Informed and ready to operate!

Oct 22

Surgical Assistant FAQ


Frequently Asked Questions



Click on a question below to jump to the answer:

What is a Surgical First Assistant?

What credentials do Surgical First Assistants typically hold?

What type of training is typically required to become a Surgical First Assistant?

How can I find a CAAHEP accredited Surgical First Assistant program in my area?

What does certification mean and how do I become certified?

What are professional organizations and why should I join?

I am a Surgical Technologist filling the role of Surgical First Assistant at my facility or with a private physician and have been doing so for several years; why should I get certified now?

What is personal liability/malpractice insurance and why should I carry a policy as a Surgical First Assistant?

What type of salary can I expect as a Surgical First Assistant?

Who are the members of the surgical team and what are their functions?

Where does the future of Surgical First Assisting lie?

Where can I get more information?




Q: What is a Surgical First Assistant?

A: Surgical Assistants, or Surgical First Assistants, are allied healthcare providers who function under the direction of the surgeon. These highly skilled practitioners are integral members of the operating room team. According to the American College of surgeons, the Surgical First Assistant provides aid in exposure, hemostasis, and other technical functions that will help the surgeon carry out a safe operation with optimal results for the patient. For a more detailed job description, read the American Medical Association's summary of the Surgical First Assistant here.

Back to top

Q: What credentials do Surgical First Assistants typically hold?

A: The Surgical Assistant, or Surgical First Assistant, is a member of the operating room team and can be either a licensed physician (MD, DO, DPM, DDS), a medical/surgical resident, or a non-physician surgical assistant with either of the following credentials: Nurse Practitioner (NP), Physician Assistant (PA, PA-C), Registered Nurse First Assistant (RNFA, CRNFA), Certified Surgical First Assistant (CSFA, formerly CFA), Certified Surgical Assistant (CSA), or Surgical Assistant-Certified (SA-C).

Back to top

Q: What type of training is typically required to become a Surgical First Assistant?

A: Because of the diversity in backgrounds among Surgical Assistants and their credentials, individual training programs may vary depending upon the type of credential being sought by the individual and the geographic area in which they plan to practice. Please see Education for more details.

Back to top

Q: How can I find a CAAHEP accredited Surgical First Assistant program in my area?

A: Currently, there are several CAAHEP accredited Surgical Assistant programs in the United States. Many of these programs offer on-line components which may facilitate those prospective students living too far away from a program to attend formal classes. A list of accredited programs can be viewed here.

Back to top

Q: What does certification mean and how do I become certified?

A: Certification is a process that helps determine, by examination, that an individual has met a national standard in both theoretical and practical knowledge in a particular field. There are currently three major bodies that certify Surgical Assistants nationally. The national certification examination for the Certified Surgical First Assistant is prepared by the National Board of Surgical Technology and Surgical Assisting (NBSTSA) and the computerized exam is administered by a national testing company. Successful completion of this exam leads to the credential "Certified Surgical First Assistant (CSFA, formerly CFA)." The CSFA title from the NBSTSA is the only credential approved and accredited by the National Organization for Competency Assurance (NOCA) and the National Commission for Certifying Agencies (NCCA), which also accredits Nurse Practitioner, Critical Care Nurse, Medical Technologist, Radiologic Technologist, and other such credentials. The national certification examination for the Certified Surgical Assistant is prepared by the National Commission for the Certification of Surgical Assistants (NCCSA) and the computerized exam is administered by a national testing company. Successful completion of this exam leads to the credential "Certified Surgical Assistant (CSA)." The national certification examination for the Surgical Assistant-Certified is prepared by the American Board of Surgical Assistants (ABSA) and the exam is administered by ABSA. Certification is recommended by the Association of Surgical Assistants (ASA), the Association of Surgical Technologists (AST), the National Surgical Assistant Association (NSAA), and ABSA. Certification is required by some employers, as well as state and local legislation in many areas. It is also important to note that the majority of hospitals and other surgical facilities will require certification as a condition of gaining privileges as a Surgical First Assistant at that institution. Note: Check local legislative and facility policies/guidelines before deciding on a specific Surgical Assistant certification. Specific facilities or regions may prefer one credential over another.

Back to top

Q: What are professional organizations and why should I join?

A: Professional organizations for the Surgical Assistant include the Association of Surgical Assistants (ASA) which represents all non-physician Surgical First Assistants holdng the CSFA, CSA, and/or SA-C credential; the National Surgical Assistant Association (NSAA) which represents the CSA specifically; and the American College of Surgeons (ACS). Surgical Assistants are encouraged to join ACS as affiliate members. Professional membership organizations fight for the rights and recognition of Surgical Assistants throughout the United States. Member benefits other than representation vary between organizations but may include discounts on liability and other insurance premiums, national conferences, subscriptions to publications related to the Surgical Assistant, workshops, specialty forums, educational information, and opportunities to earn continuing education credits.

