Surgical Technologist

A surgical technologist (ST) is an allied health professional who works as part of the surgical team to ensure that the operative procedure is conducted under optimal conditions.

Surgical team members function in two capacities – nonsterile and sterile. The nonsterile team members are the circulator and the anesthesia provider. In certain situations, other personnel such as the radiology technologist or pathologist may also be present. The sterile team members are the surgeon, the surgical assistant, and the surgical technologist in the scrub role (STSR).

Role of the STSR The ST is responsible for three phases of patient care, or surgical case management, with minimal direction or supervision from their surgical team members. All surgical team members must adhere to the principles of asepsis and the practice of sterile technique. Honesty and moral integrity are necessary to uphold these standards.

The proficient ST must display a caring attitude toward the patient, other surgical team members, and the patient care environment. It is also necessary to understand normal anatomy and physiology, the pathological condition affecting the patient, the planned operative procedure, and consider any variations that may be necessary to accommodate a specific patient.

The ST normally functions as a sterile capacity during the surgical procedure, but also performs many nonsterile duties (referred to as circulating) throughout the course of the workday. Some of the duties of the STSR in each phase of case management include:

  • Preoperative Case Management
    • Don operating room (OR) attire and personal protective equipment
    • Prepare the OR
    • Gather necessary equipment and supplies
    • Create and maintain the sterile field
    • “Scrub” and don sterile gown and gloves
    • Organize the sterile field for use
    • Count necessary items
    • Assist team members during entry of the sterile field
    • Expose the operative site with sterile drapes
  • Intraoperative Case Management
    • Maintain the sterile field
    • Pass instrumentation, equipment, and supplies to the surgeon and surgical assistant as needed
    • Assess and predict (anticipate) the needs of the patient and surgeon and provide the necessary items in order of need
    • Medication preparation and handling
    • Count necessary items
    • Specimen care
    • Dressing application
  • Postoperative Case Management
    • Maintenance of the sterile field until the patient is transported
    • Removal of used instruments, equipment, and supplies from the OR
    • Care and maintenance of instruments, equipment, and supplies following use
    • Preparation of the OR for the next patient

Most STs are employed in hospital surgery departments, obstetric departments, and ambulatory care centers. However, because of the broad educational background combined with a specialized focus, the following options are also available to the experienced ST:

  • Specialization in an area of interest such as cardiac, orthopedic, or pediatric surgery
  • Employment as a traveling ST
  • Advancement to the role of the surgical assistant
  • Employment by a veterinary surgeon or animal care facility
  • Employment by a medical corporation to represent their products
  • Research and product development
  • Employment in the materiel management or central supply areas
  • Assumption of supervisory responsibilities
  • Surgical technology educator
  • Military service
  • Volunteer opportunities (such as the Peace Corps)
  • Technical writing, illustration, and photography
  • Employment as a consultant

Note: Some of these positions will require further education.

A Growing Career It is important to consider potential job opportunities when planning a career. According to the US Department of Labor, Bureau of Labor Statistics, Occupational Outlook Handbook (2004-2005 edition – http://stats.bls.gov/oco/ocos106.htm), the demand for surgical technologists is expected to increase as the number of surgical procedures grows. In 2000, there were approximately 71,000 surgical technologists.

The employment rate of surgical technologists is expected to grow faster than average (an increase of 21-35 percent) through the year 2010. The volume of surgical procedures is expected to increase as the population grows and ages. The over 50 population, entering retirement age (due to the “baby boom” generation) will account for a large portion of the general population. Older people require more surgical procedures. Technological advances, such as fiber optics and laser technology, will also permit new surgical procedures to be performed.

Hospitals are the primary employers of surgical technologists. However, fast employment growth is expected in ambulatory surgical centers, clinics, and physician’s offices.

Rapid advances in medical technology will bring dramatic changes to the field of surgical technology. The operating room of the future will incorporate computers, lasers, fiberoptics, electronics, and robotics to carry out routine patient care. The surgical technologist must be prepared to meet these advanced challenges.

