A Physician Assistant (PA) is a licensed clinician who practices medicine as part of a healthcare team, providing diagnostic, therapeutic, and preventative care in nearly all medical settings and specialties. PAs are rigorously educated in the medical model, and their professional standing relies on two distinct but interconnected credentials: national certification and state licensure. While the common term “board certified” is generally applied to physicians, PAs achieve and maintain a national certification that provides a comparable and measurable demonstration of professional competence. This certification process is mandatory for entry into the profession and must be continually upheld throughout a PA’s career. It ensures all practicing PAs meet a standardized level of general medical knowledge, validating their capability to provide high-quality patient care.
Understanding Certification and Licensure
The ability of a Physician Assistant to practice medicine depends on two necessary credentials: national certification and state licensure. Certification is the initial recognition of competence granted by a non-governmental organization. Licensure is the formal, state-level permission required to practice legally within a specific jurisdiction. The certification process is a national standard that applies uniformly across the United States and its territories, signifying that a PA has met the educational and testing requirements for entry into the field.
Licensure is governed by individual state medical boards, which grant the legal authority to practice medicine within their borders. State boards rely on national certification as a mandatory prerequisite for granting a license. A PA must possess both the national certification and a valid state license to legally treat patients.
The National Certification Requirement
The national credential for PAs is administered by the National Commission on Certification of Physician Assistants (NCCPA), the only certifying body for the profession in the United States. New graduates from accredited PA programs must pass the Physician Assistant National Certifying Examination (PANCE) to earn the Physician Assistant-Certified (PA-C) designation. The PANCE is a comprehensive, computer-based examination that assesses a candidate’s general medical and surgical knowledge, reflecting the foundation of the PA’s generalist education.
The PANCE consists of 300 multiple-choice questions, divided into five blocks of 60 questions each, covering a broad range of medical organ systems and disease categories. This ensures the PA possesses the core knowledge to practice in any primary care or specialty setting. Successfully passing this examination is the final step after graduating from a program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). Upon passing, the PA is granted the PA-C designation, marking their national certification.
Maintaining Professional Certification
The PA-C credential requires continuous maintenance through a structured, 10-year recertification cycle. This cycle is designed to ensure that PAs remain current with medical advancements and continually demonstrate their competence throughout their careers. Within this 10-year period, PAs must complete five two-year cycles of continuing medical education (CME).
During each two-year cycle, a PA must log 100 CME credits, including a minimum of 50 Category 1 credits from approved educational activities. By the end of the 10th year, the PA must also pass a recertification examination, either the Physician Assistant National Recertifying Examination (PANRE) or the PANRE-Longitudinal Assessment (PANRE-LA). This mandatory periodic testing, combined with ongoing education, is the mechanism by which PAs uphold their national certification.
Specialty Certification for PAs
Beyond the mandatory general certification, PAs can pursue advanced credentials known as Certificates of Added Qualifications (CAQs). These are also administered by the NCCPA. CAQs are voluntary and formally acknowledge a PA’s experience, skills, and knowledge in a defined specialty area, such as Emergency Medicine, Cardiovascular and Thoracic Surgery, or Orthopedic Surgery.
To be eligible for a CAQ, a PA must first hold the PA-C credential and meet specific requirements related to their chosen specialty. These requirements include a minimum number of hours of experience (typically 2,000 to 4,000 hours) and a required number of specialty-specific CME hours. The final component is passing a rigorous, specialty-specific examination that tests advanced knowledge in that field.
Differentiating PA Certification from Physician Board Certification
The language used to describe professional credentials differs between Physician Assistants and physicians (MDs or DOs) due to their post-graduate training and certifying bodies. Physicians pursue a medical degree followed by a multi-year, specialty-specific residency program. After residency, physicians seek certification from a specialized, non-governmental board, such as the American Board of Internal Medicine, leading to the term “board certified.”
PAs, in contrast, are educated as medical generalists through a master’s level program, followed by a single, national certification exam administered by the NCCPA. The NCCPA functions as the sole national certifying body for the entire PA profession, unlike the collection of specialty-specific boards for physicians. Therefore, while PAs are nationally certified by a board-like entity, their standard credential remains Physician Assistant-Certified (PA-C), reflecting their generalist foundation.