Back to top

Q: I am a Surgical Technologist filling the role of Surgical First Assistant at my facility or with a private physician and have been doing so for several years; why should I get certified now?

A: Surgical Technologists are vital members of the operating room team. Their expertise in case management and aseptic technique is of the highest standard. However, many of the skills required to first assist in the operating room are out of the scope of practice of these individuals. In order to be properly credentialed as a Surgical First Assistant practitioner at a public or private facility, one must maintain appropriate training, certification, and personal liability insurance. Without the proper credentialing and certification, a Surgical Technologist working in the First Assistant's role can be viewed as an act of medical malpractice or negligence in a court of law. To circumvent these issues, in areas in which title protection for Surgical Assistants has not been established, Surgical Technologists performing the duties of the Surgical Assistant have been given the title "Private Scrub." It is appropriate for surgeons to employ private Surgical Technologists to aid them during operative procedures and/or to assist them with office clerical work; however this delineation should not venture out of that individual's scope of practice. For those professionals who cannot attend a proper Surgical First Assistant training program, the National Board of Surgical Technology and Surgical Assisting (NBSTSA) currently offers a clinical preceptorship route to certification as a Certified Surgical First Assistant (CSFA, formerly CFA). The specific details of this certification route can be viewed here.

Back to top

Q: What is personal liability/malpractice insurance and why should I carry a policy as a Surgical First Assistant?

A: In this new, complex world it is important for healthcare providers of all levels to protect themselves, their families, and their assets from financial disputes that may arise out of malpractice claims whether alleged or the result of care provider error, omission, or negligence. Legal and financial protection for healthcare professionals such as physicians, nurses, and surgical assistants is attained in the form of personal liability/malpractice insurance. Personal liability insurance protects healthcare workers by providing them with legal and financial security in the event they are named in a lawsuit. Even in cases where the lawsuit is proven frivolous, thousands of dollars may be spent in defense of the provider. Liability insurance protects the interests of the insured and provides them with an attorney, coverage of all reasonable costs incurred in defense of the practitioner, reimbursement for lost wages, reimbursement for fees incurred from licensing disputes, and court costs and settlement payments in addition to liability limits. If no insurance is carried by the healthcare provider named in the lawsuit, the legal costs incurred will be paid by that individual and can be financially and emotionally devastating.

While many healthcare providers are covered under an insurance program through their employer, these policies protect the interests of the company or facility over those of the individual employees. Employer provided liability coverage may not carry limits high enough to cover all of the defense costs and may not protect the employee in the event of a lawsuit. Also, companies may in turn sue their employees to recover money lost in a suit if the employee was deemed to be at fault. It is necessary for individuals to attain additional coverage through personal liability insurance to truly protect their interests and assets above those of the company they work for. Additionally, personal coverage protects medical personnel outside of the workplace such as volunteers, or in the event that a suit is filed and a provider no longer works for the company covered. Personal liability/malpractice insurance is essential in today’s complicated healthcare system. It is necessary for healthcare providers to protect their assets, families, and future from claims made against them, even those that are alleged. Insurance coverage above and beyond that which may be provided through an employer provides individuals with an advocate and added security so they may be protected in the event that a malpractice lawsuit is filed against them. For more information and a list of personal liability insurance providers, see Links and scroll down to Personal Liability Insurance.

Back to top


Q: What type of salary can I expect as a Surgical First Assistant?

A: Salaries vary greatly depending on experience, education, region, type of employer, and area of specialty surgical concentration (i.e., orthopedic, cardiovascular, or neurosurgery specialist, etc.). Surgical Assistants can also fill other specialty roles by nature of their training such as surgical sales representatives or operating room managers. According to a 2011 survey conducted by the Association of Surgical Assistants (ASA), the average base salary for the Surgical Assistant is approximately $50-60,000 yearly. This salary report does not consider call pay, shift differential, or overtime. According to a survey published by the National Surgical Assistant Association (NSAA) in 2005, the salary for a full-time Surgical Assistant may be anywhere from $50-150,000 yearly depending on experience and type of employer or practice. According to this same salary survey, “entry level CSA's (less than 1 year of experience) typically started at a hospital at approximately $23-$25 an hour with increments up to $45 an hour as experience increased for those hospitals that pay hourly.” Many Surgical Assistants will have opportunities to significantly increase their salary through shift differential, on call, and overtime opportunities.

