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Surgical Tech Career Information

S urgeons often get most of the credit and limelight when it comes to performing successful surgeries. But it takes more than just one person to ensure that a patient leaves the operating room with a positive outcome; it takes a whole team of dedicated professionals. By asking, "What is a surgical tech?" you're inquiring about one of the most crucial roles in all of healthcare.

What is a Surgical Tech?

Surgical techs, formally known as "surgical technologists," work where the critical action is. In fact, how well they perform their jobs can sometimes make the difference between whether surgical patients live or die. Their impact should not be underestimated. So, what is a surgical technologist?

A surgical technologist is:

• Someone who works in the operating room alongside other professionals such as a surgeon, surgical assistant, circulator, and anesthesia provider
• A healthcare professional with big responsibilities, especially when it comes to preparing and maintaining a sterile operating room
• NOT a nurse
• NOT the equivalent of a surgical assistant
• Sometimes also called a "surgical technician," "operating room technician," "scrub," or "scrub tech"
• Someone who works under the supervision of surgeons, registered nurses (RNs), or other surgical professionals

What Does a Surgical Tech Do?

Depending on their experience and specific roles, surgical technologists perform essential duties that must be carried out before, during, and after surgical procedures. No matter what, though, they are always involved in helping to anticipate the needs of their supervising surgeon and providing quality patient care with a special focus on safety and efficiency. So, specifically, what does a surgical tech do?

Generally speaking, there are three main roles that a surgical technologist can perform: (1) scrub surgical technologist (“scrub tech”), (2) circulating surgical technologist, and (3) second assisting surgical technologist. Each of these roles corresponds with a different set of duties, which sometimes overlap.

A scrub surgical technologist, also known as a "surgical technologist in the scrub role" (STSR), carries out responsibilities that can include:

• Checking operating room supplies and setting up surgical tables, trays, instruments, equipment, medications, solutions, and anything else necessary for a given operation
• Helping to set up sterile surgical drapes
• Preparing sterile scrubs, gowns, and gloves for the surgeon and the rest of the surgical team and assisting them as they put them on
• Counting supplies and instruments with the circulator prior to an operation and again before a surgical patient's incision is closed
• Passing surgical instruments and supplies to the surgeon during surgery
• Preparing sterile dressings
• Maintaining vigilance and high sterile standards before and during a surgical procedure
• Cleaning and preparing surgical instruments for post-operative sterilization
• Helping to clean and disinfect the operating room after a surgery
• Assisting with the preparation of the operating room for the next surgical patient

A circulating surgical technologist is a non-sterile member of the surgical team, has more interaction with patients, and performs duties such as:

• Helping to ensure that the right patient undergoes the right surgical procedure by checking a patient's chart and consent forms and verifying his or her identity and the surgery to be performed
• Transferring the patient to the operating room and assisting with placing him or her on the operating room table
• Reassuring the patient and making sure that he or she is safe and comfortable
• Assisting the anesthesia provider
• Using appropriate equipment to position the patient for the surgical procedure
• Applying tourniquets, monitors, electrosurgical grounding pads and any other necessary surgical accessories before the operation
• Preparing the patient's skin as necessary (washing, shaving, disinfecting) prior to sterile draping
• Counting supplies and instruments with the scrub surgical technologist before the procedure and again before the patient's incision is closed
• Keeping accurate written records throughout the surgery
• Providing answers about the patient to the surgeon during the operation
• Constantly assessing the patient's condition and surgical team's progress
• Anticipating the need for extra supplies and retrieving them during the operation
• Opening packages of sterile supplies
• Properly caring for surgically removed specimens that must be sent for laboratory testing
• Securing dressings after the patient's surgical incision is closed
• Helping to transfer the patient to a recovery room
• Assisting with the cleaning of the operating room and preparing it for the next patient

A second assisting surgical technologist assists the surgeon and surgical first assistant during an operation. A surgical tech in this role often performs some of the same duties as a scrub surgical technologist but also carries out tasks that can include:

• Holding retractors or surgical instruments as directed by the surgeon
• Sponging or suctioning areas of the open surgical site
• Cutting suture material as directed by the surgeon
• Applying an electrically heated instrument (electrocautery) to clamps used to stop bleeding
• Connecting drains to suction equipment
• Applying dressings to closed wounds

What is the Difference Between a Surgical Technologist and a Surgical Assistant?

The main difference between a surgical technologist and a surgical assistant is that a surgical assistant must have more advanced, specialized training. Surgical assistants are more commonly known as "surgical first assistants."

