Credential Breakdown -

Aspect	Surgical Assistant (SA)	First Assistant (FA / CSFA / CSA)	NSAACA – NACSA™ (Tier 2)
Education	May vary; on-the-job or allied health programs.	CAAHEP-accredited surgical assisting program required.	Accredited education must be verified by NSAACA.
Experience	Varies by employer or facility.	Structured clinicals as part of accredited program.	2,000 hours documented clinical experience required.
Certification	Optional or facility-based.	Nationally certified (CSFA or CSA).	Nationally Accredited Certified Surgical Assistant (NACSA™).
Scope	Positioning, retraction, basic assistance.	Hemostasis, suturing, graft harvesting, advanced intraoperative duties.	Advanced surgical assistant role; validated education + experience ensures readiness.
Tier Rank	Tier 1 (entry-level)	Tier 3 (highest/advanced)	Tier 2 (mid-level, bridges education + verified experience)
Oversight	Often direct physician supervision.	Physician-directed, legally billable in many states.	Physician-directed; emphasizes both education and workforce verification.

Bridges the gap between uncertified assistants and full First Assistant credentialing.
Adds workforce credibility by combining education accreditation + 2,000 hours job experience.
Recognized by NSAACA as a verified, nationally accredited pathway for surgical assistants.
Strengthens employer trust by ensuring candidates have both book knowledge and hands-on OR competency.