Becoming a Surgical Technologist - Guide to Education & Certifications

Providing the best medical care requires an operating room team of precision-oriented professionals including surgical technologists. These professionals, also known as surgical techs, scrub techs, and O.R. (operating room) techs, work closely with doctors, anesthesiologists, nurses, surgical first assistants, and patients to provide safe and sterile surgical procedures of all kinds. They are often the first to arrive and the last to leave an O.R., charged with ensuring that operating rooms are prepared properly prior to a procedure and restocking medical supplies such as bandages and gauze as needed.

From start to finish of a procedure, surgical techs are responsible for a full slate of tasks: preparing an operating room for surgery, sterilizing equipment, wheeling patients to and from an operating room, and tying their team members’ surgical gowns in place. In essence, surgical techs ensure everything in the surgical environment is clean and sterile: the facilities, equipment, instruments, and patients’ incisions sites. To be a surgical tech is to be meticulously focused on observing the overall view of a medical procedure, ticking off tasks on checklists, having a kind and helpful bedside manner, and depending on specialization, knowing how to prepare robotic equipment prior to surgery.

While surgical technologists need to be fastidiously clean, they must also be precise. During surgery, surgical techs perform critical medical support services. For instance, a surgical technologist must listen carefully for instructions and hand over sterile tools requested by surgical first assistants and surgeons. Having a strong physical and mental constitution is required for surgical techs as they may have to hold surgical instruments or something more vital, such as a patient’s internal organs, in place during operation.

One surgical tech task of paramount importance is counting all tools and sponges before and after an operation to ensure nothing is left inside the patient’s body. This is a basic, but essential task that if left uncompleted could put the patient at risk for infection, and the hospital at risk for litigation. After surgery, surgical techs clean and sterilize the operating room and help transfer patients to their recovery rooms.

For those who crave a multi-skilled medical career without the extensive education and training required of nurses and surgeons, becoming a surgical tech is a great career choice. According to the US Bureau of Labor Statistics (BLS), with an accredited diploma, certificate, or an associate’s degree, aspiring surgical technologists can train for an entry-level career in the field in 1-2 years. Surgical technology education programs include a mix of didactic science and technical courses as well as hands-on learning experience in supervised clinical settings.

Keep reading for more details about becoming a surgical technologist.

Role Requirements of a Surgical Technologist

Like most precision-oriented environments, an operating room follows a hierarchical chain of command. Surgical technologists are considered entry-level positions who are required to respond to the orders given by people who rank higher on the chain of command. In an operating room, the chain of command correlates to level of education and experience and begins at the bottom with a surgical tech, moves up to surgical first assistants, then nurses, and lastly anesthesiologists and surgeons.

Surgical first assistants, a similar occupation to surgical technologists, typically have more years of education and experience compared to surgical techs and are the primary point of contact with a surgeon during an operation. While the scope of practice is similar for surgical technologists and surgical first assistants, the role of the surgical tech is to take orders from the surgical first assistants. For example, if a surgeon steps out of a room, a nurse or surgical first assistant would be the next person in charge.

Skills & Traits of a Successful Surgical Technologist

There are a number of skills that can help an aspiring surgical tech to succeed in their chosen career. O*NET Online (2020) notes a number of important skills, including:

  • Teamwork: Surgical techs work closely with an entire surgery team.
  • Communication: Listening is a critical skill of surgical techs who must provide the right tool or complete a specific task as requested by the surgical team to ensure a smooth operation.
  • Attention to Detail: As is to be expected, there are many details to pay attention to in an operating room, from the position of equipment to the sterilization of tools and the scheduling of a procedure.
  • Focus: Surgical techs must be certain that they can pay close attention to important details without becoming easily distracted.
  • Active Listening: Although surgical first techs may lead a team of other surgical techs, listening carefully to doctors and patients, and being able to respond clearly is a critical part of the job.
  • Dexterity: Of course, surgeons are the ones performing the actual surgeries, but steady hands and manual dexterity are also important skills for techs in the operating room.
  • Problem Sensitivity: This is “the ability to tell when something is wrong or is likely to go wrong”. Many different things can go wrong during the course of one operation and the more a surgical tech can anticipate these issues, the better off everyone will be.
  • Monitoring: The ability to monitor others, to monitor one’s own behavior, and of course to monitor instruments can be quite helpful in performing the everyday duties of a surgical technologist.

