The AST and the Fight for Universal Professional Credentialing

“My primary reason to support the state laws is founded in the desire to provide quality patient care with a quality educated healthcare provider. I see the negative effects of not having these requirements as falling short of the surgical patients’ expectation to have a high-level standard of care based on the entire surgical team having formal education and training, along with continuing education.”
Kevin Craycraft, Vice President of the Association of Surgical Technologists (AST) Board of Directors

Think of the last time you were put under anesthesia for surgery. Were you having an outpatient procedure, like getting your wisdom teeth removed? Maybe it was a cosmetic procedure? Or perhaps it was something more serious—an unforeseen, life-threatening health issue.

Regardless of the reason or the level of risk associated with the surgery, we all like to think we are in good hands when we go under the knife.

A 41-year-old Colorado mother had to learn that, unfortunately, this is not always the case. In 2009, Lauren Lollini went under anesthesia for a routine kidney stone surgery. She ended up being one of 6,000 patients who was exposed to hepatitis C by a painkiller-addicted surgical technologist who had passed on her dirty syringes to patients.

Kristen Parker, 26, told law enforcement that she had filled her own used syringes with saline and hid them in her pocket to swap them for the Fentanyl-filled syringes in the operating carts when the other medical staff were out of the room. The technician’s actions ended up infecting 75 patients with hepatitis C, and the woman was sentenced to 30 years in prison.

The story shocked community members, who inundated the surgery center and the medical community with questions as to this could happen. The answer may have more to do with the surgery center’s specific operational standards or hiring process, but there is another reason: a lack of professional regulation that is contributing to low-quality surgical technologists slipping through the cracks.

Surgical Technology: An Unregulated Profession in 40 States

Colorado is one of 38 states that does not require medical facilities to hire surgical technologists with formal education or credentials.

In fact, surgical technologists are the only members of the surgical team that are not universally required to meet certain educational standards or hold a certification, according to the Association of Surgical Technology (AST). This may come as a surprise to many, considering that these medical professionals have access to supplies like drugs and equipment in medical centers.

If you think the hiring process of surgical techs is so lax because these medical professionals don’t do much in the operating room, you’d be disappointed. While surgical techs are known for sanitizing tools and passing them to the surgeon during an operation, they also help by holding patients’ organs in place, using retractors (i.e., the instruments used to separate the edges of a surgical incision) and helping dress the patients’ wounds after operations.

Yet the only states that require any formal credentialing or certification are Idaho, Nevada, New York, Indiana, Massachusetts, New Jersey, South Carolina, Tennessee, Oregon, and Texas. That means that in the remaining 40 states, if you go under the knife for any reason, it’s possible that a member of the staff assisting in your surgery has no legitimate qualifications.

The Importance of Recognition – National Surgical Technologists Week

Recognizing the hard work that exceptional and credentialed surgical technologists perform is critical. Without them, surgery would be much more difficult and expensive. To that end, in 1984, the AST designated the third week in September as National Surgical Technologists Week. In 2021, it will be celebrated from September 19th to the 25th.

National Surgical Technologists Week can help bring the public’s awareness to this essential yet relatively unknown career on a national level. Public service ad campaigns and hospital-sponsored events can help educate patients about who is in their operating room and what their roles are. This can also be an excellent time to discuss the importance of state licensing requirements and the dangers of unlicensed surgical technologists.

There are several ways to get involved with National Surgical Technologists Week. Surgical technologists can volunteer in elementary school classrooms to share about their profession or offer to have high school students shadow them in the operating room.

Also, surgical technologists can promote themselves and their work to their friends and family through their social media channels. Finally, community members can reach out to hospitals, outpatient clinics, and health care centers to learn what they are doing for this special week and how they can learn more.

During National Surgical Technologists Week, employers are encouraged to openly acknowledge the work that surgical technologists perform in their facility. This can be through social media posts, press releases, patient education pamphlets, and in-office signage. The goal is to bring awareness to the critical tasks surgical technologists perform and thank them for their hard work.

On an individual level, employers should send a personal acknowledgment to every surgical technologist they employ, thanking them for the work they do.

Meet the Experts: Kevin Craycraft and Norma Chyphert

Kevin Craycraft is the vice president of the AST’s board of directors. The organization represents more than 80,000 surgical technologists and is a public advocate in the push to get more states to introduce requirements.

Craycraft is also the program coordinator and an associate professor of the surgical technician program at Bluegrass Community and Technical College in Lexington, Kentucky.

Norma Chyphert is the director and program chair of the surgical technology program at Linn-Benton Community College in Central Oregon. She has 34 years of experience as a surgical technologist and witnessed Oregon introducing legislation to regulate surgical technicians in Oregon in 2016. She has been teaching surgical technology classes at the school for the last three years.

