What Is CST Certification? What NBSTSA's Credential Means, Who Earns It, and How It's Kept

A CST is a surgical technologist who has passed NBSTSA's national certification exam and keeps that certification current. The letters are a federally registered trademark of NBSTSA, and its employer page is direct about what that means: people who hold other surgical technology credentials cannot call themselves CSTs. Everything else about the credential, from eligibility to renewal, follows from that one fact: NBSTSA alone decides who holds it.

What the CST credential certifies, according to NBSTSA

NBSTSA's 2026 candidate handbook describes certification as evidence that a person meets the national standard for the knowledge behind surgical technologist practice. Its prepare page says the exam evaluates the core knowledge and practical skills expected of entry-level surgical technologists across all specialties, not in one specialty.

The CST certification page sums up the job the credential stands for: working with surgeons and the rest of the team, managing surgical instruments, maintaining the sterile field and preparing the operating room.

A few facts about the program itself, as checked on October 28, 2026:

• Accreditation. The CST program is accredited by the National Commission for Certifying Agencies (NCCA). NBSTSA's history page gives the current accreditation as running through April 30, 2030.
• Size. NBSTSA's certification data counted 88,226 CSTs "certified with currency" for 2025, and 12,117 people took the CST exam that year.
• Age. The first surgical technology exams were given in 1970, and the certifying body that became NBSTSA was set up in 1974.

NBSTSA, AST, PSI and your program: who does what for the CST

Candidates often mix these organizations up, partly because the CST touches all of them.

Three points from NBSTSA's own pages clear up most of the confusion:

1. NBSTSA is not AST. NBSTSA's page on how it sets the standard calls it an independent credentialing body, "not a professional association or trade organization."
2. AST membership is optional. The educator FAQs say NBSTSA cannot legally require membership in any professional association. Membership earns the $230 first-time rate instead of $340, as long as you are a member when you apply (FAQ).
3. The organizations are linked by governance, not merged. NBSTSA's exam development guide says its 10-member board is appointed by NBSTSA, AST and the American College of Surgeons. The handbook lists seven CSTs and CSFAs, one public member, one surgeon and one surgical technology educator.

Passy is not affiliated with any of these organizations. The planned CST prep is written to NBSTSA's published content outline, and the questions are Passy's own.

Who can earn the CST

Almost everyone qualifies by graduating from a surgical technology program accredited by CAAHEP or ABHES, or from a military surgical technology program. A current or previously certified CST can also renew by taking the exam, and NBSTSA has rules for graduates of programs that were gaining or lost accreditation. Work experience alone does not qualify you: NBSTSA's appeals policy uses exactly that case as its example of an appeal it will not accept.

NBSTSA's employer page describes the main route as graduation from an accredited program that includes at least 120 in-person patient cases in real operating rooms. The CST eligibility and application guide lists each route, the proof it needs and how the ATT works.

The CST exam in one paragraph

The CST exam has 175 multiple-choice questions, 150 scored and 25 unscored pretest items, with 4 hours to finish. You pass with at least 98 correct answers on the 150 scored questions, a standard in effect since January 1, 2024. The outline puts 97 scored items in Perioperative Care, 23 in Ancillary Duties and 30 in Basic Science. Candidates test at PSI centers, and students can also test on campus with their class where the program has set that up. In 2025, 68.6% of first-time candidates passed. The CST passing score guide explains the 98, and the content outline guide breaks down the eight sub-areas.

If you want to see what that weighting looks like in practice, compare the planned CST question counts for each subject area.

CST vs CSFA: NBSTSA's two credentials

NBSTSA also awards the Certified Surgical First Assistant (CSFA). Its CSFA page describes a first assistant who holds incisions open, controls bleeding and closes incisions, among other tasks. The two credentials are separate, each with its own program, exam and renewal rule.

Fees and renewal figures come from NBSTSA's FAQ and renewal page, as checked on October 28, 2026. Someone who holds both credentials earns 38 credits in total per cycle and submits only the CSFA renewal form.

The CST title, other credentials and state rules

NBSTSA's policies say the CST and CSFA marks may be used only by people who passed the national exam and hold a valid NBSTSA certification. The handbook adds that certified candidates may use the initials "as long as" they keep the certification current, so the right to the letters depends on renewal, not only on having passed once.

Other organizations offer surgical technology credentials under different names. NBSTSA's employer page argues that they are not equivalent and that their holders cannot be called CSTs. That page is NBSTSA's advocacy to employers, and Passy has not compared the credentials here.

The certification page also says the CST is preferred or required by most employers and required by many states. NBSTSA's pages checked for this guide don't list those states, and Passy has not verified a state-by-state list. If you need to know whether your state requires certification, check your state's statute or licensing board and the job descriptions of the employers you are targeting.

One later path to know about: if you become a registered nurse, CCI's CNOR page lists the CST among the credentials that shorten its experience requirement to 18 months, still with 2,400 hours. The CNOR eligibility guide explains that route.

Keeping a CST current: the 2-year cycle

NBSTSA certification runs in 2-year cycles. To renew by continuing education, you earn 30 AST-approved credits during the cycle, at least 4 of them live, have AST approve them, then send NBSTSA a renewal application with a $40 fee. You can also renew by passing the exam again, which costs $540. Credits must be earned while you are certified: late renewal within 90 days is possible only with credits you already earned. The CST renewal guide works through the deadlines and fees.

How a CST is verified

• Public lookup. NBSTSA's policies describe an online verification system. Anyone with a certification number, or a Social Security number, and a name can check status, and it shows only the certification number and the cycle start and expiration dates.
• Certificates and cards. NBSTSA's card request page says it no longer mails printed certificates. You can print one free from your account. A wallet card is complimentary when you pass an exam and costs $10 when you renew by CE.
• Proof during a renewal. NBSTSA says it cannot email or fax employers proof of a pending renewal, but it can confirm by phone that it received your application.

Your next step toward the CST

Start with eligibility. Confirm that your program, not just your school, holds CAAHEP or ABHES accreditation; NBSTSA asks you to call 800-707-0057 if you need to confirm past status. Then try the 20 free CST practice questions to see how NBSTSA-style scenarios feel, and put your target date into the free CST study planner. When you are ready to plan paid prep, see which of the planned 30-, 90- or 180-day CST access lengths fits your timeline; checkout is not open yet.