Surgical Technology Certifications - CST (NBSTSA), TS-C (NCCT)
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Surgical technologists assist surgeons in the operating room, ensuring that the patient and all necessary instruments are ready for surgery. This includes sterilizing and preparing operating rooms; sterilizing and inventorying equipment to make sure there is enough for surgery; preparing patients for surgery by washing and disinfecting incision sites; passing surgeons instruments while they work; keeping track of objects to make sure there are no foreign objects inside the patient after surgery; and making sure the operating room continues to stay sterile to prevent patient infection.
A surgical technologist is an essential member of a patient care team along with surgeons and nurses. This work is different from a surgical first assistant, who may assist the surgeon with suctioning or suturing a wound. These assistants typically have several years of experience working as a surgical technologist. This means they have completed all of the education and examination requirements to work as a licensed surgical technologist, as well as completed an accredited assistant program and passed an exam. Surgical technologists and first assistants are certified through the same body: the National Board of Surgical Technology and Surgical Assisting (NBSTSA).
The number of states that require surgical technologists to get certified before working varies. However, certification provides surgical technologists the opportunity to demonstrate they have knowledge and competency within a field, as well as the ability to meet the demands of the job. It also shows they are qualified and actively pursuing their career. Last, it sets a foundation for continuous learning and improvement through continuing education and recertification.
Candidates must first obtain their associate degree in surgical technology from an accredited school before taking a certification exam. These programs take anywhere from one to two years and require at least a GED to apply. The program must be accredited by the Commission on Accreditation of Allied Health Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES). Surgical technologists pass an exam through the National Board of Surgical Technology and Surgical Assisting (NBSTSA) to be considered a Certified Surgical Technician (CST).
Aspiring surgical techs are also able to gain certification through the National Center for Competency Testing (NCCT). This certification is referred to as a “Tech in Surgery – Certified” or TS-C (NCCT). Applicants to this certification must also pass an exam. While many states do not require completion of this certification, it is good practice for surgical technologists to seek certification and demonstrate that they are competent in meeting the requirements to work in their field. As certification for this field is at the national level, surgical technologists are able to use their certification regardless of what state they practice in.
After passing the NBSTSA, CSTs can apply for membership with the Association of Surgical Technologists (AST). This is a professional organization that provides resources to help CSTs stay on top of new trends and developments in the field, as well as benefits like reduced fees when it is time to recertify their license.
Active membership in this organization requires passage of the NBSTSA examination. Those with alternative credentials or who have not sought certification may apply as an associate member, although this designation means they are not able to vote. You may also apply as a student to be an associate member, which provides reduced fees for the NBSTSA exam.
Individual states may have their own certification, licensing, and/or registration requirements. They may also have additional requirements. Always double-check with the licensing board for the state where you work prior to starting the licensure process.
Ready to dive into an exciting career as a certified surgical technologist? Check out this guide on education requirements and certification options in this high-growth field.
National Board of Surgical Technology and Surgical Assisting (NBSTSA) – Certified Surgical Technologist (CST)
The CST certification offered by the National Board of Surgical Technology and Surgical Assisting (NBSTSA) provides future surgical technologists the opportunity to demonstrate their clinical skills and education background.
The exam has 175 questions. Applicants must answer at least 102 of them to pass the exam, which has a 70 percent pass rate. Note that only 150 of the questions on the test are scored. The remaining 25 are used to test exam questions. Questions are multiple choice and will have four potential answers. The NBSTSA provides a practice examination, as well as a reference handbook and content outline to help applicants study. The test covers a broad area of knowledge, including:
- Preoperative preparation
- Intraoperative procedures
- Postoperative procedures
- Administrative and personnel protocols
- Equipment sterilization and maintenance
- Anatomy and physiology
- Surgical pharmacology
There are two paths to become eligible for the NBSTSA credential exam:
- Graduates of a Surgical Technology Program: Complete a CAAHEP- or ABHES-accredited program, as well as provide a copy of your unofficial transcript, notarized letter stating your graduation date, or a copy of your graduation certificate.
- Graduates of a Military Training Program in Surgical Technology: Complete a program that has not yet received, in the process of receiving, or has received CAAHEP accreditation, as well as provide a copy of DD214 stating the base where the program was completed, a graduation certification, or a smart transcript.
Accredited programs are found on CAAHEP or ABHES websites. The cost for the CST exam is $190 for members of the Association of Surgical Technologists and $290 for non-members.
National Center for Competency Testing (NCCT) – Tech in Surgery – Certified (TS-C)
The TS-C certification offered by the National Center for Competency Testing (NCCT) focuses on providing a pathway to certification for surgical technologists already working in the field.
