Results from the June 2026 Certification Exam administration have been invalidated. Affected candidates may retest at no cost.Read the full statement

Become Certified

Exam content & exam day.

What the exam covers, how it is scored, and what to expect on the day.

For the full details, see the Certification Exam Handbook.

Purpose of the Certification Exam.

The NCCAA administers the Certification Exam to assess entry-level cognitive and deductive skills of the anesthesiologist assistant.

Exam Format.

The certification examination contains 180 items divided into two (2) blocks of 90 items, with 110 minutes to complete the block of items. The examination will be administered in the following format:

  • Pre-test tutorial: 10 – 15 minutes
  • Examination: 235 minutes – two (2) 110-minute blocks of 90 items each, with an optional break time of a maximum of 15 minutes to be taken between the first and second examination blocks only.
  • Post-test survey: 10 – 15 minutes

The items are multiple choice in nature. The items are presented one at a time on a computer screen. Each item may be viewed as long as the candidate desires. The candidate may go back to a previous item, within the current exam block, once an answer choice has been recorded. The candidate may change the answer for a previously answered item within the current exam block; a candidate may not re-enter an exam block once completed and submitted.

Exam construction is centered on the concept that the best items have demonstrated acceptable performance. Items not utilized before have unknown performance characteristics. Therefore, it is necessary to pretest items and evaluate their performance. There are 30 such items on the Certification Exam. These items appear throughout the examination. Items surviving the rigorous evaluation process are retained for use on future examinations. The pretest items are not used in the calculation of score for the examination.


The NCCAA Board of Directors appoints a group of Subject Matter Experts (SMEs) to serve on the Certification Examination Subcommittee. This subcommittee meets annually to draft and review test items for inclusion within the approved item bank. Performance statistics for items are regularly monitored and reviewed for revision, removal or continued use by the NCCAA.

Exam Administration Site.

The NCCAA contracts with Pearson to administer the Certification Exam at test centers located throughout the United States, with multiple sites in major metropolitan areas. Pearson is a global leader in exam development and administration, whose solutions deliver a science-based approach to testing across sectors, including certification, education, and licensure.

Exam Content.

The NCCAA retains responsibility for the examination content outline and test specifications. Additionally, the NCCAA maintains an item bank of approved exam items and sets the passing score for all exams.

The content for the Certification Exam is validated through a profession-wide national survey professional job analysis (JA) most recently performed in 2021 with expected analysis to occur every 5-7 years. The JA ensures the Certification Exam reflects the knowledge of an entry-level anesthesiologist assistant. Content validation is achieved by linking the JA data with knowledge and skill statements. To complete the process, the items are drafted to meet the examination content outline derived from the JA. The JA is essential to the validation that the Certification Exam is directly job-related, a fair assessment of entry-level knowledge, and legally defensible.

The following examination content outline, developed from responses to the 2021 JA is provided to assist candidates in preparing for the Certification Exam. The exam content outline is only a guide suggesting topics and subject areas used to generate and categorize examination items. The exam content outline is not all-inclusive, as some elements apply to more than one subject area. Therefore, candidates must validate their knowledge of a subject and must also be able to integrate this knowledge across the spectrum of anesthesia practice to successfully pass the certification exam.

The NCCAA reserves the exclusive right to determine certification examination content, to classify examination items, and to establish the percentage of exam items from each of the related subject areas. For candidate preparation purposes, the approximate percentages of items in each of the six (6) major content areas are provided in the Exam Content Outline.

Day of Exam.

Arrival

The candidate should arrive at the Pearson Test Center at least 30 minutes prior to the scheduled test time. The candidate who arrives at the test center more than 15 minutes after scheduled test time will not be admitted.

Identification

To gain admission to the Test Center, the candidate must present one (1) valid (current) form of government-issued identification that includes their name and photograph. No form of temporary identification will be accepted. The candidate will also be required to sign a roster for verification of identity.

  • Examples of valid forms of identification are a driver’s license with photograph; state identification card with photograph; passport; or military identification card with photograph.
  • If the first and last name on the registration is different than it appears on their identification, the candidate must bring proof of their name change (e.g., marriage license, divorce decree or court order).

Candidates must have proper identification to gain admission to the Test Center. Failure to provide appropriate identification at the time of the examination is considered a missed appointment. There will be no refund of examination fees.

Security

Pearson administration and security standards are designed to ensure all candidates are provided the same opportunity to demonstrate their abilities. The Test Center is continuously monitored by audio and video surveillance equipment for security purposes.

The following security procedures apply during the examination:

  • Examinations are proprietary. No cameras, tape recorders, pagers or cellular/smart phones are allowed in the testing room. Possession of a cellular/smart phone or other electronic devices is strictly prohibited and will result in dismissal from the examination.
  • No calculators are allowed. If a calculator is needed, it will be provided via the test delivery software.
  • No guests, visitors or family members are allowed in the testing room or reception areas.

Personal Belongings

No personal items, valuables, or weapons should be brought to the Test Center. Only wallets and keys are permitted. Coats must be left outside the testing room. Candidates will be provided a locker to store their wallet and/or keys with them in the testing room. They will not have access to these items until after the examination is completed. Please note the following items will not be allowed in the testing room except securely locked in the locker:

  • Watches
  • Hats
  • Wallets
  • Keys
  • Electronic devices

Once candidates have placed everything into the locker, they will be asked to pull out their pockets to ensure they are empty. The proctor may also ask candidates to lift up the ends of their sleeves and the bottoms of their pant legs to ensure that notes or recording devices are not hidden there. Proctors will also carefully inspect eyeglass frames, tie tacks, or any other apparel that could be used to harbor a recording device.

If all personal items will not fit in the locker, the candidate will not be able to test. The site will not store any personal belongings. The candidate may need to return items to their vehicle.

Personal belongings include, but are not limited to, the following items:

  • Electronic devices of any type, including cellular / mobile phones, recording devices, electronic watches, cameras, pagers, laptop computers, tablet computers (e.g., iPads), music players (e.g., iPods), smart watches, radios, or electronic games.
  • Bulky or loose clothing or coats that could be used to conceal recording devices or notes. For security purposes outerwear such as, but not limited to open sweaters, cardigans, shawls, scarves, hoodies, vests, jackets, and coats are not permitted in the testing room. In the event a candidate is asked to remove the outerwear, appropriate attire, such as a shirt or blouse should be worn underneath.
  • Hats or headgear not worn for religious reasons or as religious apparel, including hats, baseball caps, or visors.
  • Other personal items, including purses, notebooks, reference or reading material, briefcases, backpacks, wallets, pens, pencils, other writing devices, food, drinks, and good luck items.

If any personal items are observed in the testing room after the examination is started, the administration may be subject to forfeiture.

Test Center Environment.

It is unlikely that an NCCAA certification candidate will be the only person taking an examination in the examination room. Individuals taking other examinations will most likely be present. Some examinations may require full use of the computer keyboard, and there may be accompanying keyboard noise. In addition, Pearson personnel and other individuals may leave and enter the exam room during the certification candidate’s exam period.

Test centers will make every effort to keep movement of personnel and noise levels to a minimum during examination administrations. However, if a certification candidate believes that noise may be a distraction, they should request earplugs at the test center to use during the Certification Exam.

In the unlikely event that the test center is unable to provide a reasonable environment for examination, the candidate should notify the test center staff, request documentation of the issue from the test center and notify NCCAA as soon as practicable.

Individual exam rooms are not available at most test centers and would require accommodation application and documentation in advance to be utilized. (See Accommodations section)

Taking the Exam.

Examination Software

Prior to attempting the examination, you will be provided an exam overview with the sections and time for each section. Additionally, you will be provided a list of the key features of the examination software delivery program to familiarize yourself prior to beginning. The time you use for this process is NOT counted as part of your examination time or score. When you are comfortable with the computer testing process, you may click “Next” and begin the timed examination.

