codes, so no ATLS.  We participate in medical codes with an attending, but in any bad airway, the attending will manage the airway.  Never run codes.

 

I could pass the test easy peasy.  All my CME is mainly EM focused now anyway.  Just not sure if the expense and time of certifications is worth it.  AND are PALS, ATLS etc suggested OR required?
 

Sara

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you can take the difficult airway course for ems. 350 bucks. basically the same course. I'm required to have acls/atls/pals for my jobs so the only class I took for the caq was difficult airway. there is also street level airway management (slam) and a number of cadaver based airway courses out there. the levitan course is meant to be good.

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Would like some input about the CAQ exam....especially from the PA's that have passed the EM CAQ.

A little about myself: I did an Emergency Medicine residency at Cook County and have been practicing as a EM PA in the Midwest for 3 years. I don't plan on leaving my current job but I think it would be a positive to have a certificate that says I have substantial EM knowledge and "proof" that I can perform advanced procedures in case I decide to make a job change. Do you think it's a test worth taking? Does anyone see negatives in CAQ exams in general besides the "pigeon holed in a specialty argument" (I know SEMPA supports the idea). I had difficulty finding the actual total cost of registering for the CAQ exam. Does anyone know the bottom line price to take the exam?? I looked at the sample questions on the NCCPA website - they seem fairly basic. Is the actual exam more challenging? Thanks for the responses!

Sent you a message!

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Thanks EMed, this is helpful info.  I actually contacted NCCPA and was pleasantly surprised at the speed of the reply.

For the EM CAQ only ACLS is *required.*  The other classes are *suggested.*

Think I have my group convinced for a bonus when we pass the CAQ.  Good news!

Sara

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Thats awesome Sara! My group is "considering" a bonus and is gauging our interest. They brought it up to us so I asked for definite numbers and if they would be do a pay per hour increase for those of us that passed it vs a bonus. The medical director's concern was that he didn't want the PA's to have to jump through a ton of hoops and pass a difficult exam to get the extra credentialing if the NPs could get it easily or vice versa. Its been a few months but now that I am reading more about it I am getting more interested - just for the money aspect. 

 

As far as preparing - I thought maybe the ER bootcamp or attending something along those lines prior to taking it would be good. Those who have taken it in all seriousness if you wanted to make sure you were prepared would you suggest a refresher course? The longer I'm in "fast track" the dumber I feel. :D

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Thats awesome Sara! My group is "considering" a bonus and is gauging our interest. They brought it up to us so I asked for definite numbers and if they would be do a pay per hour increase for those of us that passed it vs a bonus. The medical director's concern was that he didn't want the PA's to have to jump through a ton of hoops and pass a difficult exam to get the extra credentialing if the NPs could get it easily or vice versa. Its been a few months but now that I am reading more about it I am getting more interested - just for the money aspect. 

 

As far as preparing - I thought maybe the ER bootcamp or attending something along those lines prior to taking it would be good. Those who have taken it in all seriousness if you wanted to make sure you were prepared would you suggest a refresher course? The longer I'm in "fast track" the dumber I feel. :D

 

Fast track alone will not prepare you to take the CAQ exam. If your "group" will continue to work only fast track after passing the CAQ, I wouldn't bother(of course the afore mentioned (possible) pay raise might influence my decision)  . Honestly, you are already the sore throat and suture "guy", so if there is no chance to move to the main ED what's the point?

 

On the other hand if there is a possibility to move to the main ED or you are looking at a main ED/solo gig else where, then by all means go for it. Especially if your employer is footing the bill   

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Ugh

 

 

When are they going to come up with a CAQ for IM......

 

The NP's are killing it in the independent political arena......

 

We have to to advance the masses of us that do the IM work.............

 

 

 

NCCPA are you listening????

 

(And don't tell me PA school prepares you for IM - that is like saying one less year of medical school with out an residency makes you prepared to enter one of the hardest specialities in the scope of knowledge you must have.....)

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I WOULD SUGGEST NOT WORKING IN FAST TRACK.....:)

 

We see who we want to see but sit in fast track area or in the back if theres no space - its not a huge ER - 26 beds? So we do a combination of work ups and fast track crap. Like I'm sure a lot of you experience some our triage nurses are seriously lacking and downgrade stuff if they just don't know what it is (75 yo female with jaw pain made "dental pain") Or...RLQ abdominal pain is still the reason they checked in even if they are eating french fries....and vaginal bleeding in pregnancy - almost always made low level 4 fast track patients. So enough of that kind of venting. We frequently get "fast track disasters" or have a chance to work in the back but I'm interested in this more for the money. When I first started (coming from inpatient cardiology) I was way more comfortable with sick people - the longer I've been there the more concerned I am I've lost those skills if I don't get enough practice. Sigh. 

 

So I don't have the option of just "not working in fast track" : )

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We see who we want to see but sit in fast track area or in the back if theres no space - its not a huge ER - 26 beds? So we do a combination of work ups and fast track crap. Like I'm sure a lot of you experience some our triage nurses are seriously lacking and downgrade stuff if they just don't know what it is (75 yo female with jaw pain made "dental pain") Or...RLQ abdominal pain is still the reason they checked in even if they are eating french fries....and vaginal bleeding in pregnancy - almost always made low level 4 fast track patients. So enough of that kind of venting. We frequently get "fast track disasters" or have a chance to work in the back but I'm interested in this more for the money. When I first started (coming from inpatient cardiology) I was way more comfortable with sick people - the longer I've been there the more concerned I am I've lost those skills if I don't get enough practice. Sigh. 

 

So I don't have the option of just "not working in fast track" : )

 

I guess the question then becomes; what do you do with the pt's that are triaged inappropriately? Do you kick them up to the main ED, or treat them in fast track? do you then involve the doc? If kicked to the main ED do you continue to be the primary provider or does the doc take over and you head back to the fast track?

 

I'm not trying to be mean or condescending in any way, I'm just trying to better understand your working environment.

 

As I stated in an earlier post fast track alone will not prepare you for the EM CAQ.  

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I guess the question then becomes; what do you do with the pt's that are triaged inappropriately? Do you kick them up to the main ED, or treat them in fast track? do you then involve the doc? If kicked to the main ED do you continue to be the primary provider or does the doc take over and you head back to the fast track?

 

I'm not trying to be mean or condescending in any way, I'm just trying to better understand your working environment.

 

As I stated in an earlier post fast track alone will not prepare you for the EM CAQ.  

 

Once I see the patient I am their provider - the nurse will sometimes put them in the back or leave them in the front with me depending on the bedding situation. I had a patient admitted from the rapid treatment area waiting room a couple days ago (colitis nothing big)...we are short on beds most days. Plus a lot of the nurses will say "well we will let them see them up here and then depending on workup we will send to the back". Which means I'm stuck with whatever random complaint or problem in the front and in the back. Its a work in progress. The nurses don't understand that once we see a patient its a waste of time to make another provider see them. I have to remind myself that its been worse. Recently a "seasoned" nurse triaged an older man with"Jaw pain" as a dental pain and left them for me to see. Of course he had no teeth and ended up being an NSTEMI... I don't know why we even call it fast track most days....am I venting too much?

 

I involve the doc if I have a question but we see everything from chest pain to abdominal pain to minor GSW...its really a mix. I have to admit I do not like strokes though and frequently get doc involved immediately...I'm weak there :(

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