CSFA First Time/Retake Applicants

The National Board of Surgical Technology and Surgical Assisting (NBSTSA) retains the sole authority to establish eligibility requirements and make all final decisions regarding eligibility.

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Before testing, individuals must first establish eligibility by submitting the appropriate examination application form along with the correct fees.

NBSTSA accepts all properly completed applications from qualified applicants regardless of the applicant’s age, sex, race, religion, marital status, disability or national origin.

For a list of Commission on Accreditation of Allied Health Education Programs (CAAHEP) approved surgical assisting programs go to www.caahep.org or call 727-210-2350.

Eligibility Requirements

For Graduates of a Surgical First Assisting Program 

Program must have been CAAHEP* accredited during your enrollment. Please provide ONE of the following documents:

• A notarized letter (on institutional letterhead) from the Program Director, which states your name, date of graduation, and type of degree awarded
• A copy of your graduation certificate
• Transcript (Transcripts do not have to be official; however, NBSTSA reserves the right to request an official transcript.)

* The website only lists currently accredited programs. Call us at 800-707-0057 to find out about previously accredited programs or programs currently undergoing the process to become accredited.

Retesting - Test Fails

Candidates may not test more than three times during any calendar year. Candidates are required to pay the total testing fee (processing and examination) each time to test. 

Rationale: Individuals who have otherwise met the eligibility requirements should be allowed multiple opportunities to attempt to pass the examination, but limitations on the number of test attempts per year are necessary in order that the candidate will receive a different set of examination questions each time. 

Application Process

The CSFA Examination Application can be submitted online by clicking the login button at the top right of this page and selecting “practitioner” login.  Mailed applications are accepted but may create delays in your process.  Additional documentation will also need to be provided (see Eligibility Requirements above).

Once approved, NBSTSA provides candidates with an Authorization to Test number (ATT), and both the phone number and web address to contact the testing agency to schedule the test.

Examination Fees

Directions here for when and how to submit examination fees. The prices listed below are for first time applicants only. NBSTSA does not refund processing fees for ineligible candidates.

• $240 AST Members
• $350 Nonmembers

The content of the examination is based on tasks performed by CSFAs nationwide. A job analysis survey was conducted to identify specific tasks related to the frequency and importance of Surgical First Assistants nationwide. The results of the job analysis were used to develop the content outline for the examination, which is evaluated on a prescribed schedule to ensure that the overall examination content reflects current surgical first assistant practice.

You will have four (4) hours to complete your examination. All questions on the examination are multiple choice. You will be allowed to take a break whenever you wish, but you will not be allowed additional time to make up for time lost during breaks. You will not be able to return to questions previously answered after taking a break.  The location of breaks is governed by the proctor and you will not be allowed to leave the building during a break. 

The CSFA examination consists of 175 multiple-choice questions, 150 of which are scored. The 25 pretest items (unscored) are randomly distributed throughout the examination for the purpose of analysis and statistical evaluation.

Passing Score

The passing score is the minimum number of questions that must be answered correctly. The current passing score for the CSFA examination is 99 (recently increased from 97) of the 150 scored questions. Score reports are provided to all candidates who take the examination.

How Did We Set The Passing Score? 

After the job analysis and one round of test development based off the updated examination content outline has been completed a separate committee of SMEs is convened, the NBSTSA Standard Setting Committee. 

Standard setting, or cut score setting, is a critical step in the test development process, which occurs after job analysis. It involves determining the minimum score a candidate must achieve to be considered competent in the skill or knowledge area the test is measuring. In simple terms, this is setting the passing score for the test.

The NBSTSA standard-setting meetings usually take one day per examination and occur in person. Standard-setting meetings occur only at the end of our job analysis cycle process, only once every 4-5 years.

The process begins with a panel of subject matter experts (SMEs) who are thoroughly familiar with the test content and the target population's abilities. For NBSTSA, these experts are always asked to remember that our examinations are for entry-level professionals. 

These SMEs review each test item and judge the item’s difficulty level. They estimate the probability that a minimally competent candidate would answer the item correctly. This process is always facilitated by a psychometrician who ensures that the panel’s judgments are statistically sound and defensible.

