surgical tech career

Let’s talk about surgical first assistant clinicals, because there are two parts to this conversation. There’s learning how to assist, getting your cases, and becoming comfortable in a different role. Then there’s figuring out how you’re going to do all of that while still paying your bills.

For me, that second part mattered. To be honest, if I had been required to stop working and complete unpaid clinical rotations, I don’t think I would have been able to complete the process.

I was able to get my required cases while working. But I also came through a different pathway, at a time when the eligibility options were different. So before I talk about what to expect and how to prepare, I want to explain that. I don’t want you listening to my experience and thinking you can automatically do exactly what I did.

I’m a Navy-trained surgical professional with more than two decades in the operating room and experience as both a CST and CSFA. That background gives me a lot of respect for what it takes to learn this work. And I understand that wanting to advance your career doesn’t mean you can put the rest of your life on hold.

My Route to Surgical Assisting Was a Little Different

Before I became a surgical tech, I became a Navy hospital corpsman. After that, I attended the military surgical technology program at the Naval School of Health Sciences in Portsmouth, Virginia.

The surgical technology program itself was six months long. Three months were didactic, which was the classroom portion, and three months were clinical at Naval Hospital Portsmouth. That was after my corpsman training, so the six months I’m talking about here was specifically the surgical technology program.

That training gave me my foundation. But by the time I pursued surgical assisting certification, it had been about ten years since I completed the program. I still had to learn and study the first-assistant curriculum.

At the time I applied, there were three options available to me: having five years as a CST, military training, or going back to school for surgical assisting. I applied with both my military training and more than five years as a CST, and I was approved.

Now, that’s how it worked when I did it. You need to check the current requirements with the certifying organization and the program you’re considering. I’m sharing my route, not telling you those same options are available today.

How I Got My Cases While Working

Once I was approved, I still had to complete around 200 cases across different surgical services. Being approved to move forward didn’t mean I was done with the learning or the requirements.

Fortunately, I was working PRN. I would look at what cases were scheduled and schedule myself on days that had cases I needed. That allowed me to keep earning money while completing those cases.

And that made a difference. I could work toward becoming a surgical assistant without losing my income during that part of the process. Some of you may have a clinical arrangement that allows you to keep working, but others may have unpaid rotations with a schedule you don’t control.

That’s why I would want you to understand the clinical arrangement before you commit. Don’t assume that because you already work in the OR, your regular work will automatically count. Get that confirmed with the people responsible for your program and clinical placement.

You Can Know the OR and Still Feel New at Assisting

If you’re already a surgical tech, you’re bringing experience with you. The room and instruments are familiar. You may have scrubbed a procedure plenty of times and know what usually happens next.

But now you’re learning a different position in that procedure. That can feel unfamiliar even when the surgery itself is familiar.

You can read about tissue handling, exposure, hemostasis, and closure. Then you get into a supervised case and have to connect what you’ve learned with what’s happening in front of you. You’re thinking about your position, your hands, the anatomy, and the direction you’re receiving.

So if those first experiences feel awkward, I wouldn’t want you to immediately decide, “Maybe I can’t do this.” You’re learning. Give yourself room to ask questions and receive instruction.

Even something like where to stand can take guidance. You may need help figuring out how to position yourself without blocking someone or becoming unnecessarily uncomfortable. If you’re unsure about what you’ve been asked to do, say that. Ask your preceptor to help you adjust.

You don’t have to act comfortable just because you’ve worked in surgery for years. Your experience is valuable, but it doesn’t remove the need for supervision while you develop new skills.

Let the Feedback Help You

And you’re going to receive corrections. It may be about your hand position, your instrument handling, or how you’re helping with exposure. Try to understand the correction instead of taking every correction as a statement about your ability.

After the case, ask, “What do I need to work on before the next one?” That gives you something to do with the feedback. You can review the anatomy, clarify an instruction, or practice an assigned skill in an approved learning setting.

If you keep personal learning notes, leave patient information out of them. You’re writing down what you need to review, not making your own record of someone’s medical care.

