Becoming a certified surgical technologist typically takes one to two years, depending on whether you pursue a certificate or an associate degree. The most common path involves completing an accredited surgical technology program and then passing a national certification exam. With a median annual salary of around $62,830, it’s a career you can enter relatively quickly compared to many other operating room roles.
Complete an Accredited Program
The first step is enrolling in a surgical technology program accredited by either CAAHEP (Commission on Accreditation of Allied Health Education Programs) or ABHES (Accrediting Bureau of Health Education Schools). Graduating from one of these programs is required to sit for the most widely recognized certification exam, the Certified Surgical Technologist (CST) credential from the National Board of Surgical Technology and Surgical Assisting (NBSTSA).
These programs are offered at community colleges, vocational schools, and some universities. Certificate programs generally take 12 months, while associate degree programs run about 24 months. Both include classroom instruction and hands-on clinical rotations in actual operating rooms, where you’ll learn sterile technique, surgical instrumentation, wound closure, patient positioning, and how to anticipate what a surgeon needs during a procedure. The associate degree route includes general education courses that can make it easier to transfer credits later if you decide to pursue further education.
When choosing a program, confirm its accreditation status before enrolling. Programs that lack CAAHEP or ABHES accreditation will not qualify you for CST certification, regardless of the quality of training.
Pass the CST Exam
After graduating, you’ll apply to take the CST exam through the NBSTSA. The application process involves submitting proof of graduation from your accredited program and paying the applicable fees.
The exam itself consists of 175 multiple-choice questions, though only 150 of them are scored (the remaining 25 are unscored pilot questions mixed in). You need a scaled score of 98 on the scored questions to pass. The test covers perioperative care, anatomy and physiology, surgical procedures across specialties, and sterilization and infection control. Most candidates take the exam within a few months of graduation, and many programs help you prepare with review courses or practice exams during your final semester.
An Alternative Certification Path
The CST isn’t the only credential available. The National Center for Competency Testing (NCCT) offers the Tech in Surgery-Certified (TS-C) credential, which has different eligibility requirements. At minimum, you need a high school diploma or GED plus three years of experience working in a surgical setting. This path exists primarily for people who trained through military service or gained operating room experience on the job before formal credentialing became widespread. It validates the same core competencies: maintaining a sterile environment, preparing for procedures, and supporting the surgical team before, during, and after operations.
That said, the CST is more widely recognized by employers and is the credential most state laws reference. If you’re starting from scratch, the accredited program plus CST exam route will open the most doors.
States That Require Certification
Not every state legally requires surgical technologists to hold a credential, but a growing number do. As of recent legislative updates, the following states have passed laws related to surgical technologist education, certification, or registration requirements: Connecticut, Idaho, Indiana, Massachusetts, Nevada, New Jersey, New York, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, and Virginia all have laws tied to education and certification standards.
Additional states require registration, which may involve documenting your credentials with a state agency: Arkansas, Colorado, Illinois, North Dakota, and Washington.
Even in states without legal mandates, most hospitals and surgical centers strongly prefer or require CST certification as a condition of employment. The credential has become a practical necessity nationwide, regardless of what state law says.
Keeping Your Certification Current
The CST credential operates on a two-year certification cycle. To renew, you must earn 30 continuing education credits before your cycle expires. At least 4 of those credits must come from live educational events, such as in-person workshops, conferences, or webinars with real-time interaction. The remaining credits can come from self-study courses, journal articles, or online modules approved for CE credit.
Letting your certification lapse can create problems with your employer and may require you to retake the exam, so staying on top of your credits throughout the two-year window is much easier than scrambling at the end.
Moving Up: Surgical First Assistant
Once you’re working as a CST, the most common advancement path is becoming a Certified Surgical First Assistant (CSFA). First assistants take on a more hands-on role during procedures, helping with tissue retraction, hemostasis, and wound closure under the surgeon’s direction. It’s a meaningful step up in both responsibility and pay.
Bridge programs designed specifically for working CSTs are the typical route. Mayo Clinic’s Surgical First Assistant Bridge Program, for example, involves roughly three months of classroom and lab education followed by six months of clinical time. You must pass each course with a grade of 70 percent or higher, and the coursework must be completed consecutively with no breaks. After finishing a bridge program, you’re eligible to sit for the CSFA certification exam.
Other advancement options include specializing in a particular surgical area (cardiac, orthopedic, neurosurgery), moving into surgical technology education, or using your experience as a foundation for nursing or physician assistant programs.
Timeline at a Glance
- Certificate programs: About 12 months of education, then the CST exam
- Associate degree programs: About 24 months of education, then the CST exam
- Alternative TS-C path: High school diploma plus 3 years of surgical experience, then the NCCT exam
- First assistant advancement: Approximately 9 months of additional training after working as a CST
From enrollment to your first day in the operating room as a certified surgical tech, you’re looking at roughly one to two and a half years. That’s a relatively fast track into a career with strong demand, solid pay, and clear options for growth.