Providers of first assisting services

AORN Journal,  June, 2004  by Frederick P. Franko

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There also are a number of types of unlicensed personnel who may serve in the first assistant role. These include the following categories.

On-the-job-trained assistants. These individuals have no formal perioperative education or clinical training before practicing in the first assistant role. They literally are trained on the job.

Certified surgical technologists (CSTs). To take the CST examination, an individual must be a graduate of a surgical technology program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP).

Certified surgical technologist/certified first assistant (CST/CFA). As of January 1, 2004, the Liaison Council on Certification for the Surgical Technologist will offer four options for individuals to be eligible to take the first assistant certifying examination for CSTs. An individual taking the examination must

* be a current CST and have proof of experience on at least 350 procedures;

* have graduated from a CAAHEP-accredited or Association of Surgical Technologists-approved surgical assistant program and proof of experience on at least 135 procedures;

* have a two- or four-year degree from a surgical technology, physician assistant, or nursing program and proof of experience on at least 350 procedures

* have a medical degree (ie, MD, DO) and proof of experience on at least 350 procedures. (7)

Surgical assistant-certified (SA-C). The American Board of Surgical Assistants (ABSA) requires that licensed and nonlicensed candidates for their certification examination completely meet several criteria. These criteria include

* provide documentation of having first assisted for a minimum of two years;

* provide documentation of having first assisted on at least 200 procedures or 750 hours, each year, for each of the last two years and be listed as the first assistant on the surgical record;

* provide transcripts of successful completion of one year of college-level human anatomy and physiology; and

* provide documentation of successful completion of a formal surgical assisting training program, with a curriculum approved by the ABSA. (8)

Physicians seeking to sit for the certification examination for surgical assistants have a different set of requirements. They must provide

* a certified copy of their medical school graduation, a certified copy of their residency or advanced training, and a copy of their curriculum vitae that document a minimum of two years primary or advanced surgical experience or

* provide documentation of having first assisted for a minimum of two years and of having first assisted on at least 200 procedures or 750 hours, each year, for each of the last two years, and be listed as the first assistant on the surgical record. (9)

Certified surgical assistant (CSA). The National Surgical Assistant Association serves as both a certifying body, awarding the CSA certification, and a membership association. The association provides at least four options for qualifying for file CSA certification examination. Applicants must