With extra education, some surgical technologists can work their way up to become surgical first assistants. In addition to having the ability to do anything that a surgical tech can do, a surgical first assistant is trained to perform duties under a surgeon's direction that can include providing aid in exposure, hemostasis (stopping the flow of blood and controlling hemorrhaging), and other technical functions during the course of a surgery that help provide the best possible outcome for the patient.

Surgical first assistants can come from many backgrounds, not just surgical technology. They are frequently medical or surgical residents, physician's assistants, or nurses.

Where Can a Surgical Technologist Work?

Most surgical technologists work in hospitals. Operating rooms are the most common work environment; however, surgical techs can also be found in delivery rooms.

Other work settings that utilize surgical technologists include outpatient clinics (for physicians and dentists that perform surgery), ambulatory surgical centers (places that perform same-day surgeries), and special mobile surgical teams (such as those focused on organ transplants). In some cases, a surgical technologist can be employed directly by a surgeon and be known as a "private scrub."

What are the Pros and Cons of Being a Surgical Technologist?

Surgical technology is not a field for everyone; however, many surgical technologists wouldn't want to do anything else. The work is highly technical and requires strict adherence to rules and constant attention to detail. Like any career, surgical technology has both drawbacks and benefits.

Here are some of the downsides of being a surgical technologist:

• The work can be physically demanding due to the need to remain constantly alert, stand on your feet for long periods, move operating room furniture, lift surgical trays, and help transfer patients. Breaks can sometimes be hard to come by, particularly during operations.
• Some days can be emotionally challenging because not all patients survive surgery, other members of your surgical team might have strong or confrontational personalities, and you may not always be thanked for performing your job well under difficult or stressful circumstances. Working in surgical technology requires combining a positive attitude with a thick skin.
• Blood, unpleasant sights and smells, and infectious diseases are all part of the regular work environment.
• Making a mistake can have deadly consequences. Not maintaining a sterile field during surgery can result in fatal infections and complications. Failing to count supplies and instruments accurately can result in a surgical patient being sewn up with objects inside that are not supposed to be there.

Despite the challenges inherent to the profession, surgical technologists can also enjoy a number of upsides. Here are a few of the most notable ones:

• It can be deeply rewarding to have a direct impact on patient outcomes and to know that you make a positive contribution to society every day through your work.
• Although you may be put on call or have the opportunity to work extra or longer shifts, the normal work week for most surgical technologists is 40 hours over five days. Weekend shifts tend to be few and far between.
• Being part of an operating room team can be thrilling, particularly when a patient is saved from a negative outcome.
• Experienced surgical technologists generally have pretty stable job security due to high demand for their services.
• Boredom is rare since there are new cases and new challenges every day.

What is the Typical Salary of Surgical Technologist Jobs?

The typical salary of surgical technologist jobs can vary significantly depending on geographic location, work setting, experience, role on the surgical team, and certification status. You aren't likely to get rich as a surgical tech, but many surgical technology jobs come with good benefits such as paid vacation and sick leave, health insurance that includes vision and dental coverage, life insurance, a retirement program, and sometimes even tuition reimbursement and child care assistance.

So, how much do surgical techs make? Based on national estimates, typical annual wages for surgical technologists break down like this: *

• The bottom 10 percent earn $28,100 or less.
• Median wages (50th percentile) are $39,920.
• The top 10 percent earn $57,330 or more.

Although most jobs are found in hospitals, other work settings are frequently better paying for an experienced surgical technologist. Salary often increases for seasoned surgical techs who specialize in a particular surgical area and find employment with physicians' offices or other outpatient care centers.

What are the Surgical Tech Requirements I Need to Know?

This is likely the most important section on this page. Surgical tech requirements can be a little confusing, especially now that many states have passed (or plan to pass) legislation that requires new surgical technologists to either register with the state or to become professionally certified.

In most states, professional certification is still voluntary even though most hospitals require or prefer the surgical technologists they hire to be certified. Recent changes, however, mean that in order to work as a surgical technologist in certain states, you will have to do more than get the right training. Here is how things break down for new surgical techs in those states (as of September 2011):

• Indiana, South Carolina, and Tennessee all require new surgical technologists to hold and maintain professional certification from the National Board of Surgical Technology and Surgical Assisting (NBSTSA). The NBSTSA administers an exam that, if passed, results in being awarded the designation of Certified Surgical Technologist (CST).
• Texas requires new surgical technologists to have successfully completed an accredited surgical technology program and to hold and maintain professional certification from either the NBSTSA or the National Center for Competency Testing (NCCT).
• Idaho requires surgical technologists to have either certification from the NBSTSA or to have successfully completed, at minimum, a one-year surgical tech program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP).
• Colorado and Washington both require anyone practicing as a surgical technologist to be registered, which does not require certification.
• Legislation that would regulate surgical technologists in one of the above ways is pending in California, Florida, Georgia, Illinois, Michigan, Nebraska, New Jersey, New York, and Wisconsin.

