Mods: not sure if you want to leave this here or move it to clinicians (not sure where it belongs).
I have been trying to think of an 'easier' way (if possible) to satisfy my needs in medicine. I am toying with the idea of applying to surgical assisting school. I heard there is a
HUGE difference in being a surgical assistant vs surgical technologist. From what I understand a SA is a person who helps the surgeon carry out safe operative procedures with optimal results for the patient in OR and the ST is a person who
not help perform the surgeries, but actually 'passes' out instruments (sterilizes) etc. Is that correct? I am confused as I have done a google search and it seems these two words interchange. Can someone help me understand the
REAL difference?
Also does anyone know about the school for SA (if I got the correct definition up there)? How long is it? What does it entail? Can you take classes online except for the clinicals? Any good links would be also helpful too. If some kind people can tell me anything and everything they know I would appreciate it very much.
As a former CST (Certified Surgical Technologist) I can help you a little. There are essentially three or four positions in surgery (not including anesthesia, perfusionists etc). The surgeon, the scrub, the circulator and at times the assist.
The surgeon should be fairly obvious.
The scrub is responsible for setting up and maintaining the sterile field. They also assist the surgeon during surgery and help turnover the room after. This is usually a CST but also may be an RN or LPN. Because of the nursing salaries most ORs have gone to a CST model.
The circulator is usually an RN who does the nursing care during the case which includes the nursing record, managing the instrument counts etc.
The assist as the title states assists with the surgery. This may include retraction, suturing, hemostasis etc. The person who does this varies. This may be another surgeon, a RN (RNFA), CST, SA (surgical assist), or PA.
Notice above I stated that there are either 3 or 4 positions. Many surgeries do not pay for an assist. Medicare publishes the surgeries that it will pay for an assist and if the surgery is not covered then the assist will not be reimbursed. For example Medicare will not pay for an assist for an appendectomy. It will pay for an assist for a liver transplant. If the case is considered simple then the scrub will frequently be the assist also. Some surgeons do not want assist even for more complex cases. Depending on where you are some hospitals may provide an assist even when it is not reimbursed.
Now you have to look at the training for the assist position since there are a number of people that can fulfill it. There are still people doing the scrub and assist positions that are not certified in some way, but it is unlikely that you would be able to get credentialled currently without some sort of certification.
CST - most programs are nine months of part time class and then three or so months of clinicals.
CFA (certified first assistant) - CST and an appropriate number of first assist cases or graduate from an approved program (there are also direct entry CFA programs).
RNFA - RN license, CNOR (requires 2 years of OR experience).
PA - Licensed as a PA.
The last part is employment. This is variable. The big problem is that except for the PA and the surgeon none of the other assists can bill Medicare. In addition the CFA and CST are unlicensed personnel in most states which further limits there ability to bill. There also has been a drive to limit CFAs in some states because of hospital liability issues.
The short answer is that since SAs (CFA) and Techs (CST) are unlicensed personnel (in most states) there really isn't a huge difference. Most SAs are Techs with some experience. There are also a number of alternative "credentialing" organizations of mixed providence that will gladly sell you "certification".
The good part about CST is that you can get into medicine with a small comittment (one year). The pay is less than nursing and more than a CNA. The pay for SA is all over the board. One hospital I worked at paid you two dollars more an hour for assisting. On the other hand I knew SAs that made in the six figures (plastics or ortho). It really depends on the payor mix. The final part is that as a CST there is little advancement. You can assist or you can work in central supply. Other than that there are few other options.
I looked at assisting but wanted to practice medicine. CST is a great prep for going to PA school and that is the transition I chose. I get to assist but I also see patients in clinic and follow them on the floor. Thats the part that I like. Your mileage may vary.
For more information on CST please check out:
http://www.ast.org/
In particular:
http://www.ast.org/pdf/GrowingCareer.pdf
For information about CFA certification:
http://www.nbstsa.org/
I don't know about distance learning options, its been a few years since I was in school. You would have to look at individual programs. If I recall there are only 5 or 6 CFA programs and I don't think that they have an online program. There are also two surgery specific PA programs at UAB and Cornell (in case you haven't noticed I have a PA bias here).
Good luck
David Carpenter, PA-C
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