The Certified Surgical Technologist (CST) examination is the NBSTSA’s national certification examination for surgical technologists: 175 multiple-choice questions in four hours — 150 scored and 25 unscored pretest items — weighted 97 items to Perioperative Care, 23 to Ancillary Duties, and 30 to Basic Science, passed by answering at least 98 of the 150 scored questions correctly, and open to graduates of CAAHEP- or ABHES-accredited surgical technology programs and military surgical technology programs. PassProfessor’s CST program is in the works, built to that published outline.
This program is part of the expanding PassProfessor catalog — join the notify list and we’ll email you when enrollment opens.
Certification is where a surgical technology program ends and a career in the operating room begins. The CST is the credential employers name in job postings and the one the National Board of Surgical Technology and Surgical Assisting (NBSTSA) has built its examination around: not a test of textbook recall, but of what a scrub technologist actually does before, during, and after a case. PassProfessor’s CST program is in the works as part of the expanding PassProfessor catalog, built on the NBSTSA’s published examination content outline — the outline effective January 1, 2023, built from the NBSTSA’s job analysis — and organized the way the real examination is organized, with Perioperative Care carrying nearly two-thirds of the score.
Which examination is this?
This page covers one credential only: the Certified Surgical Technologist (CST), awarded by the National Board of Surgical Technology and Surgical Assisting (NBSTSA), whose certification program is accredited by the National Commission for Certifying Agencies (NCCA). It is not the NBSTSA’s Certified Surgical First Assistant (CSFA) examination — a different credential from the same body, for a different role — and it is not the Tech in Surgery credential offered by another body. State law on surgical technologists varies: some states require certification to practice, others do not, and the CST is a national certification, not a state license. Keeping those boundaries straight matters when you read job postings and state rules, because the examination on this page certifies competence; it does not by itself authorize practice anywhere.
What will the program cover?
Original practice questions, written to the published outline. The program is being built from scratch against the NBSTSA’s CST Examination Content Outline — Perioperative Care (97 scored items), Ancillary Duties (23), and Basic Science (30) — so practice follows the examination’s real weighting instead of a textbook’s chapter order. No practice item is an actual examination item, a recalled item, or another provider’s material, and no item asks you to recite a code, section number, or citation: knowledge and operating-room judgment are tested, citations never are.
Procedure-level practice, the way the outline is written. The CST outline is written as tasks — perform the surgical scrub, anticipate the steps of surgical procedures, perform counts with the circulator, verify, prepare, and label specimens. The program’s design follows that grain: items framed around what the technologist does next, in sequence, at the field, rather than around definitions in isolation.
Results you can read by area and sub-area. Practice is organized by the outline’s three areas and eight sub-areas, so your results can be read at the level the examination reports: a thin sub-area — say, Equipment Sterilization and Maintenance — shows while there is still time to repair it, instead of hiding inside an overall score.
Timed practice at the real sitting’s shape. The real examination gives you four hours for 175 questions. The program’s design includes sustained timed practice modelled on that shape, so pacing is trained alongside knowledge — including the habit of answering every item, since 25 of the 175 are unscored pretest questions mixed in at random and indistinguishable from scored ones.
What are the verified facts of the real exam?
| Fact of record | Detail |
|---|---|
| Credential | Certified Surgical Technologist (CST), awarded by the National Board of Surgical Technology and Surgical Assisting (NBSTSA); the program is NCCA-accredited |
| Delivery | Computer-based, at PSI test centers (and, for enrolled students, at approved campus testing sites) |
| Format | 175 multiple-choice questions in 4 hours: 150 scored questions and 25 unscored pretest questions placed at random |
| Passing standard | At least 98 of the 150 scored questions answered correctly, as the NBSTSA publishes it |
| Content outline | Effective January 1, 2023: Perioperative Care 97 items (Preoperative Preparation 19, Intraoperative Procedures 68, Postoperative Procedures 10); Ancillary Duties 23 items (Administrative and Personnel 7, Equipment Sterilization and Maintenance 16); Basic Science 30 items (Anatomy and Physiology 18, Microbiology 6, Surgical Pharmacology 6) |
| Eligibility | Graduate of a surgical technology program accredited by CAAHEP or ABHES, or graduate of a military surgical technology training program |
| Examination fee | $340 for first-time candidates; $230 for AST members; each retake $300, as the NBSTSA publishes it. Confirm the current fee when you apply |
| Retakes | Up to 3 attempts per calendar year |
| Keeping the credential | Certification runs in two-year cycles; renewal requires 30 continuing education credits per cycle (or renewal by examination) |
How does the practice map to the outline?
