Dermatology Physician Assistant Groups Face Off Over Certification

Ken Terry

October 15, 2019

The long-standing Society of Dermatology Physician Assistants (SDPA) is objecting to the newly established American Board of Dermatology Physician Assistants'  (ABDPA) plan to offer a new certification test to physician assistants (PAs), stating there is no need for an additional exam for PAs to gain certification beyond what already exists.

The ABDPA states that its mission is just to offer PAs a "certification they could feel proud of."

Established in 2018, the ABDPA offers the first-ever board certification to dermatology PAs. The SDPA, which has been in existence since 1994, is a professional society that offers "diplomate fellowships" to its members.

These fellowships are training programs that carry continuing medical education (CME) credit. They are restricted to dermatology PAs who are already in practice and who have passed the certifying exam of the National Commission on Certification of Physician Assistants (NCCPA).

On October 7, the ABDPA announced its new board certification exam, saying it would fill a void in dermatology "by creating a national standard for those professionals who have committed their careers to the treatment of skin disease."

Although the news release didn't state specific qualifications for taking the 125-question exam, the ABDPA website said that completing an SDPA diplomate fellowship would be sufficient to qualify a candidate.

The SBDA immediately objected to this statement and to the ABDPA's overall mission. "The Society of Dermatology Physician Assistants (SDPA) was not privy to the development of any certifying exam for [Dermatology] PAs nor believes there is a need or authority to do so," the society said in a news release.

The SDPA noted that it didn't endorse the ABDPA, and it asked that the reference to its diplomate fellowship be removed from the board's website.

"Outside of medical board regulation of PA state licensure," the SDPA said, "certification of Derm PAs is solely granted by the National Commission on Certification of Physician Assistants (NCCPA). The ABDPA has no authority to grant a 'board' certification where a board does not exist. SDPA does not support an exam that has not undergone the vigorous psychometric analysis required to qualify as an accurate examination."

Gina Mangin, MPAS, PA-C, president of the SDPA, told Medscape Medical News that, unlike the ABDPA, the NCCPA is accredited. PAs who graduate from accredited PA programs can take the 300-question NCCPA exam. If they pass it, they receive a general certification, which the majority of states require for licensure, she said.

To keep their license, Mangin added, PAs must complete 100 hours of CME every 2 years. They have to retake the NCCPA exam every 10 years to maintain their certification.

The NCCPA also offers a "certification of added qualification" (CAQ) in seven fields: cardiovascular and thoracic surgery, emergency medicine, hospital medicine, nephrology, orthopedic surgery, pediatrics, and psychiatry. There is no CAQ in dermatology.

"If PAs wanted a specialty certification in dermatology, we'd likely go through the NCCPA with their CAQs," Mangin said. "But as far as the SDPA board knows, our membership has never expressed a desire to become board certified in dermatology."

No Ill Wishes Toward SDPA

Matthew Reynolds, MPAS, PA-C, founder and president of the ABDPA, told Medscape Medical News that "a large number of dermatology PAs were looking for something more than what is currently available [in certification]," which is the primary reason he started the ABDPA. Only about 17% of the SDPA's 3700 members, he added, have taken its diplomate fellowship.

While the ABDPA doesn't yet have accreditation, Reynolds said, the board is "working toward it." As for validation of the board's test, he said, "The exam is validated by the [ABDPA] board of directors and a testing committee. The exam is being tested. We're trying to get to the point where more and more of the exam is validated, and that's an ongoing process."

Before the ABDPA was announced, Reynolds noted, he and his fellow directors asked to meet with the SDPA leaders to discuss these and other details, but they refused.

"We still hope to work with the SDPA someday," he said. "We have no ill wishes toward the SDPA. We all agree SDPA is a great organization and provides valuable CME."

When the SDPA objected to the mention of its name and fellowship in connection with the board certification program, Reynolds noted, the ABDPA took that off its website.

Currently, the only qualifications for taking the board certification exam are that candidates be graduates of accredited PA training programs and that they have worked with the same dermatologist for at least 3 years.

PAs do not, however, need to be currently certified by the NCCPA to take the board certification exam, Reynolds said. All PAs take the NCCPA exam when they finish training, he said, but some dermatology PAs have not renewed their NCCPA certification in states where it's not required for licensure.

So, while the ABDPA would not offer its exam to a PA who had not passed the NCCPA test, he said, it wants to make board certification available to those who did not retake the NCCPA exam at the 10-year interval.

The ABDPA, which charges $450 for its exam, requires diplomates to take the test again once every 7 years to maintain their board certification.

According to the NCCPA, there are currently 3940 dermatology PAs who hold its general PA certification. Both the SDPA and the ABDPA estimate there are about 5000 dermatology PAs in the US. So the ABDPA appears to offer an alternative to at least 1000 dermatology PAs. In addition, some PAs might want the additional credential, Reynolds claims.

Reynolds admits that his board will probably have a small number of takers, at least at the outset. However, he says, "We wanted to offer dermatology PAs something more, not just a [general] certificate or CME, but a certification they could feel proud of."

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