How Hard is the CST Exam? A Comprehensive Guide for Aspiring Surgical Technologists


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For many aspiring surgical technologists, one of the most pressing questions is, “How hard is the CST exam?” The Certified Surgical Technologist (CST) exam, administered by the National Board of Surgical Technology and Surgical Assisting (NBSTSA), is a crucial step in becoming a certified professional in the field. Understanding the difficulty level of the CST exam can help candidates prepare effectively and approach the test with confidence. In this article, we will explore the various aspects of the CST exam, including its structure, content, and tips for successful preparation.

Understanding the CST Exam Structure

The CST exam is designed to evaluate the knowledge and skills essential for a competent surgical technologist. Here’s a breakdown of the exam structure:

  1. Number of Questions:
    • The exam consists of 175 multiple-choice questions. Out of these, 150 are scored, and 25 are pretest questions that do not count toward the final score but are used to validate future exam questions.
  2. Time Allotment:
    • Candidates are given four hours to complete the exam, which averages to about 1.3 minutes per question.
  3. Content Areas:
    • The exam covers a broad range of topics categorized into various sections, including:
      • Preoperative Preparation: Patient care, surgical instruments, sterilization, and supplies.
      • Intraoperative Procedures: Surgical procedures, anatomy, physiology, and pathology.
      • Postoperative Procedures: Patient care, documentation, and infection control.
      • Administrative and Personnel: Healthcare systems, ethics, and professional responsibilities.

Factors Influencing the Difficulty of the CST Exam

Several factors contribute to the perceived difficulty of the CST exam:

  1. The breadth of Knowledge:
    • The CST exam covers a wide range of topics, requiring a thorough understanding of surgical technology principles, procedures, and best practices. This extensive coverage can be challenging for candidates who need to be well-versed in all areas.
  2. Critical Thinking:
    • The exam questions are designed to test not only factual knowledge but also the ability to apply that knowledge in practical, real-world scenarios. This emphasis on critical thinking and problem-solving can make the exam more challenging.
  3. Time Management:
    • With 175 questions to answer in four hours, candidates must manage their time effectively to ensure they can address all questions without rushing. Time management skills are crucial to maintaining accuracy and composure throughout the exam.
  4. Preparation Level:
    • The difficulty of the CST exam is often a reflection of how well-prepared a candidate is. Those who invest time in comprehensive study and practice are likely to find the exam more manageable than those who do not.

Tips for Overcoming the Challenges of the CST Exam

  1. Create a Study Plan:
    • Develop a detailed study plan that covers all exam topics. Allocate time for each subject area, and stick to your schedule to ensure consistent progress.
  2. Utilize Quality Study Materials:
  3. Practice with Mock Exams:
    • Take practice exams to familiarize yourself with the format and question types. Mock exams can help you identify areas of weakness and improve your time management skills.
  4. Join Study Groups:
    • Study groups can provide support, motivation, and diverse perspectives on challenging topics. Collaborating with peers can enhance your understanding and retention of material.
  5. Focus on Weak Areas:
    • Identify your weak areas early in your preparation and dedicate extra time to mastering them. This targeted approach can boost your overall performance on the exam.
  6. Stay Healthy and Rested:
    • Ensure you are well-rested and in good health on exam day. Proper nutrition, exercise, and adequate sleep can significantly impact your cognitive function and concentration.


The CST exam is a comprehensive and challenging assessment designed to ensure that candidates possess the necessary knowledge and skills to excel as surgical technologists. While the exam’s difficulty level can be daunting, thorough preparation and a strategic approach can make a significant difference. By understanding the exam structure, leveraging quality study materials, and focusing on weak areas, aspiring surgical technologists can increase their chances of passing the CST exam and achieving their professional goals.