How to Get a Surgical Technician Certification (CST & TS-C)

Surgical techs work alongside surgeons during surgery, handing them instruments and helping keep the patient safe. They also prepare the patient before surgery and keep everything clean and organized in between patient operations. 

But how do you get certified as a surgical tech? Is certification required to work as a surgical tech?

15 states require surgical techs to be certified, but, even in those that don’t, most organizations prefer to hire those that are certified. 

You can earn a certification as a surgical technologist by completing an education course and passing a certification exam. The most common certification exams are the Certified Surgical Technologist (CST) and the Tech in Surgery – Certified (TS-C)

If you're interested in earning your certification, check out our 4-month online surgical tech program that prepares you to take the TS-C exam.

This guide breaks down different surgical tech certification options, how to get certified, and everything else you need to know.

Surgical Technician Certification Options

Two different surgical technician certifications are widely accepted by most states and employers—CST and TS-C.

The CST certification is the more popular scrub tech certification of the two, but either is acceptable in most cases. Note that scrub tech is just another name for surgical tech.

You may want to ask potential future employers if they prefer one over another, but most organizations view them equally. 


The National Board of Surgical Technology and Surgical Assisting (NCSTSA) is accredited by the Institute for Credentialing Excellence (ICE) and the National Commission for Certifying Agencies (NCCA). 

Their CST certification exam is re-evaluated frequently to keep all questions up-to-date.

  • Eligibility. Applicants must complete a surgical tech course that has been accredited by CAAHEP or ABHES. Alternatively, applicants can complete a military surgical-technician training program.  
  • Cost of the exam. The exam price is $190 for AST members and $290 for non-members. 
  • # questions on the exam. The exam consists of 175 questions. 150 of these questions are scored, and the other 25 are pretest questions. Candidates must answer at least 98 questions correctly to pass the exam. 
  • Pass rate: 66.7%
  • Renewal period. Every two years. 
  • Renewal requirements. Complete 30 continuing education credits, including at least 4 hours of live instruction. CSTs must submit proof of CE credit completion, a renewal application, and a $25 renewal fee during each renewal cycle. 

TS-C from NCCT

As previously mentioned, the Tech in Surgery – Certified (TS-C) from the National Center for Competency Testing (NCCT) is the second-most popular surgical tech certification.

The TS-C’s eligibility requirements, cost, and number of questions are all about the same as the CST certification. The main difference is that the TS-C certification must be renewed annually.

  • Eligibility. Applicants must have a high school diploma/GED and complete a surgical technology program from an NCCT-authorized school or have 3 years of experience as a surgical tech before their exam date. 
  • Cost of the exam. $199 for all applicants
  • # questions on the exam. The exam consists of 175 total questions, including 150 that are scored and 25 unscored pretest questions. 
  • Pass rate: 73%
  • Renewal period. Annually.
  • Renewal requirements. Earn 14 continuing education credits and pay a $77 renewal fee each year. 

Which is Better? CST or TS-C Scrub Tech Certification

Most states and healthcare organizations accept the CST or TS-C scrub tech certifications. It is up to the candidate to decide which certification is better for them. 

The CST exam has a first-time pass rate of 66.7%, while the TS-C exam has a 73% passing rate. 

Candidates have 4 hours to complete both the CST and the TS-C exams. 

The CST exam contains only multiple-choice questions. In the TS-C exam, 92% of the questions are multiple-choice questions and 8% are alternate format questions such as drag-and-drop or multi-select questions. 

If you are not a member of the AST, the CST exam is more expensive than the TS-C exam. However, the TS-C renewal fee is $77 annually, while the CST renewal fee is only $25 every two years. 

Both certifications are recognized in states that require scrub techs to earn a certification. There is no salary difference between surgical techs who pass the CST exam and those who pass the TS-C exam. 

How to Get a Surgical Tech Certification

Getting a scrub tech certification will help you feel more prepared to enter the workforce, make you a more desirable employee, and allow you to ask for a higher starting salary once you start your career. 

Following these steps will help you earn your certification and jumpstart your career working in the operating room:

1) Choose a Certification to Pursue

First, you'll need to decide which certification to pursue. Both certifications have similar eligibility requirements, exam difficulty, and coat of examination. The CST exam is more widely recognized and has less expensive renewal fees.

Make sure you look closely at your state certification requirements and talk to your employer about whether they prefer one certification over the other. 

2) Understand the Eligibility Requirements

After choosing which certification to pursue, look closely at the eligibility requirements for testing and certification. For both certifications, you can complete an accredited surgical tech training program or a military surgical tech training program. Candidates with 3 years of experience working as a scrub tech are eligible for the TS-C exam. 

