Surgical technologists are essential members of the operating room team, assisting surgeons before, during, and after surgical procedures. As the demand for surgical services continues to grow -- driven by an aging population and advances in medical technology -- qualified surgical technologists are needed in hospitals, ambulatory surgery centers, and outpatient clinics across the country.

This guide walks you through every step of the process, from completing an accredited surgical technology program to earning your Certified Surgical Technologist (CST) credential, meeting state registration requirements where applicable, and staying current with continuing education. We have also compiled verified data for all 51 states we track so you can compare requirements side by side.

What Does a Surgical Technologist Do?

Surgical technologists -- sometimes called "scrub techs" or "operating room technicians" -- assist in surgical operations under the supervision of surgeons, registered nurses, and other surgical personnel. They are an integral part of the operating room team, responsible for ensuring that procedures run smoothly and safely.

Key responsibilities include:

• Before surgery: Preparing the operating room by setting up surgical instruments and equipment, sterilizing surfaces and tools, and ensuring all necessary supplies are available.
• During surgery: Passing instruments and supplies to surgeons, holding retractors, cutting sutures, and counting sponges, needles, and instruments to ensure nothing is left inside the patient.
• After surgery: Applying wound dressings, transporting specimens to the laboratory, and preparing the operating room for the next procedure.
• Sterile field maintenance: Maintaining the sterile environment throughout the procedure and monitoring all team members for breaks in sterile technique.

Surgical technologists work in a variety of settings, including:

• Hospitals: The largest employer of surgical technologists, particularly in general surgery, orthopedics, cardiac surgery, and neurosurgery departments.
• Ambulatory surgery centers: Outpatient facilities performing same-day surgical procedures.
• Physician offices: Offices of surgeons or specialists who perform in-office procedures.
• Dental offices and oral surgery centers: Assisting with complex dental and maxillofacial procedures.

According to the U.S. Bureau of Labor Statistics, the median annual wage for surgical technologists is approximately $60,000--$62,000. Salaries vary by geographic location, facility type, experience, and specialization. Surgical technologists in metropolitan areas and those with specialized skills (such as cardiac or robotic surgery) tend to earn higher salaries.

Step 1: Education Requirements

The foundation of a surgical technology career is completing a formal education program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP). CAAHEP accreditation ensures the program meets rigorous standards set by the Accreditation Review Council on Education in Surgical Technology and Surgical Assisting (ARC/STSA).

Certificate Programs (12--18 Months)

Certificate programs focus exclusively on surgical technology coursework and clinical training. They are the fastest path to entering the field and are offered by community colleges, vocational schools, and hospitals. These programs provide concentrated instruction in surgical procedures and hands-on clinical experience, though they do not include general education courses.

Associate Degree Programs (2 Years)

Associate degree programs combine surgical technology coursework with general education courses such as English, math, and social sciences. The associate degree is the most common educational pathway and is preferred by many employers. It also provides a stronger foundation if you plan to pursue advancement opportunities, such as becoming a surgical first assistant.

Regardless of program type, CAAHEP-accredited programs include coursework in:

• Anatomy and physiology
• Pharmacology
• Microbiology
• Sterile technique and infection control
• Surgical procedures by specialty
• Patient care and safety
• Medical terminology
• Biomedical sciences

Clinical Rotations

All accredited surgical technology programs include a clinical rotation component where students gain hands-on experience in an actual operating room under supervision. Clinical rotations typically require a minimum of 120 surgical cases across a variety of specialties, including general surgery, orthopedics, obstetrics/gynecology, and other surgical disciplines. This real-world experience is essential for developing the speed, precision, and confidence needed to work effectively in the operating room.

Step 2: CST Certification

After completing an accredited surgical technology program, the next step is earning national certification. The primary credential is the Certified Surgical Technologist (CST) from the National Board of Surgical Technology and Surgical Assisting (NBSTSA).

The CST Exam (NBSTSA)

The CST exam is the gold standard certification for surgical technologists. Key exam details:

• Format: 175 multiple-choice questions; 4 hours to complete.
• Content areas: Pre-operative preparation, intra- operative procedures, post-operative procedures, and administrative and personnel tasks.
• Eligibility: Graduates of CAAHEP-accredited surgical technology programs. Alternate pathways exist for military-trained surgical technologists and those with equivalent experience.
• Testing: Administered at Pearson VUE testing centers nationwide.
• Renewal: CST certification must be renewed every 4 years through continuing education credits or re-examination.

Alternative: TS-C Certification (NCCT)

The Tech in Surgery-Certified (TS-C) credential from the National Center for Competency Testing (NCCT) is an alternative national certification for surgical technologists. While the CST is more widely recognized and preferred by most employers, the TS-C is accepted in some states and healthcare facilities. Candidates should check their state's requirements and the preferences of their prospective employers before deciding which certification to pursue.

State-by-State Surgical Technologist Requirements

Requirements vary by state. Relatively few states require surgical technologists to hold a state license or registration. In many states, there is no state-level regulation at all -- though employers may still require CST certification. Click any state name to see its complete requirements guide.

Data sourced from official state licensing board websites, the AST, and the NBSTSA. Requirements change frequently -- always verify with your state board before applying.

States Requiring Registration or Licensure

Unlike many healthcare professions, most states do not require surgical technologists to hold a state license or registration. Of the 51 states we track, only 7 require some form of state-level credential. States that do regulate surgical technologists typically require registration rather than full licensure.

It is important to note that even in states without mandatory licensure, many hospitals and employers require CST certification as a condition of employment. Of the states we track, 15 require CST certification by law. In practice, certification is the industry standard regardless of state regulation.

If you plan to work in multiple states, check each state's specific requirements. Some states that do require registration may also mandate completion of a CAAHEP-accredited program and passing a national certification exam as prerequisites.

Continuing Education Requirements

Maintaining your CST certification and any state registration requires ongoing continuing education (CE). Requirements exist at two levels: the national CST certification and state-level requirements where applicable.

CST Certification Renewal

The NBSTSA requires CST holders to renew their certification every four years. Renewal can be accomplished by earning continuing education credits or by re-taking the certification exam. Most surgical technologists choose the CE pathway, which requires accumulating a specified number of CE credits in surgical technology topics over the four-year cycle.

State Continuing Education

States that require registration or licensure for surgical technologists often have their own CE requirements for renewal. Across the 51 states we track, the average CE requirement is 23 hours per renewal cycle. Some states accept NBSTSA-approved CE credits; others require state-specific coursework.

Tips for managing CE requirements:

• Track your CE hours throughout the renewal cycle rather than waiting until the last minute. The AST offers a variety of CE opportunities.
• Attend surgical technology conferences and workshops offered by the Association of Surgical Technologists (AST) and state chapters.
• Look for CE activities that satisfy both national certification and state renewal requirements simultaneously.
• Consider specialty certifications and advanced training, which often count toward CE requirements while enhancing your skills.

Frequently Asked Questions

Sources

The information in this guide is compiled from official sources. We recommend verifying current requirements directly with these organizations before making career or educational decisions:

• Association of Surgical Technologists (AST) -- Professional Resources and Education
• National Board of Surgical Technology and Surgical Assisting (NBSTSA) -- CST Certification
• Commission on Accreditation of Allied Health Education Programs (CAAHEP) -- Accredited Program Directory
• National Center for Competency Testing (NCCT) -- TS-C Certification
• U.S. Bureau of Labor Statistics -- Occupational Outlook for Surgical Technologists
• Individual state licensing board websites -- see each state page for direct links to official regulatory authorities.