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, along with surgeons and nurses, is an essential member of the patient care team. 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 with the opportunity to demonstrate their knowledge and competency within a field and their ability to meet the demands of the job. It also shows they are qualified and actively pursuing their careers. 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 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 Certified Surgical Technicians (CST).
Aspiring surgical techs can also gain certification through the National Center for Competency Testing (NCCT). This certification is called 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 competence in meeting the requirements to work in their field. As certification for this field is at the national level, surgical technologists can use their certification regardless of the state in which they practice.
After passing the NBSTSA, CSTs can apply for membership in the Association of Surgical Technologists (AST). This professional organization 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 passing the NBSTSA examination. Those with alternative credentials or who have not sought certification may apply as an associate member, although this designation means they cannot 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 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 before 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) allows future surgical technologists to demonstrate their clinical skills and educational background.
The exam has 175 questions. Applicants must correctly answer at least 98 questions to pass the CST examination. 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, a reference handbook and a 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
- Microbiology
- Surgical pharmacology
There are two paths to becoming 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, a 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, is 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 61.5 percent pass rate. 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.
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
- Documentation
- 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 five options to become eligible for the NCCT TS-C credential exam:
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 to complete 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 before taking the exam.
5. 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.
The NCCT website lists approved educational training institutions. The TS-C exam costs $199.
Certification Renewals – NBSTSA and NCCT
Surgical technologists need to recertify their CST (NBSTSA) credentials 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 $299 if they are a current member of the Association of Surgical Technologists and $399 if they are not a current member.
Those with a TS-C (NCCT) credential need to renew it annually. They must complete 14 continuing education credits and pay a $89 fee. These credits may be taken through the NCCT or another organization, although the NCCT may audit outside credits to ensure they meet professional standards.
State Certification & Licensure for Surgical Technologists
States’ registration, licensing, and certification requirements vary 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 surgical technologists 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 must 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.