Working Conditions The OR environment is brightly lit, relatively quiet, and temperature controlled. Most of the duties of the ST require standing for extended periods of time and the ability to lift and move heavy objects. Attention must be focused. The ST can be exposed to communicable diseases, unpleasant sights, odors, and hazardous materials. Most surgical procedures are carried out during the day and a 40-hour workweek is common. The ST may be required to work the evening or night shift, weekends, holidays, and periodically take “call” (be available to work on short notice in case of emergency).

Personal Characteristics As part of the OR team, the ST must be able to work quickly and accurately, with a commitment to detail. A number of activities must be integrated according to priority when under pressure in stressful and emergency situations. Therefore, a stable temperament and a strong sense of responsibility are qualities essential to the ST. Considerable patience and concern for order are required. Manual dexterity and physical stamina are vital. Sensitivity to the needs of the patient as well as other members of the surgical team must be demonstrated. Individuals who practice this profession have a strong desire to help others and make a valuable contribution to society.

Education To qualify to take the surgical technologist credentialing exam, an individual must be a graduate of a Commission on Accreditation of Allied Health Programs (CAAHEP) or an Accrediting Bureau for Health Education Schools (ABHES) accredited surgical technology program (or a currently or previously credentialed surgical technologist). Accredited surgical technology programs range in length from 9 months (provides the graduate a diploma or certificate of completion) to 2 years (provides the graduate with an associate degree). The associate degree is the preferred academic degree for surgical technology.

Prerequisites Prior to entry into an accredited surgical technology program, the following may be required:

  • A high school diploma or equivalent (GED). Official transcripts may be required.
  • Prospective student must meet all basic admission requirements. A nonrefundable application fee may be charged.
  • A satisfactory score on the ACT or a Health Profession Pre-Admission exam may be required.
  • Admission may be on a selective basis.
  • Some courses may be required prior to acceptance into the surgical technology program.

Curriculum The curriculum will include didactic (classroom), mock surgery, and under supervision in actual operating room situations. The coursework will include:

  • Medical terminology
  • Anatomy and physiology
  • Microbiology
  • Surgical pharmacology and anesthesia techniques
  • Legal, moral, and ethical issues
  • Communication and professional behavioral skills
  • Surgical instrumentation, equipment, and supplies
  • Physical environment and safety standards
  • General patient care and safety
    • Vital signs
    • CPR
    • Patient identification and assessment
    • Consent
    • Transportation
    • Communication
    • Skin preparation
    • Foley catheterization
    • Positioning
  • Principles of asepsis and practice of sterile technique
    • Sterilization and disinfection methods
    • Creation and maintenance of the sterile field
  • Surgical procedures (operative procedure and technical considerations)
    • Diagnostic procedures
    • General surgery
    • Obstetric and gynecologic surgery
    • Ophthalmic surgery
    • Otorhinolaryngologic surgery
    • Oral and maxillofacial surgery
    • Plastic and reconstructive surgery
    • Genitourinary surgery
    • Orthopedic surgery
    • Cardiothoracic surgery
    • Peripheral vascular surgery
    • Neurosurgery
  • Wound classification and healing
  • Postoperative considerations
    • Immediate postoperative care
    • Complications
    • Prognosis

Additional courses may include:

  • Robotics
  • Computer science
  • Biomechanics

Note: Students enrolled in an accredited surgical technology program are eligible to apply for numerous scholarships offered by the Foundation for Surgical Technology.

Accreditation Accreditation is a private, voluntary system for recognizing educational institutions and professional programs affiliated with those institutions for performance, integrity, and quality. Be sure that both the institution and the surgical technology program are accredited. Institutional accreditation is granted by regional and national accrediting commissions.

