The NBSTSA certification examinations are the gold standard for validating the knowledge and skills of surgical professionals. These exams are designed specifically for individuals who have completed accredited educational programs in surgical technology or surgical assisting.

The CST exam is intended for Surgical Technologists who work alongside surgeons, anesthesiologists, and nurses in the operating room to facilitate safe and effective surgical procedures. They are responsible for maintaining the sterile field, passing instruments, and anticipating the needs of the surgical team.

The CSFA exam is designed for experienced Surgical Technologists who wish to advance their careers by becoming First Assistants. CSFAs provide aid in exposure, hemostasis, closure, and other intraoperative technical functions that help the surgeon carry out a safe operation with optimal results for the patient.

Passing these rigorous exams grants you the credentials necessary to practice in most states and hospitals, significantly enhancing your employability and professional standing.

 What the Course Entails and Exam Details

The content areas for both the CST and CSFA exams are derived from extensive job analysis studies, ensuring the tests reflect current practices in the operating room.

For the CST Exam, the curriculum covers three main domains:

• Perioperative Care (approx. 54%): This includes preoperative preparation (patient transport, room setup, positioning, prepping, and draping), intraoperative procedures (sterile technique, instrument passing, counts, specimen care), and postoperative procedures (dressing application, transferring the patient, room turnover).
• Surgical Technology (approx. 26%): This involves knowledge of instrumentation, equipment sterilization and disinfection, suture materials, surgical staples, drains, and dressings.
• Administrative and Personnel (approx. 20%): This covers professional conduct, legal issues, risk management, interpersonal relationships, and continuing education.

For the CSFA Exam, the content focuses on advanced assisting skills:

• Intraoperative Surgical First Assisting (approx. 50%): This includes tissue handling, maintaining visualization, providing hemostasis, using instruments and medical devices, and wound closure.
• Preoperative and Postoperative Management (approx. 30%): Patient assessment, planning care, and assisting with postoperative management.
• Anatomy, Physiology, and Surgical Pharmacology (approx. 20%): In-depth knowledge of human anatomy relevant to surgical procedures, physiological responses, and pharmacological agents used intraoperatively.

What to Expect in the Final Exam

Understanding the exam format is crucial for test-day success. Both the CST and CSFA exams are administered via computer at secure testing centers.

CST Exam Format:

• Questions: 175 multiple-choice questions (150 are scored, 25 are pretest items used for statistical purposes but do not affect your score).
• Time Limit: 4 hours.
• Passing Requirement: You must achieve a scaled score of at least 70 to pass.

CSFA Exam Format:

• Questions: 150 multiple-choice questions (125 are scored, 25 are pretest).
• Time Limit: 3 hours.
• Passing Requirement: You must achieve a scaled score of at least 70 to pass.

Important Rules and Information:

• These are closed-book exams. No reference materials are allowed in the testing room.
• You will be provided with erasable scratch paper and a calculator if necessary.
• Arrive at least 30 minutes early for your appointment. You must present valid, government-issued photo identification.

 How to Study and Exam Centers

Preparing for these exams requires a structured approach that combines content review with rigorous practice testing.

Actionable Study Strategies:

Start with the Candidate Handbook: The official NBSTSA Candidate Handbook is your blueprint. Review the detailed content outlines and suggested reference texts.

Review Course Materials: Go back to your textbooks and class notes, focusing on areas where you feel less confident, such as specific surgical procedures or pharmacology.

Utilize Free Practice Tests: This is the most effective preparation strategy. Taking a free NBSTSA practice test 2026 version helps you become familiar with the question style, format, and difficulty level. Use your results to identify knowledge gaps and create a targeted study plan.

Create a Study Schedule: Dedicate specific times each week for study. Consistency is key. Avoid cramming.

Join Study Groups: Collaborating with peers can help clarify complex topics and keep you motivated.

Where and How to Take the Exam:

The NBSTSA exams are administered by a professional testing service called PSI Services. They operate numerous secure testing centers nationwide.

Eligibility and Application: First, you must apply to the NBSTSA and provide proof of graduation from an accredited program (CAAHEP or ABHES).

Authorization to Test (ATT): Once your application is approved, you will receive an Authorization to Test letter via email.

Scheduling Your Exam: Visit the PSI website or call them directly to schedule your exam date and location. It is recommended to schedule early to secure your preferred date and center.

 Job Opportunities from the Course

Earning your CST or CSFA credential opens the door to a wide range of rewarding career opportunities in various healthcare settings.

• Certified Surgical Technologist (CST):
• Hospital Operating Rooms: Work in general surgery, orthopedics, neurosurgery, cardiac, and other specialized teams.
• Ambulatory Surgery Centers (ASCs): Provide technical support for outpatient surgeries, typically offering more predictable hours.
• Labor and Delivery: Assist with Cesarean sections and other obstetric procedures.
• Certified Surgical First Assistant (CSFA):
• Advanced Hospital Roles: Work in complex surgical cases, providing direct assistance to the surgeon.
• Surgical Clinics and Physician Practices: Assist with minor procedures and preoperative/postoperative patient management.
• Medical Sales and Clinical Education: Utilize your clinical expertise to educate healthcare professionals on new surgical devices and technologies.
• Organ Procurement Teams: Assist in the retrieval of donor organs in specialized settings.

By diligently preparing for your exam using these resources and strategies, you are taking a significant step toward a successful and fulfilling career in surgical services.