Steps to Becoming a Surgical Technologist

It takes anywhere from 12 to 24 months (after graduating from high school) to become a surgical technologist. Many practicing surgical techs chose to obtain an associate’s degree from a community college or technical school. Two-year degree programs with a concentration on surgical technology can provide a strong foundation for the career, and many programs include some hands-on experience as part of their degree completion requirements.

An example of a CAAHEP-accredited surgical technology program is Hinds Community College (HCC) in Raymond, Mississippi. Students applying to this program must complete prerequisite courses in anatomy and physiology, English composition, algebra, and humanities at HCC or another educational institution. This program begins every year in August and requires three semesters to complete.

While there are a few different pathways that a student can take to become a surgical tech, the basic steps to tackling this career are virtually the same.

Step 1: Graduate from High School (Four Years)

First, students should earn a high school diploma or GED. This is a prerequisite for most post-secondary surgical technologist programs. High school students who want to pursue this career should take courses in biology, anatomy, and hard sciences in order to prepare for college-level courses. Pursuing an internship at a local hospital is also recommended to gain general experience in a healthcare environment.

Step 2: Earn an Associate Degree or Garner the Equivalent Experience (Two Years)

Aspiring surgical technologists should enroll in an accredited training program at a community college. Alternatively, professional training options are available through US military medical programs, which provide surgical training that can be completed in 12 to 14 weeks. When choosing programs, students are advised to verify that their program is accredited from a proper agency, such as the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES). Graduates from schools without proper accreditation may not be eligible for certification exams.

Step 3: Get Hands-On Professional Experience (Timeline Varies)

While completing an educational program, it is recommended to get as much hands-on training as possible, through internships, job shadowing, or other means. These experiences can make a huge difference in practical knowledge as well as professional connections when it comes time to search for a job.

Step 4: Prepare for Certification Exams (Timeline Varies)

After graduation, graduates should prepare for one of the national certification exams through the National Board of Surgical Technology and Surgical Assisting (details in the following section). While not all states require certification, having it shows commitment to the profession and greatly increases the likelihood of finding a job. The exam can be completed in one day, but students should allow approximately three months for their application to be approved and to set a date for the exam. More information about surgical technologist certification is detailed in the next section.

Step 5: Apply for Jobs (Timeline Varies)

Once certified, graduates are prepared to find entry-level surgical technologist positions. According to the BLS, more than 70 percent of surgical technologists find employment at hospitals, with the remainder working in physicians and dental offices (BLS 2019). School career counselors can also assist in securing a position.

As well, becoming a member of a professional organization such as the Association of Surgical Assistants (ASA) or the National Surgical Assistant Association (NSAA) can provide professional networking opportunities and access to job postings.

Surgical Technologist Certification

In terms of certification, there are two main certifications available for surgical technologists. The first is offered by the National Board of Surgical Technology and Surgical Assisting (NBSTSA) and provides those who pass an examination with the credential of Certified Surgical Technologist (CST).

In order to qualify for the CST examination, applicants must be a graduate of an accredited surgical technologist program, surgical first assisting program, or a military training program. Those who already have on-the-job experience as surgical techs may also be eligible, but must first complete the Accelerated Alternate Delivery Pathway.

To apply, applicants mail their application and wait up to six weeks to receive their authorization to test (ATT) letter from NBSTSA. Rush processing is available for an additional $50 which shortens the process substantially and guarantees an ATT in 3-5 business days. Examinations are given by appointment only at testing agencies throughout the country. The total cost for application and examination for members is $190 and for non-NBSTSA members the cost is $290.

