The two main med-surg nursing certifications, the CMSRN (from MSNCB) and the MEDSURG-BC (from ANCC), are both nationally recognized and accredited. Neither is objectively “better.” The right choice depends on your experience level, your employer’s preferences, and how you plan to use the credential. Here’s how they compare on the details that actually matter.
The Two Certifications at a Glance
The CMSRN (Certified Medical-Surgical Registered Nurse) is offered by the Medical-Surgical Nursing Certification Board (MSNCB), which is closely tied to the Academy of Medical-Surgical Nurses (AMSN). It’s designed specifically for bedside med-surg nurses and focuses heavily on clinical practice knowledge.
The MEDSURG-BC (Medical-Surgical Nurse, Board Certified) comes from the American Nurses Credentialing Center (ANCC), which is the credentialing arm of the American Nurses Association. ANCC is one of the largest and most broadly recognized certification bodies in nursing, offering credentials across dozens of specialties. The MEDSURG-BC is accredited by the Accreditation Board for Specialty Nursing Certification (ABSNC), the same body that accredits the CMSRN.
Both credentials signal the same thing to employers: you’ve demonstrated competence in medical-surgical nursing beyond your RN license. Most hospitals and health systems accept either one interchangeably for Magnet recognition, clinical ladder advancement, and certification pay differentials.
Eligibility Requirements
The barriers to entry are similar but not identical. For the CMSRN, you need 2,000 practice hours in a med-surg setting within the past three years. MSNCB recommends (but does not require) two full years of med-surg experience with your RN license before sitting for the exam.
ANCC describes its MEDSURG-BC as an “entry-level” competency assessment after initial RN licensure, though you still need to meet eligibility requirements around clinical hours and nursing education. Both exams expect you to have meaningful hands-on med-surg experience before testing.
Pass Rates and Exam Difficulty
This is where the two exams diverge meaningfully. In 2024, the ANCC MEDSURG-BC had a 75% pass rate out of 4,672 test-takers. The CMSRN had a 69% pass rate out of 4,337 test-takers the same year. That six-point gap is consistent enough to suggest the CMSRN exam is slightly more difficult, though differences in test-taker preparation and experience levels also play a role.
Content-wise, the CMSRN leans more heavily into bedside clinical scenarios: think disease-specific nursing interventions, medication administration, and patient assessment across body systems. The MEDSURG-BC covers similar clinical territory but also incorporates professional role development, evidence-based practice, and systems-level thinking. If you’re a strong clinical nurse who spends most of your time at the bedside, the CMSRN content may feel more natural. If you’re comfortable with questions about leadership, quality improvement, and nursing theory, the MEDSURG-BC exam style may suit you better.
Exam Costs
The CMSRN costs $267 for AMSN members and $394 for non-members. A first-time retake within one year of your initial attempt drops to $189 for members and $315 for non-members. All fees include a non-refundable $79 processing fee.
ANCC exam fees typically follow a similar structure, with discounts for ANA members. Pricing tends to land in a comparable range. Before you pay out of pocket, check whether your employer offers certification reimbursement. Many hospitals cover exam fees entirely, especially those pursuing or maintaining Magnet designation.
Renewal and Recertification
Both certifications require renewal every five years, but the renewal processes differ in flexibility.
ANCC requires 75 continuing education contact hours in your certification specialty over the five-year period. Clinical practice hours are not mandatory for renewal, though you can use a minimum of 1,000 practice hours as one of several renewal categories if you prefer. This flexibility is appealing if you’ve shifted into education, management, or another role that takes you away from direct patient care.
The CMSRN also allows renewal through continuing education or by retaking the exam. Retake fees mirror the initial exam costs. If you plan to stay in bedside med-surg nursing for the foreseeable future, either renewal pathway is straightforward. But if you anticipate a career move away from direct care, the ANCC’s approach gives you more options to maintain your credential.
Which One Employers Prefer
In most cases, employers treat the CMSRN and MEDSURG-BC as equivalent. Both count toward Magnet hospital certification metrics, both satisfy clinical ladder requirements at the vast majority of health systems, and both typically qualify for whatever annual certification bonus your facility offers. These bonuses vary widely by employer, but the credential itself (CMSRN vs. MEDSURG-BC) rarely determines the amount.
That said, ANCC has broader name recognition outside of med-surg nursing. If you’re early in your career and might eventually pursue certifications in other specialties, building a relationship with ANCC’s renewal system could simplify things down the road. On the other hand, if you’re deeply invested in the med-surg specialty and value a certification built exclusively around bedside med-surg practice, the CMSRN and its parent organization (AMSN) offer a more focused professional community, including conferences, study resources, and networking geared specifically toward med-surg nurses.
How to Choose
Start by asking your manager or education department which certification your hospital prefers. Some facilities have a slight lean toward one or the other based on historical relationships with the certifying body, existing study groups, or reimbursement agreements. If your employer has no preference, consider these factors:
- You’re a bedside-focused nurse who wants a clinically rigorous exam: The CMSRN is purpose-built for med-surg practice and is widely respected among med-surg nurses specifically.
- You want broader name recognition or may change specialties: The ANCC MEDSURG-BC comes from a certifying body that credentials nurses across many specialties, which can simplify future transitions.
- You might leave direct patient care: ANCC’s renewal process, which doesn’t require clinical hours, offers more flexibility if your career path shifts toward education, informatics, or leadership.
- You’re an AMSN member: The member discount on the CMSRN exam saves you $127, making it the cheaper option if you already belong.
The total number of actively certified nurses is remarkably similar across both credentials. In 2024, there were roughly 30,400 certified CMSRNs and about 31,700 MEDSURG-BCs. Neither certification is niche or obscure. Both carry weight, both are accredited by the same oversight board, and both tell the same story on your resume: you know med-surg nursing well enough to prove it on a standardized exam.