Surgical technologists are inside the operating room for every procedure. You prepare the sterile field, pass instruments to the surgeon, and anticipate what comes next in the case. It is a demanding, fast-paced role that requires technical precision and the ability to stay focused under pressure. If you want to be in the OR without the years of medical school or nursing school, surgical technology is one of the most direct paths.
What Does a Surgical Technologist Do?
Surgical technologists, also called scrub techs or operating room technicians, work as part of the sterile surgical team. Your responsibilities fall into three phases of every surgical case:
Preoperative (Before Surgery)
- Setting up the sterile back table and Mayo stand with the correct instrument sets
- Performing surgical counts (instruments, sponges, sharps) with the circulating nurse
- Preparing sutures, drains, and specialty items for the case
- Draping the patient to establish the sterile field
- Confirming correct instruments are available for the scheduled procedure
Intraoperative (During Surgery)
- Passing instruments to the surgeon in the correct sequence and orientation
- Cutting sutures when directed by the surgeon
- Maintaining the sterile field throughout the case
- Handling specimen containers and labeling them for pathology
- Managing sponge and instrument counts continuously throughout the case
- Operating and troubleshooting surgical equipment (electrosurgical units, suction, laparoscopic towers)
Postoperative (After Surgery)
- Completing final instrument, sponge, and sharp counts before wound closure
- Assisting with wound closure (cutting sutures, handing wound closure materials)
- Breaking down the sterile field and preparing instruments for sterile processing
- Documenting case information
CAAHEP-Accredited Surgical Technology Programs
To sit for the NBSTSA CST exam, you must graduate from a program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) through its Accreditation Review Council on Education in Surgical Technology and Surgical Assisting (ARC/STSA). This is a hard requirement — non-CAAHEP graduates do not qualify for the CST exam pathway.
Program Length
Most CAAHEP-accredited surgical technology programs are 12-24 months in length:
- Certificate programs (12-15 months): Offered at community colleges and vocational schools. Focused and efficient, these programs meet minimum CAAHEP requirements and prepare you for the CST exam. Minimum 120 surgical cases and 270 clinical hours required by accreditation standards.
- Associate degree programs (18-24 months): The most common format. Includes general education requirements alongside surgical technology coursework and clinical hours. Most associate degree programs require 120+ surgical cases and 540+ clinical hours, exceeding the minimum.
Curriculum
CAAHEP programs cover:
- Anatomy and physiology (with surgical applications)
- Microbiology and infection control
- Surgical pharmacology and anesthesia awareness
- Sterile technique and aseptic principles
- Surgical procedures by specialty (general, orthopedic, OB/GYN, neurosurgery, cardiovascular, ENT, ophthalmology, etc.)
- Surgical instrument identification and use
- Patient care and positioning in the OR
- Medical-legal and ethical issues
NBSTSA CST Exam
The National Board of Surgical Technology and Surgical Assisting (NBSTSA) administers the Certified Surgical Technologist (CST) exam. This is the primary national credential for surgical technologists and is required or preferred for employment at most hospital systems.
Eligibility
To sit for the CST exam:
- Graduate from a CAAHEP- or ABHES-accredited surgical technology program, OR
- Be a documented veteran or current active duty military member with documented surgical technology training
Exam Format
The CST exam has 175 questions (150 scored, 25 pretest), delivered by computer over three and a half hours. Content domains include:
- Perioperative care (preoperative, intraoperative, postoperative)
- Fundamental knowledge (anatomy, physiology, microbiology, pharmacology)
- Specialty surgical procedures by organ system
The passing score is a scaled score of 700 out of 800. Results are typically available within 24-48 hours through the testing vendor.
Renewal
The CST credential requires renewal every four years with 60 continuing education credits (CECs) or by re-examination. This is a longer renewal cycle than many allied health credentials.
Career Outlook
The BLS projects 5% growth for surgical technologists through 2033, reflecting steady demand from aging population surgery volumes and the shift of more procedures to ambulatory surgical centers. Employment settings include:
- Hospital operating rooms (primary employer)
- Ambulatory surgery centers
- Oral and maxillofacial surgery offices
- Ophthalmology surgery centers
- Military surgical facilities
The national median annual salary for surgical technologists is approximately $57,800, with experienced CSTs in high-demand markets and specialty ORs earning $65,000-$80,000 or more.
Practice Questions
-
During abdominal surgery, the scrub tech notices a discrepancy in the sponge count before wound closure. What is the appropriate action?
A) Proceed with closure and document the discrepancy postoperatively B) Notify the surgeon immediately and hold the count until the discrepancy is resolved C) Ask the circulating nurse to recount independently and continue D) Remove one sponge from the back table to balance the count
Answer: B. A sponge count discrepancy before closure requires the surgeon to be informed immediately. Surgery should not proceed until the count is reconciled or an X-ray confirms no retained foreign body.
-
Which organization accredits surgical technology programs that qualify graduates to sit for the NBSTSA CST exam?
A) NCCA B) CAAHEP/ARC/STSA C) ACEN D) ABHES only
Answer: B. CAAHEP accredits surgical technology programs through the ARC/STSA. ABHES is also accepted but CAAHEP is the primary accreditor.
-
A surgical technologist receives a scalpel from the surgeon after an incision. The correct method for accepting a sharp instrument back is:
A) Catch it with bare fingers directly from the surgeon hand B) Use a neutral zone or designated instrument passing area on the sterile field C) Pass it directly to the circulating nurse D) Place it in a kick bucket
Answer: B. Neutral zone technique (hands-free passing) is the standard safety method for handling sharps to prevent needlestick and sharps injuries in the OR.