Both certifying organizations require that applicants complete their training programs within 5 years of taking the exam. 

3) Research Surgical Tech Training Programs

There are many different surgical technician training programs to choose from. You can select an online surgical tech program like we offer here at Stepful, a certificate program through a technical school, or a degree program at a college or university. 

Consider cost, length of the program, exam passing rate, and clinical opportunities when choosing a program. 

>> Read More: Cost to Become a Surgical Tech (Programs & Certification) or Length of Surgical Tech Programs

4) Enroll in & Complete your Training Program

Depending on the type of surgical technician training program you choose, you should plan to spend 6 months to 2 years in class, studying, and completing clinical hours. 

Training programs typically teach their students about anatomy and physiology, maintaining sterile technique, microbiology, handling surgical instruments, and more. 

5) Complete Clinical Hours

Most surgical technician training programs include in-person clinical hours to help you get real-life experience before you begin working—typically between 120 to 600 hours.

6) Prepare for Your Exam

When you complete your training course, you should be familiar with the basic concepts of working as a surgical technician and feel prepared to enter the workforce. However, you should still spend some time studying and preparing for your certification exam. 

There are a lot of online test-prep materials available through both the NBSTSA and the NCCT. These materials are specifically designed to help students prepare for and pass their certification exams. 

7) Take Your Exam & Wait for the Results

After submitting proof of course completion and paying the exam fee, you can schedule your certification exam. Tests must be taken at a testing center or with an online proctor. You should receive your official results for both tests either when you graduate from your school program or 48 hours after completing your test. 

8) Maintain Your Certification

Both the CST and the TS-C scrub tech certifications require continuing education and renewal fees. The CST requires 30 hours of continuing education every 2 years, while the TS-C requires 14 hours of continuing education annually. 

How to Choose a Surgical Technician Training Program

Choosing a surgical technician training program is one of the most important decisions you make as you work towards becoming a scrub tech. Look for the following as you research different programs and decide which one will help you reach your goal. 

If It’s Accredited

When a program is accredited, it means that they have met a specific set of standards for the information it provides to their students and how that information is taught. 

Choosing an accredited program not only increases the chances of you getting a high-quality education, but all certifying agencies require students to complete accredited programs to be eligible for certification. 

Choose a program that is either accredited by CAAHEP or ABHES, or that has a specific NCCT approval. 

Graduation Rate

Most successful training programs list their graduation rates on their websites or make the information easily available. If you cannot find a graduation rate listed anywhere, call the program director to ask. 

Enrolling in a program with a low graduation rate puts you at a high risk of failure, and programs with low graduation rates often have too little support for students. 

Certification Exam Pass Rate

In addition to checking program graduation rates, check the certification exam passing rates. Exam passing rates are a good measure of how well a program prepares its students to earn their certificate at the end of the training. 

Look for programs with passing rates that meet or exceed the national average. The CST exam has an average passing rate of 66.7% and the TS-C exam has an average 73% passing rate, for reference.


The cost of a surgical technician training program can vary widely. Online surgical tech programs are typically less expensive than college certificate programs, and degree programs are the most expensive option. 

Scrub tech programs can cost between $4,000 and $40,000. 


Most people want to get their training completed as quickly as possible. This makes sense if you have time to commit to full-time study and can learn quickly. 

If you will be working or caring for others during your training program, it may make more sense to choose a longer and less intense training option. 

Scrub tech training courses can be completed in 4 months to 2 years, and most require several hundred clinical hours. 

Talk to your school’s guidance counselors about the time commitment required to complete the program successfully. 

Online vs. In-Person

Both online and in-person programs have benefits and drawbacks. Online programs are convenient, offer flexible scheduling, and eliminate your commute. They are often self-paced, allowing you to work on the course content as slowly or quickly as you would like. 

On the other hand, some people learn better while in a classroom environment and benefit from face-to-face instruction. 

Both online and in-person classes will require all future surgical technologists to complete some in-person clinical hours before graduation. 

Is it Possible to Get a Scrub Tech Job With No Experience or Certification?

Yes, it is possible to get a job as a scrub tech with no experience or certification. However, there are a few states that require surgical techs to earn a certification before they will be allowed to get a job in the operating room. These states include: 

  • Connecticut
  • Idaho
  • Illinois
  • Indiana
  • Massachusetts
  • Nevada
  • New Jersey
  • New York
  • Oregon
  • Pennsylvania
  • South Carolina
  • Tennessee
  • Texas
  • Washington
  • Virginia

If you live in a state that does not require certification, you may be able to find a job with no certifications or experience, however, most healthcare organizations prefer to hire surgical technicians who have completed a training program and have earned a certification. 

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