The American Board of Surgical Assistants defines

First and Second Assistants as follows:

First Assistant

The first assistant on a surgical procedure is defined as the individual providing primary assistance to the primary (main) surgeon, during a surgical procedure. This individual CANNOT be involved in any other role or function, during the surgical procedure (i.e. first or second scrub and/or passing instruments). This individual must also be listed on the operative record as the first assistant, not as a first or second scrub!

Although descriptions may vary from institution to institution, the role of the first assistant requires active participation, during the surgical procedure. This involves providing exposure, hemostasis, tying or sewing plus other functions (excluding acting as the scrub nurse or technician) as determined by the primary surgeon, responsible for the patient and procedure.

An individual may not act as a first assistant, for example, on a simple hernia repair or similar case with only themselves and the surgeon. This is a surgeon/scrub role and not a surgeon/assistant role.

Second Assistant

This individual is not the primary assistant to the primary surgeon and is hereby defined and designated as a retractor holder. An assistant as defined under this section does not qualify as a first assistant.

Important to Note

We acknowledge that the role and function of a surgical assistant is to assist the surgeon, in the performance of a surgical procedure.
It is understood and acknowledged that certification as a surgical assistant through the ABSA does not allow for any independent performance of any medical or surgical procedures, within the United States of America or its territories.

Please Note: Anyone found guilty of "Practicing Medicine Without a License," in the United States of America or its territories, either by court trial or plea agreement, will lose their certification
and never be eligible to certify with the ABSA again.

Clarification Note: The above mentioned definition of "independant performance of any medical or surgical procedure" does not include the "closing / suturing" of a patient, following a surgical procedure.

Surgical Assistant Titles

  • Hospitals and/or free-standing surgical centers often refer to Non-MD surgical assistants by general terms such as: certified first assistants, first surgical assistants, first assistants, or just surgical assistants.
  • Different credentialing organizations utilize different registered designations.
    Please contact each individual organization for their specific credential.
  • The ABSA designation is Surgical Assistant - Certified (SA-C).
  • The Surgical Assistant - Certified (SA-C) may function in the role of either a first or second assistant, as determined by the primary surgeon, depending on the operative procedure.

To download a Surgical Assistant Scope of Practice / SA Position Description: