CCA Cheat Sheet 2026: One-Page Review of Must-Know Facts

The Credential at a Glance

The Certified Clinical Anaplastologist (CCA) credential is awarded by the Board for Certification in Clinical Anaplastology (BCCA). Anaplastology is the clinical and artistic discipline of designing, fabricating, and fitting prostheses for facial, ocular, and body defects, whether congenital, traumatic, or surgical in origin. The credential signals that a practitioner has met a defined standard of training, supervised clinical hours, documented case work, and examination performance.

This page is a compressed reference. If you need depth on any single area, the CCA study guide covers preparation strategy, and the complete guide to all six content areas expands every domain below. If you are brand new to the credential, start with what CCA certification is and come back here for the review.

Exam Format and Fee Mechanics

What the Test Looks Like

The written exam consists of 100 four-option multiple-choice questions, and you have three hours to complete it. That works out to roughly 1.8 minutes per question, which is generous enough for careful reading of clinical scenarios but not generous enough to deliberate at length on every item. The test is administered by the board itself rather than through a commercial testing provider, and it is a paper-and-pencil format, so you should practice marking answers by hand and managing a physical booklet rather than relying on on-screen navigation habits.

Questions are written in English. Candidates for whom English is a second language should rehearse clinical vocabulary in English specifically, including material terminology, anatomical landmarks, and patient-education phrasing.

Fees and Paperwork

For 2026, the application fee is $300 and is nonrefundable. The written exam fee is $800. Together that is $1,100, and that figure does not include training costs, travel, or any venue-specific charges, which may change. Treat the number as a floor for planning rather than a ceiling. For a fuller accounting, see the CCA certification cost breakdown.

Several logistics are not verified in the source material this review relies on: whether any remote option exists, whether the exam is open-book, whether calculators are permitted, and whether the test is adaptive. Do not assume any of these. Check the BCCA's current candidate materials before you register, and plan around the confirmed paper-and-pencil, fixed-length format. Scheduling specifics are covered in CCA exam dates, windows, and deadlines.

The Four Eligibility Routes

There is no single path to the credential. The BCCA recognizes four current routes, and each pairs education with supervised clinical time.

Notice the trade-off built into the structure. The more clinical and anaplastology-specific your formal education, the less supervised time is required; the further your background is from clinical practice, the longer the supervised apprenticeship. Route 2 is notable for its short, concentrated hour requirement, reflecting that a clinical doctorate already carries substantial patient-care training, with the art coursework filling the craft gap.

Two details trip people up. First, the time windows (24 months, eight weeks, 36 months) are part of the requirement, not just the hour totals. Second, supervised hours must be verified, so keep contemporaneous records from day one. The full prerequisite picture is in CCA requirements and how to qualify.

The 18-Case Portfolio Requirements

Regardless of route, every candidate must submit 18 cases: three detailed cases and 15 concise cases. Alongside the cases, the BCCA requires records, verification of supervised hours, patient permissions, and two qualifying physician recommendations.

• Three detailed cases: Expect to document the full clinical arc, from initial assessment through fabrication, delivery, and follow-up, with the reasoning behind your decisions.
• 15 concise cases: Shorter documentation that still demonstrates range across defect types, materials, and techniques.
• Patient permissions: Consent for the use of case information and images must be in hand before submission, not chased afterward.
• Two physician recommendations: The recommenders must meet the board's qualifying criteria, so confirm eligibility before you ask.

Six Domains: What to Know Cold

The exam is organized around six official domains that follow the clinical workflow and end with professional conduct. The blocks below summarize the high-value content in each. These are study orientation points, not a substitute for the full domain guide, and the board does not publish them here with weightings, so do not budget study time by assumed percentages.

Because the exam follows a clinical sequence, scenario questions often test whether you can identify the correct next step or the domain a problem belongs to. If a question describes a patient struggling with retention months after delivery, you are in Domain 5 territory; if it describes a consent gap in case photography, it is Domain 6. Learning to classify a scenario quickly narrows the plausible answers.

Standards, Legacy Criteria, and Key Dates

The current certification standards took effect January 1, 2024. During the transition, legacy criteria remain accepted through December 31, 2026. For anyone mid-pipeline, that deadline matters: if your training and documentation were structured under the older criteria, you have a defined window to complete certification under them, and after it closes you will be held to the current standards.

For a sense of how demanding the process is overall, including the portfolio, see how hard the CCA exam really is. And if you are curious about outcomes data, the CCA pass rate discussion explains why no number should be quoted without a verified source.

Renewal Rules in One Place

Certification is not permanent. The renewal cycle is three years, and renewal requires 36 BCCA CE credits/CEUs earned by November 1, along with payment of current annual fees. Practical implications:

• Track credits continuously. Thirty-six credits across three years is manageable if spread out and painful if left to the last autumn.
• Mind the November 1 date. It is the cutoff for earning the credits, so a credit earned afterward does not count for that cycle.
• Keep annual fees current. Renewal requires that annual fees be up to date, so a lapse in payment can complicate an otherwise complete renewal.
• Count BCCA-recognized credits. The requirement is specifically for BCCA CE credits/CEUs, so confirm that an activity is recognized before relying on it.

Sequencing Your Review by Domain

You do not need an elaborate system. The one useful structuring idea is to study in clinical order and spend extra time where documentation experience is thinnest. A candidate who has fabricated dozens of prostheses may be strong on Domain 3 but weak on Domain 6 consent standards; a candidate from an allied-health background may know assessment and follow-up well but need to shore up sculpting and coloration vocabulary.

Because the exam is paper-based, do at least one timed run on paper, marking answers by hand. Then use our CCA practice questions to find weak domains, and keep returning to the main practice test site for mixed sets as your date approaches.

Where Certified Clinical Anaplastologists Work

Practitioners typically work in settings where patients with facial and body defects receive care: hospital-based prosthetic and maxillofacial services, academic medical centers, cancer treatment programs, and private anaplastology practices that take referrals from surgeons, oncologists, and other physicians. The two required physician recommendations in the certification process reflect how embedded this work is in physician referral networks.

Employment and income vary considerably by setting and region, and this page does not quote specific figures because none are verified here. For a qualitative look at earnings drivers, read the CCA salary guide, weigh the trade-offs in whether the credential is worth it, and explore the market in CCA jobs.

What This Cheat Sheet Will Not Guess At

A reliable cheat sheet is as useful for what it declines to state as for what it states. The following are not verified and should be confirmed directly with the BCCA before you rely on them:

• Whether remote proctoring or any off-site delivery is available
• Whether any reference materials, calculators, or open-book aids are permitted
• Whether the exam adapts to candidate performance (the confirmed format is a fixed 100-question test)
• Any numeric passing score, pass rate, or domain weighting
• Any venue-specific charges, which may change from the fees above

Treat any source that confidently supplies these details without citing the board with caution.

Frequently Asked Questions