Timed Examination

Before beginning the examination, instructions for taking the examination are provided on-screen. The computer monitors the time you spend on the examination. The examination will terminate if you exceed the time allowed for the current item block or the examination. You may click on the time or the clock icon in the upper right corner of the screen to toggle the timer on and off. A digital clock indicates the time remaining for you to complete the section currently attempting. The candidate can turn off the Time feature during the examination. However, the time for administration of the exam continues to run.

Only one examination question is presented at a time. The question number appears in the lower right portion of the screen. Choices of answers to the examination question are identified as A, B, C, or D. You must indicate your choice by either typing in the letter or clicking on the option using the mouse. To change your answer, enter a different option by typing A, B, C, or D or by clicking on the option using the mouse. You may change your answer as many times as you wish during the examination time limit.

To move to the next question, click on the “Next” (>) button in the lower right portion of the screen. This action will move you forward through the examination question by question. If you wish to review any question or questions, click the “Review” button and click on the item number you wish to review.

An examination question may be left unanswered for return later in the examination session. Questions may also be flagged for later review by clicking in the blank square below the time and item number with the label “Flag for Review” immediately to the right of the blank square. To identify all unanswered and bookmarked questions, click the button labeled “Navigator” at the bottom of the screen. Item status, flags and notes for each item in the section will appear. Click on the item number you desire to review. If not all questions have been answered and there is time remaining, return to the examination and answer those questions that do not list “Complete” as the item status. The number of unseen/incomplete items will appear in the bottom right corner of the Navigator screen.

Candidate Comments

During the examination, you may make comments for any question by clicking on the “Give Feedback” button at the bottom of the screen This opens a dialogue box where comments may be entered. Comments will be reviewed, but individual responses will not be provided. The comments will be used by the NCCAA to identify issues with items to improve exams and provide appropriate scoring of exams.

Following the Examination

After completing the examination, you are asked to answer a short evaluation of your examination experience.

If a personal emergency requires you to take a break during an examination block, an Irregularity Report will be filed. The test center administrator will report this irregularity to the NCCAA.

Examination Format.

The Certification Examination contains 180 items divided into two (2) blocks of 90 items, with 110 minutes to complete the block of items. The examination will be administered in the following format:

  • Pre-test tutorial: 10 – 15 minutes
  • Examination: 235 minutes – two (2) 110-minute blocks of 90 items each, with an optional break time of a maximum of 15 minutes to be taken between the first and second examination blocks only.
  • Post-test survey: 10 – 15 minutes

Behavior During an Exam.

The candidate is not permitted to bring any personal belongings into the testing room, including but not limited to written or printed materials, mechanical or electronic devices, handbag, wallet, notes, study materials, calculator, watch, recording or filming devices, cell phone, food, or beverages.

The candidate is not permitted to communicate with, seek aid from, or provide aid to any other candidate during the examination.

During the examination, calculations may be performed by using the marker board and marker provided by the test center. An online calculator will be presented to candidates during the examination. The calculator icon can be found on the computer screen.

Test center staff monitor all testing sessions during examinations.

Test center staff are not authorized to answer questions from candidates regarding examination content, testing software, or scoring.

Restrooms are provided at the test center. A candidate may be excused from testing to use the restroom according to test center regulations.

Audio and video monitoring is employed at all test centers. Inappropriate behavior during testing may result in termination of testing. Inappropriate behavior during testing may result in the candidate’s examination being declared invalid.

Behavior Following the Exam.

The content of the NCCAA Certification Exam, and each individual exam item, is the property of the NCCAA and is copyrighted and protected from publication via electronic, written or other means. The retention, possession, copying, distribution, disclosure, discussion, or receipt of any NCCAA exam item, in whole or in part, by written, electronic, oral, or other form of communication, including but not limited to emailing, copying, or printing of electronic files, and reconstruction through memorization and/or dictation, before, during, or after the NCCAA Certification exam is strictly prohibited and may result in disciplinary action, assessment of monetary damages, and further legal liability. Candidates who are aware of improper behavior should report it to the NCCAA. All reasonable attempts will be made by NCCAA to maintain the report as confidential.

Governing document

Certification Exam Handbook

Where a page on this site and the handbook differ, the handbook applies. Rev. October 1, 2026.

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