One difficult case doesn’t tell you everything about how you’ll do as a first assistant. But paying attention to what you need to improve can help you make better use of the next opportunity.

There’s More to Learning First Assisting Than Suturing

Surgical Tech Career

Suturing gets a lot of attention when people talk about becoming a surgical assistant. I understand that. It’s a visible skill, and people want to know when they’ll get to practice it.

But I wouldn’t want you to focus so much on suturing that you overlook everything else you’re there to learn.

With suturing, ask your instructor which parts of the skill you need to work on. That might involve needle handling, tissue handling, or another part of the technique they’re teaching you. Follow their guidance and your program’s requirements.

If your program allows practice with simulation materials, use that time. Let someone evaluate what you’re doing so you know whether your practice is helping. Repeating something over and over doesn’t do you much good if you’re repeating the same error.

And don’t get caught up in proving how fast you can do something. You’re there to learn how to do it appropriately under supervision. Speed shouldn’t be the thing you’re trying to prove during a live case.

Understand What You’re Helping the Surgeon See

The same attention needs to go into things that might look simple from the outside, like retraction. I would encourage you to understand what you’re helping expose and why the team is asking for a particular adjustment.

What anatomy are you looking at? What needs to be protected? How does your assigned task help with the next part of the procedure? Those are things your supervising clinician can explain when it’s an appropriate time to ask.

You’re building understanding along with the physical skill. Don’t guess at positioning or pressure if you’re unsure. Get direction.

And remember, not every case will give you the same opportunity. Some may involve more supervised participation. Others may involve more observation because of the patient’s condition, the complexity of the procedure, or what the team needs at that moment.

There can still be something to learn. You can review the anatomy, pay attention to the sequence, and discuss what you saw afterward. But if you consistently aren’t getting opportunities to perform required skills, you need to bring that up with your preceptor and program.

If a surgeon doesn’t want you performing a particular task in a case, respect that decision. Then work with your program to find another appropriate opportunity. You don’t want to wait until the end and discover that you’ve spent all this time in the OR but haven’t met an important requirement.

Keep Up With Your Case Logs

That’s also why I would stay on top of documentation. Follow your program’s instructions for your case logs, evaluations, and signatures. Document promptly, when it’s appropriate, while the details are still clear.

Be honest about what you did. Observing a task and performing it aren’t the same thing. If you aren’t sure whether something counts, ask. It’s better to clarify it early than to find out later that you recorded it incorrectly.

For another related topic, see Common Mistakes New Surgical First Assistants Make.

You Need Support, and You Need to Show Up Prepared

Your relationship with your preceptor matters. Be on time, be respectful, and come prepared to learn. When you know what cases are coming up, review the procedures and the relevant anatomy beforehand.

Let the person working with you know where you are in your training. What have you already been introduced to? Tell them which skills you’re still working on and where you need help.

That gives them a better idea of how to support you. It also gives you a way to communicate instead of hoping they can figure out what you do and don’t know.

At the same time, preparation doesn’t mean you should be expected to manage everything alone. You need appropriate supervision. And if the environment is unsafe, inappropriate, or isn’t providing the learning your program requires, involve the program.

You can be open to feedback and still speak up about a problem. Those things can exist together.

Ask More Than “Did I Do Okay?”

I would also use those post-case conversations to ask more than, “Did I do okay?” Ask what went well, what could improve, and what you should review before another similar case. When there’s time, ask about the reasoning behind something you didn’t understand.

That helps you connect the skill to the situation. You want to understand why the team made a decision, not just remember that somebody told you to move your hand.

Before you even start, find out who will supervise you, who will evaluate you, and whom you should contact if you need help. Ask who arranges the clinical placement and what happens if that site can’t provide the experience you need.

If you’re still comparing schools, those are questions I would bring into the decision. You can also read How to Choose a Surgical First Assistant Program.

But How Are You Going to Pay Your Bills During Clinicals?

surgical tech career

This brings me back to the part that would have been difficult for me: unpaid clinical rotations.

