Becoming a Surgical Technologist - Guide to Education & Certifications
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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. They are often the first to arrive and the last to leave an O.R., charged with ensuring that operating rooms are prepared properly before 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’ incision 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 must 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 during operations.
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 basic but essential task, 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.
Become a surgical tech for those who crave a multi-skilled medical career without the extensive education and training required of nurses and surgeons. According to the US Bureau of Labor Statistics (BLS), with an accredited diploma, certificate, or associate’s degree, aspiring surgical technologists can train for an entry-level career in the field in one to two years. Surgical technology education programs include a mix of didactic science and technical courses and a 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 the 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 education and experience than 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 assistant would be the next person in charge.
Skills & Traits of a Successful Surgical Technologist
There are several skills that can help aspiring surgical techs succeed in their chosen career. O*NET Online (2024) notes many, 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 is a critical part of the job.
- Dexterity: Of course, surgeons perform 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 a student can take a few different pathways to becoming 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 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 by 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.
Some examples of schools providing associate degree programs in surgical technology include:
Wallace Community College offers an associate in applied science degree in surgical technology. It provides laboratory, clinical, and classroom instruction to students and enables them to perform as competent, entry-level surgical technologists after graduation.
Made up of 71 credits, the program includes courses such as introduction to surgical technology; applied surgical techniques; surgical procedures; pharmacology for the surgical technologist; microcomputer applications; general microbiology; general psychology; and role transition in surgical technology.
- Location: Dothan, AL
- Accreditation: Commission on Accreditation of Allied Health Education Programs (CAAHEP); Southern Association of Colleges and Schools Commission on Colleges (SACSCOC)
- Expected Time to Completion: Five semesters
Covering eight states, Concorde has 17 convenient locations in many of the nation’s largest cities and neighboring communities. Its associate degree program in surgical technology is offered at 14 Concorde campuses, including one in San Bernardino, CA. Concorde also offers an online surgical technology degree completion program that can be completed in as few as eight months.
San Diego’s surgical technology requires the completion of 68 credits. The program blends theory with hands-on practical experiences where students can apply their knowledge in on-campus lab operational settings and become familiar with the practices and processes of an operating room. Students will complete 300 on-campus lab hours, including operating room simulations and patient prep settings.
Before graduation, students will also be required to complete 570 clinical hours in the field through clinical settings under the guidance of surgical technologists and licensed surgeons. Through these clinicals, they can engage with 120 different surgical cases, divided into several types of surgery.
As part of the program, students will delve into anatomy and physiology; surgical technology theory; surgical technology lab; surgical procedures; and a clinical review.
- Location: San Bernardino, CA
- Accreditation: Commission on Accreditation of Allied Health Education Programs (CAAHEP); Accrediting Commission of Career Schools and Colleges (ACCSC)
- Expected Time to Completion: 17 months
Colorado Mesa University’s associate of applied science program in surgical technology is designed to cover the clinical and academic skills necessary for performing as a surgical technologist. The program utilizes St. Mary’s Hospital’s skills laboratory and classroom to engage students in a hospital setting to prepare for clinical experience. The program begins in the fall semester each year. Prerequisite courses are completed in the first year before admission to the program’s professional portion (year two).
Comprising 65 credits, the program includes courses such as human anatomy and physiology; health and wellness; pathophysiology; medical terminology in surgical technology; fundamentals in surgical technology; pharmacology for surgical technology; safety and equipment; and specialty surgical procedures.
- Location: Grand Junction, CO
- Accreditation: Commission on Accreditation of Allied Health Education Programs (CAAHEP); Higher Learning Commission (HLC)
- Expected Time to Completion: 24 months
Gwinnett Technical College offers an associate of applied science program in surgical technology, which provides students with an opportunity for an exciting career behind the doors of the operating room. Students in this program will study the practices and techniques needed to keep surgical patients safe while also learning how to manage surgical equipment and assist surgeons during procedures effectively.
The program’s curriculum includes hands-on guidance in technologically advanced labs, clinical rotations in area hospitals, and classroom instruction. This 72-credit program includes courses such as an introduction to surgical technology; principles of surgical technology; introductory microbiology; surgical pharmacology; surgical procedures; and a seminar in surgical technology.
- Location: Lawrenceville, GA; Alpharetta, GA
- Accreditation: Commission on Accreditation of Allied Health Education Programs (CAAHEP); Southern Association of Colleges and Schools Commission on Colleges (SACSCOC)
- Expected Time to Completion: 24 months
College of Southern Idaho’s associate of applied science program in surgical technology instructs students in several aspects of surgery including aseptic technique, procedures, instrumentation, anatomy, and microbiology. Graduates of this program will be able to find instant placement in this fast-paced operating room environment and will be eligible for national certification testing.
Consisting of 60 credits, the program includes courses such as medical terminology; central sterile processing; surgical concepts; surgical practice and procedures; leadership skills for surgical techs; human anatomy and disease; surgical pharmacology; anesthesia; surgical procedures; and wound closure techniques.
- Location: Twin Falls, ID
- Accreditation: Commission on Accreditation of Allied Health Education Programs (CAAHEP); Northwest Commission on Colleges and Universities (NWCCU)
- Expected Time to Completion: 24 months
For a more detailed list of surgical technology programs, please check out the surgical technologist schools page.