The NBSTSA publishes the scored-item distribution across its outline, and the practice program is organized on the same distribution:
| Outline area | Scored items on the real exam | Share of scored items |
|---|---|---|
| Perioperative Care — Preoperative Preparation | 19 | 13% |
| Perioperative Care — Intraoperative Procedures | 68 | 45% |
| Perioperative Care — Postoperative Procedures | 10 | 7% |
| Ancillary Duties — Administrative and Personnel | 7 | 5% |
| Ancillary Duties — Equipment Sterilization and Maintenance | 16 | 11% |
| Basic Science — Anatomy and Physiology | 18 | 12% |
| Basic Science — Microbiology | 6 | 4% |
| Basic Science — Surgical Pharmacology | 6 | 4% |
| Total scored | 150 | 100% |
What does Perioperative Care cover?
Ninety-seven items — 65% of the scored examination. Preoperative Preparation (19 items) covers the work before the incision: the basic hand wash and surgical scrub, donning gown and gloves, opening and setting up the sterile field, draping the Mayo stand and back table, gowning and gloving sterile team members, and preparing the room and the patient. Intraoperative Procedures (68 items) is the examination’s centre of gravity: anticipating the steps of surgical procedures, passing instruments and supplies, maintaining aseptic technique and recognizing breaks in it, performing counts with the circulator at the appropriate times, handling and labelling specimens, monitoring medications and solutions used at the field, irrigating, suctioning, and sponging as directed, preparing drains, catheters, and tubing, observing the patient’s intraoperative status, and acting appropriately in an emergency. Postoperative Procedures (10 items) covers the close of the case: preparing dressings and the wound site, assisting with casts, splints, and braces, removing drapes and equipment, and turning the room over.
Intraoperative Procedures alone is 45% of the scored examination. Preparation that does not start there is preparation in the wrong order.
What does Ancillary Duties cover?
Twenty-three items in two sub-areas. Administrative and Personnel (7 items) covers the professional frame around the case: revising and maintaining surgeons’ preference cards, cost containment, disaster-plan protocol, recognizing safety and environmental hazards — fire, chemical spill, laser, smoke — electrical safety, ethical and legal practices, interpersonal skills and group dynamics, cultural diversity, concepts of death and dying, and serving as a preceptor. Equipment Sterilization and Maintenance (16 items) covers the instrument life cycle: decontamination, sterilization methods and their monitoring, packaging, storage, and the care and maintenance of the equipment the field depends on.
The sterilization sub-area is the quiet score-mover: 16 items governed by rules with exact conditions — times, temperatures, indicators — that reward precise study over general familiarity.
What does Basic Science cover?
Thirty items in three sub-areas. Anatomy and Physiology (18 items) covers medical terminology and abbreviations and the anatomy and physiology of the body systems as they relate to surgical procedures, including surgical pathology — the abnormal anatomy, disease processes, and injuries that bring patients to the operating room. Microbiology (6 items) covers the classification of microorganisms and the principles of surgical microbiology as applied to operative practice. Surgical Pharmacology (6 items) covers the medications used in surgery — what is used at the field, in what form, and with what risks.
Basic Science items are rarely pure recall: the anatomy question arrives wearing a procedure’s name, and the pharmacology question arrives at the moment a medication is handed to the field.
How is the CST examination scored?
Scoring is a straight count with a published line: of the 150 scored questions, you must answer at least 98 correctly to pass. The other 25 questions in the booklet are unscored pretest items, placed at random, being evaluated for future examinations; they look exactly like scored questions, which is why the only workable strategy is to answer all 175 as if each one counted. There is no way to know your standing partway through, and no partial credit structure to game: the examination rewards breadth held to a consistent standard across four hours. The practical reading follows from the outline weights — Perioperative Care is 97 of 150 scored items, so the examination is decided at the field first; but Basic Science and Ancillary Duties together carry 53 items, comfortably more than the distance between a pass and a miss for a borderline candidate.
Who can take this exam, and what does it certify?
Eligibility runs through education. You qualify by graduating from a surgical technology program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES), or by graduating from a military training program in surgical technology. You apply through the NBSTSA, and the examination is delivered by computer at PSI test centers; students in accredited programs may test at approved campus sites, with score release tied to program completion on the terms the NBSTSA publishes. Passing certifies that you meet the NBSTSA’s national standard for entry-level surgical technology practice. Certification is maintained in two-year cycles, by earning 30 continuing education credits or by re-examination. Whether certification is legally required to work as a surgical technologist depends on your state; the credential itself is national and portable.