Once the SMEs have rated all the items, their ratings are aggregated to form an initial recommended cut score based on an analysis of the statistical data provided by the ratings. This score is then reviewed and adjusted as necessary based on a variety of considerations, such as the consequences of false positives (passing candidates who are not truly competent) and false negatives (failing candidates who are competent), the need for consistency with other tests in the same program, and legal and regulatory requirements.

The NBSTSA Board of Directors meets with the psychometrician, and any other necessary test development team members, to be presented with the findings of the standard-setting committee after the standard-setting meeting has been completed.  The Board has final approval and oversight of the passing score (cut score) for all NBSTSA examinations.

Once the cut score is set, it is announced concurrently with the launch of the new examination forms.

After the cut score is set, it’s not the end of the process. The cut score should be periodically reviewed and possibly adjusted to account for changes in the test content or the abilities of the test-taking population. This ensures the examination remains both valid and fair over time.  NBSTSA typically only changes the cut score during standard setting following an examination development cycle after a job analysis.

Standard setting is a complex, iterative process that requires a combination of expert judgment and statistical analysis. Ensuring that certification tests are fair, valid, and valuable in their intended contexts is crucial.

For a full overview of how the examination is developed and maintained, please see our NBSTSA Guide To Examination Development, available in the helpful resources bar at the left. 

The timing of receipt of your scores varies.  

• For those students testing on-campus at a campus testing center (WBT), you will receive your scores when you have completed the graduation requirement and your school has released the scores to you.  
• If you are a surgical first assisting student who is not testing at a campus testing center but is testing at one of our PSI testing centers, you will receive your score report via a link in an email message within around 48 business hours, when your scores have been transferred to NBSTSA by PSI and your file is complete.  
• If you are testing as a post-graduate, at a testing center, usually more than 45 days after graduation, and submitted your own transcripts, you may receive a score report on test day.  

Military applicants stationed overseas may request to test through their base education officer, rather than at one of the NBSTSA’s established testing centers.

The base education center can administer a web based examination if the military post is more than 100 miles from a testing center. The NBSTSA will mail the test results directly to the testing candidate within six weeks of the examination.

To utilize a military base education center, applicants must submit a letter with the examination application requesting administration through their base education center. The letter must include the base name, geographic location (base, city, state and country), the testing officer’s name and e-mail, the mailing address and phone number.

NBSTSA provides reasonable accommodations in accordance with the Americans with Disabilities Act as amended (ADAAA) for individuals with documented disabilities who demonstrated a need for accommodation(s). In accordance with the ADAAA, NBSTSA does not discriminate against individuals with disabilities in providing access to its examination program.

The ADAAA and accompanying regulations define a person with a disability as someone with a physical or mental impairment that substantially limits one or more major life activities such as walking, seeing, hearing or learning.

The purpose of accommodations is to provide equal access to NBSTSA examinations for all individuals. Accommodations “match up” with the identified functional limitation so that the area of impairment is relieved with an auxiliary aid or an adjustment to the testing procedure. Functional limitation refers to the aspects of a disability that interfere with an individual’s ability to function; that is, what someone cannot do on a regular and continuing basis as a result of the disability.

The purpose of documentation is to validate that an applicant for test accommodations is covered under the ADAAA as a disabled individual. Comprehensive information by a qualified professional is necessary to allow NBSTSA to understand the nature and extent of the applicant’s disability and the resulting functional impairment that limits access to its examinations. Documentation also allows NBSTSA to provide appropriate accommodations for such a disability.

NBSTSA will provide, without cost to the candidate, reasonable accommodations designed to facilitate equal access to its certifying examination for those candidates whose documentation supports such a determination. In no case will accommodations be provided which would compromise the examination’s ability to test accurately the skills and knowledge it professes to measure. Similarly, no auxiliary aid or service will be provided that would fundamentally alter the examination.

Confidentiality: NBSTSA strictly adheres to a policy of confidentiality and does not disclose names of applicants with disabilities or information concerning the application or accompanying documentation. Examinations administered with accommodations are not identified to third party score recipients and are scored no differently than examinations of other certification candidates.