Becoming a Certified Surgical First Assistant: Salary & Requirements

Oct 20, 2021

Certified first assistants aid surgeons by prepping patients, dressing wounds and providing post-operative care. They need to complete a CSFA certification program prior to entering the workforce. Most 1-2 year programs require completion of college-level course work prior to starting the program.

How to Become a Surgical First Assistant

You might be wondering how to become a first assistant surgical tech? The steps are as follows:

  1. Earn an associate's degree or higher in a medical field
  2. Gain surgical experience
  3. Enroll in a Certified Surgical First Assistant (CSFA) program
  4. Pass the certification exam

A certified first assistant, also called a Certified Surgical First Assistant (CSFA), is a medical professional who assists surgeons during surgeries. Accredited CSFA education programs are available at the certificate and associate's degree levels that satisfy the training and eligibility requirements to sit for the requisite certification exam. Since this is an upper-level position, applicants to CSFA programs typically must already work in the health field, whether as licensed surgical technologists, nurses, or a similar position.

surgical technologist first assistant requirements

Required Education Completion of a CSFA certificate or associate's degree program
Certification and Licensure Current licensure or certification as a surgical technologist or similar professional; CPR certification
Projected Job Growth (2019-2029)* 8% (for surgical technologists)
Median Annual Salary (May 2019)* $48,300 (for surgical technologists)

Source: *United States Bureau of Labor Statistics

Surgical First Assistant Education Requirements

A common path to becoming a certified surgical tech first assistant includes completing a training program that is accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP). These training programs commonly maintain prerequisite acceptance requirements that may include current certification as a Certified Surgical Technologist (CST) or Certified Nurse-Operating Room (CNOP), current CPR certification and completion of college-level coursework in such subjects as microbiology and physiology. Some applicants complete a bachelor's or advanced degree in nursing or a related subject before applying to a CSFA program.

Accredited programs are commonly 1-2 years in length and culminate in either a certificate or associate's degree. Some schools offer a portion of their curriculum in online formats. Surgical first assistant requirements in terms of coursework may include surgical anatomy and perioperative bioscience. Programs also typically include completion of practical experience called a clinical preceptorship.

CSFA Certification Requirements

Becoming a CSFA requires passing the Certified Surgical First Assistant examination administered by the National Board of Surgical Technology and Surgical Assisting (NBSTSA). It's composed of 175 graded, multiple-choice questions, of which 112 must be answered correctly to pass. To be eligible to sit for this exam, the applicant must be a graduate from a CAAHEP-accredited training program. This requirement may be waived by satisfying specific work experience, continuing education, and certification requirements.

What Does a Surgical First Assistant Do?

Before Surgery

Certified first assistants are trained to provide direct support to surgeons during surgical procedures. Their job duties include coordinating with the patient and addressing concerns as well as communicating with the different medical staff involved in the surgery such as anesthesiologists, surgeons, and nurses. Certified first assistants are also tasked with positioning and prepping patients prior to surgery. The position is chosen based on the site of surgery, along with the surgeon's preference and the anatomical limitations of the patient.

During Surgery

During surgery they ensure clear visibility for the surgeon by using instruments such as retractors and sponges and controlling bleeding. They also may remove tissue that is excised through the surgery and aide in implanting or removing specific devices or drains depending on the surgery.

After Surgery

At the end of surgery, the surgical first assistant is also responsible for counting sponges and other equipment to ensure that all equipment is accounted for. They also close surgery sites using sutures or staples and properly dress wounds. They also collaborate with doctors and other surgical team members to ensure proper post-operative care of patients, such as assessing skin and wound integrity, transporting the patient as needed and answering any patient questions and addressing their concerns.

Specialization for Surgical First Assistants

Surgical first assistants may also specialize in different areas within surgery. Although there is no special certification, surgical first assistants may find themselves working in cardiac surgery, orthopedics, ophthalmology, gynecology, or other specialized areas depending on the needs of the hospital. Surgical first assistants may also receive special training on vein and graft procedures.

Surgical First Assistants vs. Surgical Technologist

Surgical first assistants and surgical technologists have similar duties, but their jobs in the operating room vary. Surgical technologists are more concerned with preparing the equipment and the space for surgery. However, a surgical assistant is responsible for assisting the surgeon during surgery. The job duties of surgical technologists and surgical assistants may overlap depending on the specific hospital in question. Many surgical first assistants follow the path of surgical tech to first assistant, starting with a career as a surgical technologist.

Surgical First Assistant Salary & Job Outlook

Although the U.S. Bureau of Labor Statistics (BLS) does not collect data specifically on surgical assistant salary, they do collect data on surgical technologists, which include surgical tech first assistant salarys. The BLS reports that employment for surgical technologists is expected to grow 8% from 2019-2029 due to the increasing demand for surgical procedures, especially among the elderly population. As of May 2019, the surgical technologist salary has a median of $48,300, according to the BLS.

Certified first assistants must complete a CAAHEP-accredited training program and pass an exam before being cleared to work. Many candidates complete an associate's or bachelor's degree in addition to a certification program. Once in the workforce, they assist surgeons to make sure everything goes smoothly before, during and after surgical procedures.

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