What makes this test demanding?
Two features. First, the concentration: with 68 of 150 scored items in a single sub-area, Intraoperative Procedures, the examination is unusually exposed to one body of skill — anticipating procedures step by step, across specialties, while maintaining asepsis and counts. Candidates who prepared by reviewing instruments specialty by specialty, without rehearsing procedural sequence, meet that exposure head-on. Second, the grain: the outline is written as tasks performed under time pressure in a room where errors are concrete — a broken sterile field, a wrong count, a mislabelled specimen. Items test whether you know the correct next action, not whether you can define the terms in it, and the distractors are usually plausible actions performed at the wrong moment or in the wrong order.
An honest note on format
Every PassProfessor practice question is a single-answer, four-option item, matching the real examination’s multiple-choice format in shape. The NBSTSA does not release its examination questions, and no provider can offer them. Practice here builds the knowledge and procedural judgment the outline requires; it does not reproduce the examination itself. Practice results are a study gauge — a way to see which sub-areas are thin while there is time to repair them — not a prediction of an examination outcome.
How should you use this page while the program is in the works?
- Join the notify list today. Enrollment is not open yet, and the notify list is how you hear the moment it is. While you wait, read the exam guide — it walks the outline sub-area by sub-area and lays out eligibility, scoring, fees, and study planning in full.
- Study from the official outline now. The published outline summarized on this page is the syllabus; organizing your review by its areas and weights is useful work today, before any practice program opens.
- When the program opens, survey every sub-area first. Early practice should touch all eight sub-areas, so your first picture of yourself is honest rather than flattering.
- Drill the sub-area that costs you. Let results, not preferences, set the next block of study — and give Intraoperative Procedures the largest block regardless, because the examination does.
- Finish with timed, mixed practice. Sit full timed practice at the real sitting’s four-hour shape, answering every item, before you book your date.
Frequently asked questions
How many questions are on the CST exam, and how long is it? 175 multiple-choice questions in four hours. Of the 175, 150 are scored and 25 are unscored pretest questions placed at random — you cannot tell them apart, so answer every question as if it counted.
What score passes the CST exam? At least 98 of the 150 scored questions answered correctly, as the NBSTSA publishes it.
Who is eligible to take the CST exam? Graduates of surgical technology programs accredited by CAAHEP or ABHES, and graduates of military surgical technology training programs.
What does the CST exam cost? The NBSTSA publishes a first-time examination fee of $340, with a discounted fee of $230 for AST members; a retake costs $300. Confirm the current fee when you apply. That is the NBSTSA’s examination fee, separate from any preparation program.
How many times can I retake the CST exam? Up to three attempts per calendar year, as the NBSTSA publishes it.
What is the biggest part of the CST exam? Perioperative Care, at 97 of the 150 scored questions — and within it, Intraoperative Procedures alone carries 68 scored questions, about 45% of the scored examination.
Is the CST the same as the CSFA? No. The Certified Surgical First Assistant (CSFA) is a separate, different credential from the same body, the NBSTSA, covering the first-assisting role. This program prepares you for the CST examination only.
Does the CST license me to work as a surgical technologist? The CST is a national certification, not a state license. Some states require certification to practice as a surgical technologist and others do not; check your state’s rules alongside the credential.
How do I keep the CST once I earn it? Certification runs in two-year cycles. Renewal requires 30 continuing education credits per cycle, or renewal by examination, on the NBSTSA’s published terms.
Are these the real exam questions? No. Every question in the program is an original PassProfessor practice question written to the NBSTSA’s published content outline. The NBSTSA does not release its examination questions, and no provider can offer them.
When will enrollment open? The program is in the works. Join the notify list on this page and we will email you when enrollment opens.
Disclaimer
PassProfessor is an independent exam-preparation provider; this program is not endorsed by, affiliated with, or sponsored by the National Board of Surgical Technology and Surgical Assisting (NBSTSA), the Association of Surgical Technologists (AST), or PSI. CST and Certified Surgical Technologist are marks of the NBSTSA. This program is examination preparation only: the details on this page are drawn from the official sources recorded in the companion guide and are current as of November 2026; the NBSTSA’s official publications govern if anything here differs from them. The credential is awarded by the NBSTSA alone when its requirements are complete; this program confers no credential.