Step 3: Get Hands-On Professional Experience (Timeline Varies)
While completing an educational program, getting as much hands-on training as possible is recommended, through internships, job shadowing, or other means. These experiences can make a huge difference in practical knowledge and professional connections when searching 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 71 percent of surgical technologists find employment at hospitals, with the remainder working in physicians and dental offices (BLS 2024). School career counselors can also assist in securing a position.
Also, 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 a Certified Surgical Technologist (CST) credential.
To qualify for the CST examination, applicants must be graduates of an accredited surgical technologist program, surgical first assisting program, or military training program. Those with 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; 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 several allied health professions, including medical assistants, phlebotomy technicians, and of course surgical techs.
To qualify for this credential, known as the Tech in Surgery – Certified TS-C (NCCT), there are five options to become eligible for this exam. The NCCT offers five options for eligibility to take the exam: current high school student; current non-high school student; graduate; experience; and military. These pathways are detailed below.
1. Current High School Student: This pathway is for current high school students in a surgical technology program from an NCCT (authorized) school. Applicants must be United States high school students. Upon obtaining a passing score on the Tech in Surgery certification exam, they will receive a provisional certification and upon graduation, they must submit a copy of their surgical technology diploma, certificate of completion, or transcript with graduation date within 60 days of graduation; or contact NCCT for other suitable arrangements. They must also complete and submit a Tech in Surgery TS-C (NCCT) Critical Skills Competency form. Candidates are allowed a maximum of two years from graduation for completion of case documentation.
2. Current Non-High School Student: This pathway is for current non-high school students in a surgical technology program from an NCCT (authorized) school. Applicants must be United States high school graduates or hold equivalent credentials (e.g., GED). They must submit a copy of their surgical technology diploma, certificate of completion, or transcript with graduation date within 60 days of graduation; or contact NCCT for other suitable arrangements. They must also complete and submit a Tech in Surgery TS-C (NCCT) Critical Skills Competency form. Candidates are allowed a maximum of two years from graduation for completion of case documentation.
3. Graduate: This pathway is for graduates from an NCCT (authorized) school, within the past five years. They must be United States high school graduates or hold equivalent credentials (e.g., GED). Additionally, they must submit a copy of their diploma from their surgical technologist program, certificate of completion, or transcript with graduation date. They must also complete and submit a Tech in Surgery TS-C (NCCT) Critical Skills Competency form. Candidates are allowed a maximum of two years from graduation for completion of case documentation.
4. Experience: 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.
3. Military: 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.
Approved educational training institutions can be found on the NCCT website. The cost for the TS-C exam is $199.
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 to perform work legally:
- Graduate from a CAAHEP-accredited surgical technology program
- Obtain the Certified Surgical Technologist (CST®) credential from the National Board of Surgical Technology and Surgical Assisting (NBSTSA)
- 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 under AST recommendations. Here’s a list of states following the above AST requirements and the year their laws were signed into place:
- Idaho (1991) – Idaho requires that surgical technologists (referred to as “operating room technicians”) either complete a CAAHEP-accredited program or satisfy the NBSTSA requirements for CST/certification
- Indiana (2010)
- Massachusetts (2012)
- Nevada (2017)
- New Jersey (2011)
- New York (2014)
- Oregon (2016)
- Pennsylvania (2020)
- South Carolina (2008)
- Tennessee (2006)
- Texas (2009)
- Connecticut (2023)
- Virginia (2021)
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)
- Illinois (2013)
- Colorado (2021)
- North Dakota (2019)
- Washington (2010)
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, and earn, and maintain certification through the NBSTSA.
Career Outlook, Work Environments, and Salaries for Surgical Technologists
Career growth for surgical technologists is projected to be strong in the coming decade. Between 2022 and 2032, the BLS estimates that surgical tech job openings in the US will swell by 5 percent, which is faster than the average for all occupations at 3 percent (BLS 2024). If this projection is accurate, an estimated 5,900 new positions will be created by 2032 adding to the current 109,200 positions.
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.
Surgical Tech Work Environments
In 2022, 109,200 surgical techs were employed in the following work environments (BLS 2024):
- Hospitals: state, local, and private: 71 percent
- Offices of physicians: 12 percent
- Outpatient care centers: 12 percent
- Administrative and support services: 2 percent
- Offices of dentists: 1 percent
Surgical Tech Salaries
The BLS (May 2023) shows the average annual salary for surgical technologists is $62,250, which is slightly less than the national average for all occupations ($65,470).
The BLS (May 2023) found the following percentiles for surgical technologists around the country:
| United States | |
|---|---|
| Number of technologists Employed | 110,320 |
| Annual Mean Wage | $62,250 |
| 10th percentile | $40,640 |
| 25th percentile | $49,940 |
| 50th percentile | $60,610 |
| 75th percentile | $72,520 |
| 90th percentile | $83,150 |
Interestingly, PayScale (July 2024)—an aggregator of self-reported wages—found lower figures among its 3,163 surgical technologist respondents:
- 10th percentile: $38,000
- 50th percentile (median): $56,243
- 90th percentile: $76,000
Not surprisingly, wages and employment figures in this field also tend to vary based on region. The BLS (May 2023) found that the top-employing states for surgical technologists correlated roughly with population size:
- California: 11,100 employed ($76,170 annual average salary)
- Texas: 9,460 employed ($60,070 annual average salary)
- Florida: 8,430 employed ($56,730 annual average salary)
- New York: 5,190 employed ($73,150 annual average salary)
- Pennsylvania: 4,380 employed ($58,900 annual average salary)
Considering that only two years of postsecondary school is the typical entry-level education for this career, it can prove a very lucrative professional field.