The alphabet soup of organizations and designations can be challenging to sort through, but it is very important that you understand the following points about surgical technologist certification:

• In order to be eligible for the NBSTSA exam (as someone who is new to the field of surgical technology), you must first graduate from a surgical technology program that is accredited by either the CAAHEP or the Accrediting Bureau of Health Education Schools (ABHES).
• The Certified Surgical Technologist (CST) designation (awarded by the NBTSA) must be renewed every four years. In order to maintain this certification, you must earn 60 hours of approved continuing education over each four-year period and retake and pass the NBSTSA exam at the end of each period.
• You cannot legally call yourself a Certified Surgical Technologist or CST unless you have successfully passed the NBSTSA exam and maintain your certification status.
• The National Center for Competency Testing (NCCT) also offers surgical tech certification, awarding the Tech in Surgery-Certified (TS-C) designation to those who pass its exam. In order to qualify for the exam, you must (1) complete an accredited surgical technology program, (2) undergo a two-year on-the-job training program at a hospital, or (3) acquire seven years of working experience as a surgical tech. The NCCT certification must be renewed every five years through either continuing education or reexamination.
• The Association of Surgical Technologists (AST), the national professional organization for surgical techs, does NOT recognize the TS-C certification awarded by the NCCT. (The AST, a non-profit organization, feels that the certification process from the NCCT, a for-profit corporation, does not adequately represent the field of surgical technology and should not be used to fulfill surgical tech certification requirements.)
• The only certification recognized by the AST (as well as many employers) is the CST designation awarded by the NBSTSA, a non-profit organization. It is considered the "gold standard" of surgical technologist certification.
• With more and more hospital policies and state regulations requiring CST certification, it is becoming increasingly difficult to get a job as a surgical tech with only TS-C certification since it isn't as marketable.
• Earning a certificate, diploma, or degree from a surgical technology school does NOT automatically make you a certified surgical technologist.

Of course, surgical technologist requirements don't just come in the form of regulations or hard-to-follow acronyms. To have any chance at a successful and rewarding career as a surgical technologist, you will need to understand how to be a surgical tech by demonstrating the following characteristics:

• A passion for helping others and a desire to make a valuable contribution to society
• A caring, compassionate attitude
• Patience
• Manual dexterity, particularly with your hands
• A love for order and details
• Physical stamina
• An emotionally stable temperament
• A strong sense of responsibility and right and wrong
• A willingness to follow directions
• The ability to think quickly and anticipate the needs of someone else
• A love for learning

How Do I Become a Surgical Technician?

When asking, "How do I become a surgical technician?" it is important to understand that the formal way of referring to this occupation is "surgical technologist." Beyond that small distinction, you should know that, depending on your individual circumstances, you have some options. At minimum, you will need a high school diploma or the equivalent to get started, and it is a good idea to have taken (and done well in) classes such as biology, health, chemistry, and math.

Options for beginning your pursuit of a career in surgical technology can include:

• Joining the military and training to become a surgical tech through the institution that invented the occupation
• Finding a hospital that runs an on-the-job surgical tech training program (usually for existing staff) and trying to get hired in an entry-level position so that you can apply
• Completing a post-secondary surgical technology program (understanding that it should be CAAHEP- or ABHES-accredited in order to provide you with the best training and a chance at recognized professional certification)

Due to recent trends, the best option for most people who want to know how to become a surgical technologist is to get a formal education from a school with an accredited surgical tech program. In addition, you should consider the following points:

