HealthcareSeptember 25, 20268 min read

How to Become a Surgical Technologist in 2026: Step by Step

The full route to working as a surgical technologist, in order: program, NBSTSA CST exam, state licence and renewal, with timings and what each step costs you.

  • $64,650Median pay
  • +5%Job growth
  • Associate degreeTraining
  • NBSTSA CSTExam
  • $230Exam fee
How to become a surgical technologist: step-by-step route 2026

Table of Contents

The route, start to finish

Becoming a surgical technologist is a fixed sequence: an approved program, the NBSTSA CST exam, then whatever your state requires on top. Here is every stop in order, with realistic timings.

  1. 1

    Choose an accredited surgical technology program

    Prerequisite

    Pick a program accredited by CAAHEP or ABHES (check the program, not just the school). Graduating from a non-accredited program makes you ineligible for the CST.

  2. 2

    Complete coursework and clinical rotations

    Associate degree program

    Study anatomy, microbiology, pharmacology and surgical procedures, then scrub real cases. NBSTSA says CST candidates complete 120 cases and 300-400 hours of operating-room experience.

  3. 3

    Apply to NBSTSA and get your ATT

    2-4 weeks

    Apply online through the NBSTSA Learning Builder portal with proof of graduation and the $230 (AST member) or $340 fee. Processing takes 2-4 weeks, or 3-5 business days with the $85 rush fee.

  4. 4

    Schedule and pass the CST exam

    4-hour exam

    Book a PSI testing center (or test with your class on campus) and answer 175 questions in 4 hours. You need 98 of the 150 scored questions correct.

  5. 5

    Meet your state's rules

    Some states tie employment to certification. Texas and New York require health care facilities to hire certified surgical technologists (with exemptions), Virginia certifies them through its Board of Medicine, and Washington and Colorado require registration.

  6. 6

    Renew every two years

    Every 2 years

    Earn 30 AST-approved CE credits (including 4 live credits) each 2-year cycle, submit them to AST, then file the $40 NBSTSA renewal. You can instead recertify by retaking the exam.

Step one: the right program

The program is the one step you cannot shortcut. The exam body checks where you trained before it lets you sit, so an unaccredited course can cost you the whole route.

Program: Surgical technology program at a community college, technical school or university with classroom, lab and supervised operating-room clinical rotations; ARC/STSA requires graduates of CAAHEP-accredited programs to earn at least an associate degree (for cohorts completing on or after August 1, 2021). Programs require 120 cases and 300-400 OR hours of clinical experience
Accreditation: CAAHEP (on the recommendation of ARC/STSA) or ABHES. Only graduates of programs accredited by one of these two, or of a military program, can sit for the CST.
Typical length: Associate degree

Who is eligible to sit the exam

RouteWhat you need
Accredited program graduateGraduate of a surgical technology program accredited by CAAHEP or ABHES; the program itself (not just the school) must have been accredited during your enrollment. Proof: diploma/graduation certificate, transcript, or a notarized letter on school letterhead giving graduation date and degree type.
Military program graduateGraduate of a military surgical technology training program. Proof: DD214 (listing the base where the program was completed), a graduation certificate, or a Joint Services (smart) transcript.
Current or previously certified CSTEvidence of current or prior CST certification (used for recertification by exam or retakes). CSTs certified before September 1, 1977 can regain currency with 30 CE credits earned in the prior two years or by passing the exam.

The exam itself

This is the checkpoint the whole route builds towards. The essentials:

Exam: NBSTSA Certified Surgical Technologist (CST) Certifying Examination
Questions: 175 (150 scored)
Time: 240 minutes
Where you test: Computer-based, by appointment at PSI testing centers nationwide (Mon-Sat), or with your class on campus as a web-based test (WBT) at participating schools; overseas military candidates can test through a base education office
Passing standard: Raw cut score: 98 correct out of 150 scored questions, effective January 1, 2024 (set by a modified-Angoff standard-setting study in November 2023). The 25 pretest items do not count.
Fee: $230

We broke the exam down domain by domain, with the weight of each and what its questions ask, in the NBSTSA CST content outline.