Back to top

Q: Who are the members of the surgical team and what are their functions?*

A: Surgical team members function in two capacities – non-sterile and sterile.

The non-sterile team members are the circulator and the anesthesia provider. In certain situations, other personnel such as the radiology technologist, medical device manufacturer/sales representative, or pathologist may also be present.

Circulator: The circulator is a Registered Nurse, Licensed Practical or Vocational Nurse, or a Surgical Technologist. Some of the circulator’s duties include: preparing the operating room, interviewing the patient preoperatively, transporting the patient to the OR, transferring the patient to the OR table, positioning the patient, assisting the anesthesia provider, prepping the patient, assisting with draping, connecting various cords and tubings, providing additional items to the sterile field during the procedure, maintaining the patient’s operative record, affixing the dressing, transporting the patient to the postanesthesia care unit, and preparing the operating room for the next patient.

Anesthesia Provider: The anesthesia provider may be either a physician or a Certified Registered Nurse Anesthetist. Some of the anesthesia provider’s duties include: administering the anesthetic, monitoring the patient’s vital signs and, providing any supportive measures during the surgical intervention.

The sterile team members are the Surgical Technologist in the scrub role (STSR), the surgeon, and the Surgical First Assistant.

Surgical Technologist: The Surgical Technologist functions in a sterile capacity during the surgical procedure, but also performs many non-sterile duties throughout the course of the workday. The main sterile functions of the surgical technologist are: creating and maintaining the sterile field, entering the sterile field and assisting team members as they enter the sterile field, organizing the sterile instruments, equipment, and supplies for use, assessing and anticipating the needs of the patient and surgeon throughout the procedure, and providing the necessary items in order of need.

Surgeon: The surgeon performs the necessary procedure. The surgeon may be a Medical Doctor (MD), Doctor of Osteopathy (DO), Doctor of Podiatric Medicine (DPM), or a Doctor of Dental Science (DDS).

Surgical First Assistant: The surgical first assistant may be a physician or non-physician. The duties of the first assistant include: assisting the surgeon by providing visualization of the surgical site through retraction of tissue, suctioning, and sponging, assisting with achieving hemostasis and, suturing of body planes.

Back to top


Q: Where does the future of Surgical First Assisting lie?*

A: Rapid advances in medical technology will bring dramatic changes to the fields of Surgical Technology and Surgical Assisting. The operating room of the future will incorporate computers, electronics, and robotics to carry out routine patient care. The Surgical Assistant must be prepared to meet these advanced challenges.

Back to top

Q: Where can I get more information?

A: See the following contact information for details.

Contact the American Board of Surgical Assistants at:

American Board of Surgical Assistants
26221 East Kettle Circle
Aurora, CO 80016-2020

Toll Free: 1 (877) 617-8345
Local: (303) 617-8345
Fax: (303) 539-9847

http://www.absa.net/

office@absa.net


Contact the Association of Surgical Assistants at:

Association of Surgical Assistants
6 W Dry Creek Circle, Suite 210
Littleton, CO 80120-8031

Toll Free: (800) 637-7433

http://www.surgicalassistant.org/

asaboard@surgicalassistant.org


Contact the Association of Surgical Technologists at:

Association of Surgical Technologists
6 West Dry Creek Circle, Suite 200
Littleton, CO 80120-8031 

Toll Free: 1 (800) 637-7433
Local: (303) 694-9130
Fax: (303) 694-9169

http://www.ast.org/


Contact the National Board of Surgical Technology and Surgical Assisting at:

The National Board of Surgical Technology and Surgical Assisting
6 West Dry Creek Circle, Ste. 10
Littleton, CO 80120

Toll Free: 1 (800) 707-0057
Fax: (303) 325-2536

http://www.nbstsa.org/
mail@nbstsa.org


Contact the National Surgical Assistant Association at:

National Surgical Assistant Association
1425 K Street NW, Ste 350
Washington, DC 20005

Toll Free: 1 (855) 270-6722
Local: (202) 266-9951
Fax: (202) 587-5610

http://www.nsaa.net/
nsaa@namgmt.com


Back to top




*Some of the information contained within this FAQ is adapted from the Association of Surgical Technologists video series.

News


Archive


Quick Links

American Board of Surgical Assistants

American College of Surgeons

American Medical Association

Association of periOperative Registered Nurses

Association of Surgical Assistants

Association of Surgical Technologists

Commission on Accreditation of Allied Health Education Programs

Health Insurance Portability and Accountability Act

Illinois Surgical Assistant Association

The Joint Commission

Medline Plus

National Board of Surgical Technology and Surgical Assisting

National Surgical Assistant Association