Surgical First Assistant: Education Requirements & Job Duties

Career Information at a Glance

A surgical first assistant, or surgical assistant, works closely with the surgical team during an operation and anticipates their needs throughout the procedure. They can prepare the operating room, select equipment, close incisions, and perform other related tasks. Learn more details in the table below.

Sources: *U.S. Bureau of Labor Statistics; **PayScale

What Are the Job Duties of a Surgical First Assistant?

A surgical first assistant works under the direction of a supervising surgeon according to law and operating room policies. In general, they are responsible for positioning the patient for the operation, choosing the specific equipment needed for the procedure, maintaining sterility of the operating room, and taking inventory. Surgical first assistants hold open incisions during the procedure, stop bleeding, apply dressings to surgical wounds, and close the incision at the end of the surgery. They may be asked to assist in the resuscitation of patients during a life-threatening event in the operating room. The specific roles of a surgical first assistant depend on the setting and medical specialty.

What Are the Education Requirements?

Students often complete a surgical assisting program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) to become a surgical first assistant. While the specific admission requirements for the programs vary, they typically require a bachelor's or an associate degree in a health field, operating room experience, cardiopulmonary resuscitation (CPR) or basic life support (BLS) certification, and basic science coursework. Alternatively, experienced surgical technologists could learn the necessary skills through on-the-job training.

A surgical assisting program generally takes 10-22 months to complete. During this time, students take courses in advanced surgical anatomy, surgical pharmacology, surgical microbiology, fundamental technical skills, and medical ethics. Students will also complete clinical training in an operating room to learn advanced skills.

Is Certification Required?

While certification is not required, many employers do expect surgical first assistants to become certified. Certification is acquired by passing an exam administered from either the National Surgical Assistant Association (NSAA) or the National Board for Surgical Technology and Surgical Assisting (NBSTSA). After successful completion of the NSAA exam, surgical first assistants can use the Certified Surgical Assistant (CSA) designation. Those who pass the NBSTSA exam can use the Certified First Assistant (CFA) credential. Both organizations require a minimum number of continuing education credits every two years to maintain certification. some states, such as Texas, require a license.

Where Do Surgical First Assistants Work?

Most surgical first assistants work in the surgical department of a state, local, or private hospital. Some work in outpatient surgical centers or operating rooms in physician offices. Others choose to work in a specialty office, such as dentistry, orthopedics, or plastic surgery. These positions are typically full-time and can be either daytime or evening shifts. Depending on the setting, surgical first assistants may need to be on call overnight or during weekends.

What Is the Salary and Job Outlook?

According to PayScale.com, the median 2021 salary of a surgical first assistant was $63,513, with a range of around $40,000-$116,000. The surgical technologists field is expected to grow by 9% or more over the 2020-2030 decade. This is considered as fast as average, notes the U.S. Bureau of Labor Statistics. As medical technology continues to advance, operations have become safer and can treat a wider variety of conditions. In addition, as the baby boomer generation ages, they will require more operations. As a result, more surgical first assistants will be required to meet this need.