You can be interested in the career, willing to study, and ready to put in the work. The rent or mortgage still needs to be paid, along with food and transportation. If you have children, their needs don’t stop because you’re completing clinicals.

That’s why I don’t think we should talk about this as if wanting it badly enough solves the financial part. It doesn’t. You need an actual plan.

My first suggestion would be budgeting and saving before you start. Find out what the clinical schedule is expected to look like and how long that part of the program may take. Then look at how much paid work you could realistically keep doing.

Be honest with yourself about that schedule. You also need time to study, commute, and rest. Don’t build a budget around working hours you won’t be able to sustain.

Put a Number on What You Need to Save

Once you have that information, sit down with your expenses. What do you need each month for housing, food, transportation, childcare, and your other obligations? Will clinicals add parking costs, a longer drive, or extra childcare?

Then look at the reliable income you expect to have during that period. The difference between your expenses and that income is what you need to prepare for.

Let’s say you expect to be short $1,000 a month for six months. That gives you a $6,000 savings goal. That’s just an example, and it’s separate from tuition or school expenses you haven’t already covered. Your numbers may be different, but putting them on paper gives you something concrete to work toward.

I would also try to leave a cushion. What if completing the cases takes longer than expected? What if something changes with your work schedule? You don’t want every dollar depending on the process going exactly as planned.

You may decide to cut some expenses, set aside more from your current income, or move your start date so you can save. That doesn’t mean you aren’t serious about becoming a first assistant. It means you’re thinking about what it will take to complete it.

Find Out What Help Is Actually Available

I would also ask about scholarships, employer assistance, and any education benefits you may qualify for. If you’re a veteran, check with VA and the school about your eligibility and whether the specific program is approved.

But find out what is actually available to you before counting it in your budget. How much is approved? What does it cover? When will you receive it? If the employer offers reimbursement, will you need to pay the money yourself first?

And if accepting assistance means agreeing to stay with an employer, understand that agreement. Ask what happens if you leave before the commitment ends. Help with school can be useful, but you still need to know what you’re agreeing to.

I Wouldn’t Suggest a Loan Without a Repayment Plan

I know student loans may come up when people think about covering the cost. My position is that I would not advise anyone to take out a loan without a repayment plan in place.

Before you borrow, understand the amount, interest, fees, when repayment begins, and what the payment could be. Then look at how that payment fits into your life afterward.

I wouldn’t want the whole plan to be, “Well, I’ll be a first assistant, so I’ll make more money.” You need to look at what you could realistically repay, including if things take longer than you expect.

What if you don’t get a first-assistant position right away? What if the job available to you doesn’t pay what you thought it would? Would you still be able to manage that payment?

Those questions deserve answers before you commit to the debt. I would start with saving, budgeting, and confirmed assistance. If borrowing is still part of the plan, know how you’re going to handle it.

For me, completing my cases while working meant I could keep income coming in. I’m grateful I had that option. I also recognize that somebody else may need to prepare differently because their clinical arrangement won’t allow it.

What I Want You to Take From My Experience

When you’re looking at surgical first assistant clinicals, think about both what you need to learn and what you need in place to be there.

You want supervision, useful feedback, opportunities to develop the required skills, and a clear understanding of how your progress is documented. You also need a schedule and financial plan that fit your responsibilities.

My military background and the eligibility pathways available at that time helped me get started. My PRN schedule helped me complete around 200 cases while working. Those were important parts of my experience, but I don’t want you to assume your requirements or opportunities will be identical.

Ask questions early. Understand the program you’re entering. Give yourself permission to learn, even if you’ve already been in surgery for years. And prepare financially instead of waiting until you’re in the middle of clinicals to figure out how everything will get paid.

If you’ve already completed surgical first-assistant clinicals, I want to hear from you. Were yours paid or unpaid? Were you able to keep working? Did the school arrange your site, or did you have to find it? What helped you get through the learning and the financial part?

And if you’re getting ready to start, what are you most concerned about?

Leave it in the comments. Those experiences can help somebody else ask a question they hadn’t thought to ask. That’s the kind of conversation I want us to have here at Surgical Tech Career.

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