A surgical first assistant (SFA) is a vital surgical team member, working closely with the surgeon to ensure the operation’s success.

The role of an SFA is multifaceted and includes tasks such as retracting tissue, holding instruments, and providing hemostasis (control of bleeding).

Certified First Assistant Programs

SFA programs are designed to train healthcare professionals to become skilled and proficient in these tasks and are open to a wide range of practitioners, including nurses, physician assistants, and surgical technologists.

These programs provide the education and training necessary for individuals interested in surgery to become valuable assets to the surgical team.

SFAs play a critical role in the care of patients, and as such, their part is essential to the operation’s success.

Education and Training

Surgical First Assistant (SFA) programs typically consist of didactic and clinical components to prepare students for a career as a surgical first assistant.

The didactic portion includes coursework in anatomy, psychiatry, and surgical procedures. The clinical part involves hands-on training in the operating room under the supervision of a licensed surgeon.

The duration of SFA programs varies depending on the institution and the student’s prior education and experience.

Some programs can be completed in as little as six months, while others may take up to 2 years. It’s important to note that the duration of the program can be affected by the student’s prior education and experience.

Some programs may require more time for students with limited experience or education in the healthcare field. In contrast, others may be able to complete the program more quickly with previous experience.

It’s best to check with the institution for specific details on the duration of the program.

Entry Requirements

Surgical first assistant programs are designed to train individuals for careers as surgical first assistants who work alongside surgeons during operations.

Entry requirements for these programs vary by institution.

Generally, they include a high school diploma or equivalent, prerequisite coursework such as biology and chemistry, prior healthcare experience, certification as a surgical technologist or related healthcare professional, a minimum GPA of 2.5 or higher, a valid healthcare professional license, and current health insurance and vaccinations.

Some programs may also require a criminal background check, drug screening, an entrance exam, and additional requirements such as an interview, essay, or personal statement.

It is essential to check with the institution for specific entry requirements, as they may vary.

Meeting the minimum requirements does not guarantee acceptance into the program, as many programs are competitive and have limited spots.


After completing an SFA program, practitioners can seek certification through various organizations.

The National Surgical Assistant Association (NSAA) offers the Certified First Assistant (CFA) credential, which the National Commission recognizes for Certifying Agencies (NCCA).

The American Board of Surgical Assistants (ABSA) offers the Certified Surgical Assistant (CSA) credential. Both certifications require passing an exam and meeting specific education and experience requirements.

It is important to note that accreditation is not always needed for practitioners to work as SFAs, but it may be preferred or required by certain employers.

Scope of Practice

The scope of practice for Surgical First Assistants (SFAs) varies depending on state laws and regulations.

In some states, SFAs are allowed to perform a wide range of tasks, such as suturing, while in others, they are limited to functions that the surgeon delegates.

It is essential for SFAs to be aware of their scope of practice and only to perform tasks that they have been trained and authorized to do.

This means that SFAs should be familiar with the laws and regulations in their state and should only perform tasks they have been specifically trained and authorized to do.

This is important to ensure patient safety and avoid legal or professional repercussions.

It is also essential for SFAs to be aware of state laws and regulations changes and update their knowledge and skills accordingly.

Additionally, SFAs should also be mindful of the surgeon’s preference regarding the tasks they can perform to avoid any confusion or miscommunication during the surgical procedure.

Career Paths

A career as a surgical first assistant (SFA) offers a variety of opportunities for growth and advancement.

SFAs can work in different healthcare facilities and specialties, such as general surgery, orthopedic surgery, cardiovascular surgery, and many more.

One of the common career paths for SFAs is to gain experience as a first assistant and then move into a supervisory role such as lead SFA, charge SFA, or surgical services manager, which involves overseeing the work of other SFAs, managing schedules and staffing, and ensuring compliance with regulations and standards.

Another career path is to specialize in a specific area of surgery, become an expert in a particular surgical procedure or a specific type of surgery like pediatrics or plastics, and some may become surgical educators.

SFAs can also pursue opportunities outside the operating room, like research, developing new surgical techniques and technologies, or working in sales or marketing for medical device companies, providing education and training on using specific products.

Overall, a career as an SFA offers a wide range of opportunities for growth and advancement.

Work Settings

Surgical First Assistants (SFAs) work in various settings, including hospitals, surgical centers, and other healthcare facilities.

The most common work setting for SFAs is hospitals, where they can gain experience in different areas of surgery and specialties.

Surgical centers are another familiar work setting for SFAs; these centers are typically focused on specific types of surgery, such as orthopedic, plastic surgery, or gynecological surgery, providing SFAs with an opportunity to specialize in a particular area of surgery.

SFAs may also work in Ambulatory surgery centers focused on same-day surgical care and discharge patients on the same day and in research settings such as universities or medical research institutions.

They may also work in sales or marketing for medical device companies, providing education and training on using specific products.

The work environment can be fast-paced and demanding but can also be very rewarding as SFAs are an integral part of the surgical team and play a vital role in the care of patients.

They should be comfortable working in a fast-paced and high-stress environment and possess the ability to think critically and make quick decisions.


Surgical first assistant programs provide healthcare professionals with the education and training necessary to assist surgeons during operations.

Graduates of SFA programs can seek certification through organizations such as the NSAA and ABSA, and the scope of practice for SFAs varies by state laws and regulations.

Becoming a surgical first assistant can be a challenging but rewarding career for individuals interested in surgery.