• The clinical externship portion of your surgical tech education is extremely important. Ideally, you'll want to attend a school that can place you in a hospital setting for your real-life training since it can allow you the chance to scrub in on the widest variety of surgical cases.
• Depending where you go to school, you might not have a choice about the facility you are placed in for your externship. It could be a long commute from your home.
• Hospitals sometimes hire the best and most eager surgical tech students from among those performing clinical externships at their facilities. If you're lucky, this is the ideal path to your first job as a surgical technologist.
• When selecting a school, keep your future ambitions in mind. If you think you might want to pursue a more advanced degree later on, then you'll want to know whether or not the credits you earn as part of your surgical technology program will transfer to another school or count toward a different degree program.
• After you graduate, one of your first priorities should be taking and passing the National Board of Surgical Technology and Surgical Assisting (NBSTSA) exam so that you can use the title of Certified Surgical Technologist (CST). This will make you more marketable as you search for your first job.
• As you look for employment as a recent graduate, keep in mind that more and more employers, particularly hospitals, will only consider certified surgical techs who have one or more years of experience. This is especially true in regions where the field of surgical technology is saturated with a lot of graduates.
• To land your first job, you might have to adapt and be flexible in your options. Many new surgical techs find that they have better luck finding employment by relocating to a region that has a shorter supply of surgical technologists. County hospitals can sometimes be a good place to target in such locations even though the pay tends to be lower than you might otherwise receive.
• It can sometimes help to call the O.R. (operating room) departments of hospitals directly and ask to speak to the O.R. manager. Display a confident attitude and ask if there are any openings. State that you are a recent surgical tech graduate looking to break into the field. (Hospitals and other employers don't always advertise their job openings.)
• If you fail to have any luck landing your first job as a surgical technologist, then you'll want to consider being flexible in the type of position you are willing to take, even if it is not your first choice. Some surgical techs, for instance, are able to work their way up to the position they want by first starting as a sterile processing and distribution (SPD) technician or as a laboratory and delivery technician. Working in a department with a name such as SPD, Central Supply (CS), Central Processing (CP), or Central Processing and Decontamination (CPD) can be a great way to ingrain your knowledge of surgical instruments. Plus, hospitals tend to prefer hiring from within for new openings, which means you would be in prime position to go after any new surgical technologist jobs.
• Sometimes, getting a surgical tech job is about who you know. That's why it is so important, during your externships, to develop positive relationships with the people you are working for and who are teaching you, especially the surgeons. It can also help to spend some time volunteering for a hospital in the operating room or PACU (post-anesthesia care unit).
• The bottom line is that you need to have patience and persistence. If you can show confidence, communicate effectively, and answer the hard questions during interviews, then you are bound to eventually land the kind of surgical tech position you really want.

How Long is Surgical Tech School?

A frequent question of those considering a career in this field is "How long is surgical tech school?" The answer is fairly straightforward, but it does depend on the type of academic credential you want to graduate with. So, how long does it take to become a surgical tech?

Accredited surgical technology programs that award a certificate or diploma are generally designed to take anywhere from nine to 15 months to complete. Programs that offer associate's degrees usually last two years (24 months).

Keep in mind that an associate's degree, while not a must, represents the preferred level of surgical technology education by most employers and will make you more marketable as you look for your first job.

What is the Cost of Surgical Tech School?

The cost of surgical tech school can vary substantially depending on the type of post-secondary institution you attend and whether you wish to graduate with a certificate/diploma or an associate's degree. Total costs (including tuition and other fees) can range from about as little as $3,500 to $25,000 or more, depending on the institution.

Most schools, if you qualify, can assist you in getting financial aid, which can include student loans or grants from the federal government or private lenders. If you are an older worker, you might also be eligible in some states for financial assistance as part of a retraining program. In addition, the Foundation for Surgical Technology awards scholarships to outstanding students who are members of the Association of Surgical Technologists (AST) and are pursuing their education in a CAAHEP-accredited surgical technology program.

What Should I Know About Surgical Tech Accreditation?

As you go about comparing surgical technologist schools, you'll want to pay close attention to this very important aspect, especially if you hope to maximize your chances of getting hired as a surgical tech. Accreditation can make the difference between being taken seriously by employers or not being respected in the field you love.

There are essentially two types of accreditation: (1) school accreditation and (2) program accreditation. Ideally, you want both. And you don't want just any accreditation; you want the right accreditation.

The school you attend should be accredited by an organization that is recognized by the U.S. Department of Education. In addition, regional school accreditation is considered better than national school accreditation.

The program you enroll in should be accredited by either the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES).

It is important to keep in mind that although a school itself might be accredited, that does NOT automatically mean that the surgical technology program you are interested in is appropriately accredited. Make sure you know the difference, and don't be afraid to ask school representatives for proof of both types of accreditation.

What are the Typical Surgical Tech Course Requirements?