The exam has an overall 73 percent pass rate. The NCCT offers three options for eligibility to take the exam: education, experience, and military education/experience. These pathways are all detailed below.
Those who took the exam through the education eligibility option had an 81 percent pass rate. Those who took the exam through the experience and military eligibility option had a 97 percent and 100 percent pass rate. (Please note that the military eligibility option has a much lower number of applicants than the experience and education eligibility options.)
Similar to the NBSTSA examination, the test has 175 questions and 25 of these questions are unscored. Applicants have four hours to take the exam, which is multiple choice. The NCCT provides a detailed test plan to help applicants study and a candidate handbook. The test covers the following topics:
- Setting up for surgical procedure
- Executing patient safety
- Applying sterile technique
- Assessing the integrity and sterility of items
- Utilizing preference cards
- Documenting unusual events
- Understanding environmental safety
- Preparing the operating room
- Understanding basic sciences as they relate to surgical procedures
- Supporting the needs of the surgeon
- Executing end of procedure tasks
- Preparing supplies
- Recognizing post-operative complications
- Executing end-of-case procedures
There are three options to become eligible for the NCCT TS-C credential exam:
1. Education Option (Current Students): Complete a surgical technology program at an NCCT-authorized school, as well as have a GED or high school diploma. Current students should submit a copy of their surgical technology diploma, a certificate of completion, or a transcript with graduation date within 60 days of graduation. They must also complete a TS-C Critical Skills Competency Form within two years of taking the exam. While the documents above are not required to take the exam, students will not be considered “certified” until they are submitted. The exam fee for students is $155.
Education Option (Recent Graduates): Recent graduates must also complete the same requirements as current students, but must submit the required documents before taking the exam. In addition, if they wait longer than nine months to take the exam, the cost increases to $195.
2. Experience Option: Those pursuing the experience option must have three years of experience working as a surgical technologist. Specifically, they must have three years of full-time employment or 6,240 hours within the last five years working as a surgical technologist under the supervision of a certified/licensed physician, primary care provider, and/or RN. They must also hold a GED or high school diploma and complete a TS-C Qualification by Experience form prior to taking the exam. The exam fee for experienced surgical technologists is $195.
3. Military Option: Those currently in the military or who have completed their service within the last five years are eligible to take the exam. If they have completed a surgical technology training program within the last five years, they are eligible to take the exam. They must also provide a copy of a smart transcript or DD214, complete a TS-C Critical Skills Competency Form, and have a high school diploma or GED.
Alternatively, military applicants may also take the exam if they have three years of full-time experience as a surgical technologist within the last five years and are either a member or spouse of an active, retired, or veteran of the Armed Forces.
Last, they must have three years of full-time employment or 6,240 hours within the last five years working as a surgical technologist under the supervision of a certified/licensed physician, primary care provider, and/or RN. They must also hold a GED or high school diploma and complete a TS-C Qualification by Experience form prior to taking the exam. Those pursuing the military option must pay a $155 exam fee.
Approved educational training institutions can be found on the NCCT website.
Certification Renewals – NBSTSA and NCCT
Surgical technologists need to recertify their CST (NBSTSA) credential every two years. The annual renewal deadline is the date you were originally certified. Many CSTs take continuing education credits through the Association of Surgical Technologists (AST). They must have taken 30 credits of continuing education courses within the last two years or pass a recertification examination. Those who wish to renew by examination must pay $399 if they are a current member of the Association of Surgical Technologists and $499 if they are not a current member.
Those with a TS-C (NCCT) credential need to renew their credential annually. They must complete 14 continuing education credits and pay a $77 fee. These credits may be taken through the NCCT or through another organization, although outside credits may be audited by the NCCT to ensure they are meeting professional standards.
State Certification & Licensure for Surgical Technologists
States vary in their registration, licensing, and certification requirements for surgical technologists. Some states require certification while others require registration at the state level. Other states do not require surgical technologists to pursue any formal recognition through the state. Always check with the licensing board in your state for current information on application and continuing education requirements.
For example, California does not require surgical technologists to have certification prior to working. Alternatively, Illinois requires those working as a surgical technologist to receive and maintain licensure through the state Department of Financial and Professional Regulation (IDFPR). Those applying must either pass an exam administered by the state, hold credentials from a qualifying national examination body, or hold a license from another state with requirements similar to Illinois. The application fee is $100 and must be recertified by April 30 of each even-numbered year. The state does not have any continuing education requirements.
Generally, states that require surgical technologists to register or get licensed at the state level have different renewal procedures. These may vary anything from two to five years. However, those applying for recertification typically need to demonstrate compliance with all certification requirements, pay a fee, and update their contact information. They also need to disclose any formal disciplinary actions filed against them or if they have received a conviction.