The second possibility is obtaining certification through the National Center for Competency Testing. This organization offers credentialing for a number of allied health professions, including medical assistants, phlebotomy technicians, and of course surgical techs.

In order to qualify for this credential, known as the Tech in Surgery – Certified TS-C (NCCT), candidates must have completed (or be in the process of completing) one of three routes: a surgical technologist program from an accredited institution, have completed military training, or have three verifiable years of experience in surgical technology.

To receive certification, students must provide valid documentation of high school diploma or GED; a copy of their surgical technology diploma, certificate of completion, or transcript with (projected) graduation date; and complete a Tech in Surgery – Certified (NCCT) Critical Skills Competency form. While it’s not necessary to submit this documentation prior to taking the exam, all documents must be received by the NCCT before certification is released. Depending on the eligibility route, the exam fees range from $155 to $195.

State Licensing for Surgical Technologists

Each state has its own licensure requirements for surgical technologists, so professionals should check the laws in the state where they plan to work. The Association of Surgical Technologists (AST) advocates for state laws that require all surgical technologists to complete the following in order to legally perform work:

  1. Graduate from a CAAHEP-accredited surgical technology program
  2. Obtain the Certified Surgical Technologist (CST®) credential from the National Board of Surgical Technology and Surgical Assisting (NBSTSA)
  3. Maintain the CST® credential by completing mandatory continuing education (CE) hours

Recently, some states have passed laws requiring surgical technologists to be educated and licensed in accordance with ACT recommendations. Here’s a list of states following the above ACT requirements and the year their laws were signed into place:

  • Idaho (1991) – Idaho requires that surgical technologists (referred to as “operating room technicians”) and either complete a CAAHEP-accredited program or satisfy the NBSTSA requirements for CST/certification
  • Indiana (2009)
  • Massachusetts (2012)
  • Nevada (2017)
  • New Jersey (2011)
  • New York (2015)
  • Oregon (2016)
  • South Carolina (2018)
  • Tennessee (2013)
  • Texas (2009)

Three other states have agreed to require surgical technologists to register, but not earn the CST credential:

  • Colorado (2016) (CST not required for registration)
  • North Dakota (2011) (“Unlicensed Assistive Person” registry; CST not required for registration)
  • Washington (2010) (CST not required for registration)

As well, three other states offer optional registration and title protection for surgical technologists:

  • Arkansas (2017) (Must be a CST in order to qualify for the registry/title protection)
  • Illinois (2004) (Must be a CST in order to qualify for the registry/title protection)
  • Virginia (2014) (Must be a CST in order to qualify for the registry/title protection)

It’s clear to see the certification at the state level is trending, so to be eligible for future career growth, surgical techs would be well-served to choose a CAAHEP-accredited program, earn, and maintain certification through the NBSTSA.

Career Outlook for Surgical Technologists

Career growth for surgical technologists is projected to be strong in the coming decade. Between 2019 and 2029, the BLS estimates that surgical tech job openings in the US will swell 7 percent, which is faster than the average for all occupations at 4 percent (BLS 2019). If this projection is accurate, an estimated 7,600 new positions will be created by 2029 adding to the current 111,300 positions. Surgical techs currently earn a median annual salary of $48,300 (BLS 2019).

As they advance through their careers, many surgical technologists go on to pursue careers in healthcare as anesthesia technicians, surgical first assistants, registered nurses, physician assistants, physicians, or post-secondary instructors.

Jocelyn Blore
Jocelyn Blore Managing Editor

After graduating from UC Berkeley, Jocelyn traveled the world for five years as freelance writer and English teacher. After stints in Japan, Brazil, Nepal, and Argentina, she took an 11-month road trip across the US, finally settling into lovely Eugene, OR. When Jocelyn isn’t writing about college programs or interviewing professors, she satirizes global politics and other absurdities at Blore’s Razor (Instagram: @bloresrazor). Thank you for being interested.