Surgical tech course requirements are designed to provide students with an intensive education. Operating rooms are places where even small mistakes can have life-or-death consequences. That's why the surgical technologist education requirements that are most widely supported in the field have the goal of producing graduates with minimum core competencies that include:

• A practical knowledge of basic surgical technology concepts and the ability to put them into action
• Understanding how to prepare for surgical cases
• The ability to apply (and recognize the importance of) the principles of asepsis (sterility) in order to provide the best possible care to surgical patients
• The confidence and ability to position patients with ease
• The ability to work on all basic surgical cases in the role of a surgical technologist in the scrub role ("scrub tech")
• The ability to recognize all basic sets of surgical instruments
• A commitment to behave safely and responsibly
• The ability to interact and communicate effectively as part of an operating room team

Surgical technology programs that are CAAHEP-accredited generally follow the curriculum recommendations of the Association of Surgical Technologists (AST). In such programs, the surgical tech education requirements include a combination of classroom learning, hands-on instruction in a skill lab (which is also used for mock surgeries), and supervised clinical experience in a real-life operating room setting.

Surgical tech courses that are part of accredited programs typically consist of subjects such as:

• Anatomy and physiology
• Medical terminology
• Microbiology
• Surgical pharmacology
• General patient care (reading vital signs, performing CPR, identifying and assessing patients, obtaining consent, communicating, transporting patients, preparing a patient's skin for surgery, performing Foley catheterization, positioning patients, etc.)
• Communication and professionalism
• Ethical, moral, and legal issues
• Sterile technique and the principles of asepsis (carrying out appropriate disinfection and sterilization methods and creating and maintaining a sterile field for surgery)
• Safety standards
• Surgical instrumentation, supplies, and equipment
• Surgical procedures (understanding the different technical considerations and operative procedures used for different types of surgeries)
• Classification and healing of wounds
• Postoperative considerations

Because of the rapidly changing nature of healthcare technology, many surgical tech programs include additional courses in subjects like robotics, biomechanics, and computer science.

What is the Surgical Technician Job Outlook?

Formally known as a "surgical technologist," the employment prospects look good for anyone working as an experienced surgical technician. Job outlook is considered bright since employment of surgical technologists is expected to grow by 25 percent between the period from 2008 to 2018. **

Reasons for the increasing demand for surgical techs include the fact that the aging baby boomer generation will need more surgeries and the fact that there are now a growing number of surgical procedures made possible by technological advances in areas such as fiber optics and laser technology.

The best-paying and fastest job growth in the surgical technology sector is likely to be in physicians' offices and other outpatient care centers. Job prospects are also best for surgical techs who are certified and willing to relocate.

What Options Exist for Advancement as a Surgical Technologist?

Although the field of surgical technology itself is relatively narrow, experienced surgical technologists do have some options when it comes to mobility within their careers.

With additional education and training, a surgical technologist can become a circulating technologist or a surgical first assistant. Surgical techs can also choose to specialize in a specific area of surgery such as neurosurgery, orthopedic surgery, or open-heart surgery.

After they've gained enough experience, some surgical technologists choose to work as traveling surgical techs by signing up with companies that hire scrubs to contract out to hospitals in a variety of locations on a short-term basis (usually three months to a year). In addition to regular wages and benefits, such companies typically pay for your temporary housing and utilities while you fill in for other surgical techs who are on sick leave or maternity leave.

Other options for experienced surgical techs can include working for a veterinary surgeon at an animal hospital, becoming a product representative for a medical company, assisting with medical product research and development, working in a managerial role, or teaching surgical technology at a post-secondary institution.

How Do I Get Started?

Call some hospitals and surgical centers in your area to get a sense of the demand for new surgical techs. Just remember: even if the demand is low where you are, it might be very high somewhere else. Surgical technology is a field that isn't going away anytime soon. In fact, it will only keep growing. So, if you want to get started, check out the surgical technologist schools in your area. Then get ready for a career that lets you make a real difference.

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Main Sources

* Bureau of Labor Statistics, U.S. Department of Labor, Occupational Employment Statistics, web site last accessed on September 30, 2011.

** Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition, web site last accessed on September 30, 2011.

The Occupational Information Network (O*NET), web site last accessed on September 30, 2011.

Association of Surgical Technologists (AST), web site last accessed on September 30, 2011.

National Board of Surgical Technology and Surgical Assisting (NBSTSA), web site last accessed on September 30, 2011.

Accreditation Review Council on Education in Surgical Technology and Surgical Assisting (ARC/STSA), web site last accessed on September 30, 2011.

Commission on Accreditation of Health Education Programs (CAAHEP), web site last accessed on September 30, 2011.

Accrediting Bureau of Health Education Schools (ABHES), web site last accessed on September 30, 2011.

National Center for Competency Testing (NCCT), web site last accessed on September 30, 2011.