Program accreditation is granted by national professional organizations. The Accreditation Review Committee on Education in Surgical Technology (ARC-ST) is composed of representatives from the American College of Surgeons (ACS) and the Association of Surgical Technologists (AST). Together the ACS and AST establish, maintain, and promote standards of quality for educational programs in surgical technology. They recognize educational programs that meet or exceed the requirements, set forth by CAAHEP, in the Standards and Guidelines for an Accredited Program in Surgical Technology. Based on compliance with the Standards and Guidelines and the recommendation of the ARC-ST, accreditation is granted by CAAHEP.

CAAHEP, in cooperation with the ARC-ST, is recognized by the Commission on Recognition of Post-secondary Accreditation (CORPA) to comply with their respective standards for national accrediting agencies. Accreditation of a surgical technology program involves thorough review of the program’s resources including faculty, student/faculty ratio, financial resources, physical resources, learning resources, admissions policies, student records, curriculum, and student evaluation methods.

Accreditation of a surgical technology program is an on-going process during which regular reports are submitted to and reviewed by the ARC-ST to ensure continuing compliance with the established criteria.

Surgical technology program accreditation is a valuable service to the public, students, educational institutions, employers, and the profession. Employers have confidence in the education provided by an accredited surgical technology program.

Credentialing Credentialing for the ST is currently a voluntary process that helps determine, by examination, that an individual has met a national standard in both theoretical and practical knowledge in a particular field. Those who obtain the certification credential and become a Certified Surgical Technologist (CST) demonstrate a commitment to maximum performance and quality patient care

Only graduates of CAAHEP-accredited surgical technology programs (and currently or previously credentialed surgical technologists) are eligible to take the certification examination. Upon passing the certification examination, an individual is authorized to use the CST credential. Several states require surgical technologists to hold the CST credential in order to be credentialed by state regulatory agencies, or require that hospitals hire only Certified Surgical Technologists in their operating rooms.

The certification examination is administered by the Liaison Council on Certification for the Surgical Technologist (LCC-ST). The LCC-ST determines the guidelines for certification and prepares, reviews and establishes the validity of the national certifying examination. The LCC-ST is composed of a nine-member board that includes representatives from the American College of Surgeons (ACS), the Association of Surgical Technologists (AST) and one public member.

Professional Organization The Association of Surgical Technologists is the professional organization for surgical technologists. For three decades, the primary purpose of AST has been to ensure that surgical technologists have the knowledge and skills to administer patient care of the highest quality.

AST offers educational publications, products, and events of interest to surgical technology students, instructors, and practicing surgical technologists.

For additional information, please contact AST by mail, telephone, Internet, or use the Fax-On-Demand service.

Association of Surgical Technologists 7108-C South Alton Way Centennial, CO 80112-2106 National Headquarters 800-637-7433 Website www.ast.org Fax-On-Demand Service 888-627-8018

Related Organizations Accreditation Review Committee on Education in Surgical Technology (ARC-ST) www.arcst.org

American College of Surgeons (ACS) www.facs.org

Association of Surgical Assistants (ASA) www.surgicalassistant.org

Commission on Accreditation of Allied Health Education Programs (CAAHEP) – Accredits surgical technology programs upon the recommendation of the ARC-ST www.caahep.org

Foundation for Surgical Technology (FST) – Sponsors scholarship for students of accredited surgical technology programs. Selection is based on academic performance and financial need. www.ffst.org

The Liaison Council on Certification for the Surgical Technologist (LCC-ST) www.lcc-st.org

Disclaimer This informational brochure is provided by the Association of Surgical Technologists (AST) to assist prospective students in researching a career as a surgical technologist. AST strongly supports accreditation of surgical technology programs and recommends that all prospective students consider accreditation status when selecting a program. A current listing of accredited surgical technology programs is available from AST online, via the Fax-On-Demand service, or will be mailed by request. AST has made every effort to ensure that the program listings are current and correct, but AST does not guarantee the accuracy of the listings. It is the student’s responsibility to research the selected program(s). AST is not affiliated with any program and assumes no liability for the actions of any program.

Last updated: September 2004