VirginiaPhysician Assistant License Requirements

Prerequisite Education

Physician assistants must earn a master's degree from an ARC-PA accredited program. Programs typically span 24-28 months and include didactic coursework and over 2,000 hours of clinical rotations across various medical specialties.

Retake Policy

90-day waiting period between attempts; maximum 6 attempts within the first 6 years after graduation

The PANCE is a computer-based exam administered by the NCCPA (National Commission on Certification of Physician Assistants). It consists of 300 multiple-choice questions covering medical and surgical knowledge. A scaled score of 350 is required to pass. Many states also require a jurisprudence exam on state-specific PA laws and regulations.

OTP Details

Virginia requires a supervising physician. Virginia was the 7th state to enact the PA Compact (April 4, 2024), which triggered compact activation.

PA supervisory requirements vary significantly by state. Some states have adopted Optimal Team Practice (OTP), which allows PAs to practice without a formal supervisory agreement. Other states require collaborative or supervisory agreements with specified physician-to-PA ratios and chart review schedules.

Scope Determined By

Practice Agreement with supervising physician and state law

Practice Settings

Specialty Restrictions

No specialty restrictions; PAs may practice in any medical or surgical specialty

Prescriptive Limitations

• •Must be authorized by supervising/collaborating physician
• •DEA registration required for controlled substances
• •Must comply with state-specific formulary restrictions if applicable

Restricted Activities

• •Independent surgery (without physician)
• •Final interpretation of imaging studies
• •Activities outside scope defined by practice agreement

PA scope of practice is determined by state law, supervising physician agreements, and practice setting. Most states grant PAs prescriptive authority including controlled substances, though Schedule II prescribing varies. DEA registration is required for prescribing controlled substances in most states.

NCCPA Certification Maintenance

Must maintain NCCPA certification; 100 CME hours per 2-year cycle; PANRE every 10 years

PANRE Cycle

Every 10 years

NCCPA CME Cycle

100 hours per 2 years

Regulatory Board

PA licenses must be renewed on schedule with the state board. Additionally, PAs must maintain NCCPA certification by completing 100 CME hours every 2 years and passing the PANRE (Physician Assistant National Recertifying Exam) every 10 years. State CME requirements may differ from NCCPA requirements.

Reciprocity Requirements

• •Active PA-C certification from NCCPA
• •Current license in good standing in another state
• •Graduation from ARC-PA accredited program
• •Passage of PANCE
• •Pass criminal background check
• •Submit endorsement application

The PA Licensure Compact is an emerging interstate compact that allows PAs to practice across state lines. For non-compact states, PAs must apply for licensure by endorsement, which typically requires NCCPA certification, verification of credentials, and meeting state-specific requirements.