Licensure: what your state adds

The CST is a national certification, not a state license, and most states do not license surgical technologists. Several states regulate them: Texas and New York bar health care facilities from employing surgical technologists unless they completed an accredited program and hold a national certification such as the CST (with military, grandfathering and new-graduate exemptions); Virginia certifies surgical technologists through its Board of Medicine and requires the NBSTSA CST for the C.S.T. title; Washington requires registration with the Department of Health (RCW 18.215); and Colorado requires registration with its Division of Professions and Occupations. AST also lists education or certification laws in states including Indiana, Massachusetts, New Jersey, Oregon, South Carolina, Tennessee, Idaho and Nevada. Check your state rules before you accept a job.

StateWhat it requires
TXHealth care facilities may only employ surgical technologists who completed an accredited program AND hold NBSTSA (or another DSHS-approved) certification, completed a US military or USPHS surgical technology program, were employed as surgical technologists before September 1, 2009, or work for the federal government. New graduates of accredited programs may work up to 180 days after graduation before certifying. Enforced through facility licensure review; does not apply to private scrubs hired by surgeons.
NYPublic Health Law 2824 (effective January 1, 2015): hospitals and ambulatory surgery centers may not employ or contract a surgical technologist unless the person completed a nationally accredited program and holds and maintains a CST credential from a nationally accredited credentialing organization, completed a US military or USPHS program, or was grandfathered (1 year of employment within the 4 years before the law). 15 hours of CE required every year; work must be under the supervision of a licensed professional in the surgery.
VABoard of Medicine certifies surgical technologists. Using the title 'surgical technologist' or 'S.T.' requires Board certification; using 'C.S.T.' also requires an accredited program and a current NBSTSA CST. Certification is granted for an accredited program plus current NBSTSA CST, a military program, or (grandfather) practice/training before October 1, 2022 with registration by December 31, 2022.
WARCW 18.215: no one may represent themselves as a surgical technologist without Department of Health registration. The statute does not make national certification a condition of registration.
COSurgical technologists must register with the Division of Professions and Occupations (Office of Surgical Assistant and Surgical Technologist Registration) under C.R.S. Title 12, Article 310; registration program created in 2010.

Pay and job outlook

The US Bureau of Labor Statistics files surgical technologists under “Surgical technologists (SOC 29-2055)”. Median means half earn more and half less; pay moves a long way with state, setting and experience, so read this as a benchmark, not an offer.

$64,650Median pay (May 2025)
+5%Job growth 2025-35
68.6%Exam pass rate (2025)

Keeping the credential

Cycle: Every 2 years
Requirement: 30 AST-approved CE credits per 2-year cycle, including 4 live credits, all earned within the cycle and submitted to AST for approval before you file the NBSTSA renewal. Extra credits do not roll over. Alternatively, recertify by passing the CST exam again. You can file up to 6 months before expiration; late filing is allowed 1-90 days after expiration only if the CE was earned inside the cycle.
Fee: $40 renewal application (plus $100 late fee if filed 1-90 days after expiration). Renewal by exam costs $440 for AST members or $540 for non-members. AST may charge a fee for CE earned during non-membership periods.

The exam is the step most people underprepare for

ExamCert AI has 1,305 CST practice questions with explanations, built around the same outline this page walks through. Work them by domain, find the weak area, and fix it before test day.

Practise CST on ExamCert AICST Exam Content Outline 2026

FAQ

Can you take the CST exam without going to an accredited program?

No. You must graduate from a CAAHEP- or ABHES-accredited surgical technology program or a military surgical technology program. The program itself must have been accredited while you were enrolled; the school's general accreditation does not count.

How much does the CST exam cost?

The first-time CST exam costs $230 for AST members and $340 for non-members. Rush processing adds $85, and every retake requires a new application and the full fee.

Which states require surgical technologist certification?

Texas and New York require health care facilities to employ surgical technologists who completed an accredited program and hold a national certification, with some exemptions. Virginia certifies surgical technologists through its Board of Medicine, and Washington and Colorado require state registration. Rules differ by state, so check with your state regulator.

How much do surgical technologists make?

BLS reports a median annual wage of $64,650 for surgical technologists in May 2025. Employment is projected to grow 5% from 2025 to 2035, with about 8,600 openings a year for surgical assistants and technologists combined.

Sources

Figures on this page come from NBSTSA and the other primary sources below:

Checked September 25, 2026. Fees, outlines and eligibility rules change — confirm with NBSTSA before you book.