The Importance of Professional Credentialing Among Surgical Techs

Craycraft says providing a more universal set of criteria would help to better protect patient safety: “[There should be] a base level of knowledge and care, much like the other surgical team members we work elbow-to-elbow with, such as physicians, anesthesiologists, surgical first assistants and nurses,” he said.

According to Craycraft, licensure or similar laws would require graduation from nationally accredited surgical technology programs, of which there are currently 450 operating under a common set of curriculum requirements, accreditation standards, and outcomes in the U.S.

These training programs are usually about one year long but can be as short as nine months or as long as 18, depending on the school. Attending such a program gives students the skills they need to take the National Board of Surgical Technology and Surgical Assisting (NBSTSA) exam upon graduation.

“CSTs [certified surgical techs] then maintain their certification by participation in continuing education and must earn an average of 15 continuing education credits annually,” Craycraft mentioned.

The notion of introducing such requirements is not agreed upon by all concerned parties. According to Craycraft, the main reason there has been so much lag in increasing educational standards is due to employers (i.e., hospitals and surgery centers)—some of whom say these measures may “impede recruitment and employment.”

Expectedly, this is true in states where educational requirements have been put in place, such as in Oregon, which changed its law about five years ago.

“There is a huge demand for surgical techs in Oregon, mainly because of the legislation change,” Cyphert confirmed.

While it is only logical that hospitals and surgical centers would have more trouble finding technologists with state requirements in place, both Craycraft and Cyphert agree that passing such legislation is well-worth it.

“My primary reason to support the state laws is founded in the desire to provide quality patient care with a quality educated healthcare provider,” Craycraft said. “I see the negative effects of not having these requirements as falling short of the surgical patients’ expectation to have a high-level standard of care based on the entire surgical team having formal education and training, along with continuing education.”

Cyphert agreed. “I am totally for it because I’ve seen what occurs when you take somebody who is, say, in housekeeping and then you just say ‘Okay, we’re going to train you to be a surgical tech.’ If you don’t have someone that’s good then they can be sloppy and it puts patients at risk,” she said.

As Cyphert points out, the introduction of legal standards has caused a boost in demand for CSTs in states like Oregon, but even outside of requirement states, demand for these professionals is expected to grow significantly.

The Bureau of Labor Statistics (BLS) estimates that the employment of surgical technologists in the U.S. will grow by seven percent between 2019 to 2029, largely due to the aging of the Baby Boom generation, as older people usually require more surgical operations.

Interested in Becoming a Surgical Tech?

You may be wondering how much money surgical technicians make, considering the relatively short length of the programs and the high demand for certified professionals.

The median annual wage for surgical technologists in the U.S. is $51,510 (Bureau of Labor Statistics, May 2020), with the lowest 10 percent earning less than $34,120 and the highest 10 percent earning more than $73,110 or more. It’s worth noting that CSTs make more money at hospitals than they do in surgical centers and have higher average hourly wages in West Coast states.

“You can make an amount of money in the low $20s [per hour] and be able to go up from there. As long as you do your job well, you can advance pretty quickly with pay at a good hospital,” Cyphert said.

But there is more appeal to the job than a fast track into a lucrative profession. Many surgical techs say they get a deep sense of satisfaction from the work: “It’s very demanding, and you have to be on your game, paying attention at all times, but when you join any hospital team, it becomes a big family of sorts,” Cyphert said. “There’s almost never a dull moment, especially if you’re in a trauma center. You’re scrubbed in right in the middle of everything.”

The Linn-Benton Community College surgical technician program is offered online with weekly lab sessions. Cyphert said that for every 18 positions open in her fall and spring groups, she receives 80 applications.

“There’s a lot of interest in it, and it doesn’t take a lot of time,” she said. “Our program is really short. It’s nine months online with labs one day a week. I nicknamed it ‘surgical tech boot camp.’” She also said that the program has a 95 percent success rate of students graduating with jobs, and about 90 percent of students pass the certification test on their first attempt.

While the role of the surgical technologist is one that can provide enough monetary incentive and excitement to sustain you for your entire career, like Cyphert, others find that it can be a gateway to pursuing further education for other medical careers.

“Some of the techs choose to become a CFA [certified first assistant], which allows them to assist surgeons, usually at orthopedic offices, and some of the others decide to become nurses or physicians assistants,” she said. “It can even be a stepping stone if you want it to be.”

Nina Chamlou
Nina Chamlou Writer

Nina Chamlou is an avid freelance writer from Portland, OR. She writes about economic trends, business, technology, digitization, supply chain, healthcare, education, aviation, and travel. You can find her floating around the Pacific Northwest in diners and coffee shops, or traveling abroad, studying the locale from behind her MacBook. Visit her website at