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First Assistant Jobs in Texas (NOW HIRING)

Introduction Do you have the career opportunities as a First Assist you want with your current employer? We have an exciting opportunity for you to join Methodist Hospital Metropolitan which is part ...

Jump-start your career as a First Assist today with Methodist Hospital. Benefits Methodist Hospital, offers a total rewards package that supports the health, life, career and retirement of our ...

Jump-start your career as a First Assist today with Methodist Hospital. Benefits Methodist Hospital, offers a total rewards package that supports the health, life, career and retirement of our ...

Jump-start your career as a First Assist today with Methodist Hospital. Benefits Methodist Hospital, offers a total rewards package that supports the health, life, career and retirement of our ...

The Surgical First Assistant works as a member of the perioperative team under the direction of the surgeon. He/she performs responsibilities of both the Surgical Technologist and the Surgical First ...

The Surgical First Assistant works as a member of the perioperative team under the direction of the surgeon. He/she performs responsibilities of both the Surgical Technologist and the Surgical First ...

Jump-start your career as a First Assist today with Methodist Hospital. Benefits Methodist Hospital, offers a total rewards package that supports the health, life, career and retirement of our ...

Jump-start your career as a First Assist today with Methodist Hospital. Benefits Methodist Hospital, offers a total rewards package that supports the health, life, career and retirement of our ...

Introduction Do you have the career opportunities as a First Assist you want with your current employer? We have an exciting opportunity for you to join Methodist Hospital Metropolitan which is part ...

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First Assistant information

See Texas salary details

$30.3K

$124.3K

$178.4K

How much do first assistant jobs pay per year?

As of Jul 12, 2026, the average yearly pay for first assistant in Texas is $124,331.00, according to ZipRecruiter salary data. Most workers in this role earn between $37,700.00 and $168,200.00 per year, depending on experience, location, and employer.

What are First Assistants?

First Assistants, often referred to as First Assistant Directors (First ADs) in film and television production, are responsible for coordinating all production activities on set. They assist the director by managing the shooting schedule, ensuring that cast and crew are prepared, and facilitating communication between departments. Their role is essential in keeping the production running smoothly, safely, and on time. First Assistants also help enforce safety protocols and can be involved in overseeing rehearsals and blocking scenes. Overall, they play a key organizational and leadership role in any production.

What are the key skills and qualifications needed to thrive as a First Assistant, and why are they important?

To thrive as a First Assistant, you need a comprehensive understanding of surgical procedures, aseptic techniques, and anatomy, usually backed by a relevant certification such as Certified Surgical First Assistant (CSFA) or equivalent clinical training. Familiarity with surgical instruments, operating room protocols, and electronic medical records is typically required. Strong attention to detail, effective communication, and the ability to work well under pressure are essential soft skills. These competencies ensure optimal surgical outcomes, enhance patient safety, and support seamless teamwork in the operating room.

What is the difference between First Assistant vs Second Assistant?

AspectFirst AssistantSecond Assistant
CredentialsTypically requires medical or legal certifications, depending on industrySimilar credentials, often with less experience required
Work EnvironmentHigh-pressure settings, assisting lead professionalsSupport role, often in administrative or support settings
Employer & Industry UsageUsed in legal, medical, or film industries as a primary support roleSupporting role, often subordinate to First Assistant
Common Search & ComparisonOften compared for responsibilities and qualificationsLess frequently searched in comparison to First Assistant

The First Assistant typically holds more responsibilities, requires specific certifications, and works closely with lead professionals in high-pressure environments. The Second Assistant generally provides support and performs delegated tasks, often with less experience or certification requirements. Understanding these differences helps clarify career progression and role expectations within the industry.

What's the easiest hospital job to get?

The easiest hospital job to get is often a patient transporter or hospital aide, which typically requires minimal formal education and on-the-job training. These roles usually have high turnover and may not require certifications, making them accessible entry-level positions in healthcare settings.

How much do first assistants make per hour?

First assistants typically earn between $15 and $25 per hour, depending on experience, location, and the industry they work in. They often work in fast-paced environments and may require skills in organization and communication.

What are some common challenges First Assistants face when supporting high-level executives or teams?

First Assistants often juggle multiple priorities, such as managing complex calendars, responding to urgent requests, and coordinating logistics for meetings or events. One common challenge is maintaining clear communication and anticipating the needs of executives, which requires strong organizational skills and discretion. Additionally, First Assistants may need to adapt quickly to changing schedules or last-minute tasks, making flexibility and problem-solving essential. Building good relationships with both internal teams and external contacts also helps ensure smooth workflow and successful collaboration.

Where do surgical first assistants make the most money?

Surgical first assistants tend to earn the highest salaries in regions with a high cost of living and advanced healthcare facilities, such as metropolitan areas or states with strong medical industries. Factors like experience, certifications, and the complexity of surgeries also influence earning potential, with those working in specialized or high-demand surgical fields typically earning more.

What does a first assistant do?

A first assistant is a key member of a production team, often in film or theater, responsible for supporting the director or producer by managing schedules, coordinating communication, and assisting with logistical tasks. They may also handle administrative duties, oversee daily operations, and ensure the smooth flow of the project. Strong organizational skills and knowledge of production processes are essential for this role.
What are the most commonly searched types of First jobs in Texas? The most popular types of First jobs in Texas are:
What cities in Texas are hiring for First Assistant jobs? Cities in Texas with the most First Assistant job openings:
Infographic showing various First Assistant job openings in Texas as of July 2026, with employment types broken down into 1% As Needed, 76% Full Time, 19% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $124,331 per year, or $59.8 per hour.
Surgical First Assist

Surgical First Assist

Methodist Healthcare System

San Antonio, TX • On-site

Other

Posted 6 days ago


Methodist Healthcare System rating

7.2

Company rating: 7.2 out of 10

Based on 177 frontline employees who took The Breakroom Quiz

326th of 881 rated healthcare providers


Job description

First Assist Opportunity At Methodist Hospital

Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a First Assist today with Methodist Hospital.

Job Summary and Qualifications

General Statement of Duties: The Surgical First Assistant works as a member of the perioperative team under the direction of the surgeon. He/she performs responsibilities of both the Surgical Technologist and the Surgical First Assistant based on department needs and as directed by the unit director or designee. The Surgical First Assistant practices within the scope of the job description and performs clinical and technical skills under surgeon supervision to assist with carrying out a safe operation with optimal patient results. This is done in collaboration with the circulating RN and other perioperative/OB team members. The Surgical First Assistant is educated and skilled in both the use of surgical instruments on tissues and the handling of instruments; however, the surgical first assistant does not concurrently function as the scrub nurse.

Minimum Education, Experience, Training, Required Knowledge, Skill, Abilities and Other Job-Related Characteristics:

1. Education: Must have completed ALL of the following:

  • High School Diploma or GED
  • Successful completion of an accredited surgical first assistant training program.
  • Meets ONE of the following:
    • Graduate/completion of CAAHEP Surgical First Assistant, Surgical Assistant Program, Medical School Graduate OR an allied health professional with 2250 hours of surgical rotation.
    • Practiced as a surgical technologist prior to 9/1/2009

2. Experience: New hires as of 3/29/2011- 2 years experience in the perioperative setting within the last 4 years in either a surgical technologist or surgical first assistant role.

3. Employee completes initial and ongoing training and competencies as defined by service line, facility and department/unit which are specific to the needs of the patient population served (if applicable).

Minimum License, Certificates, or Registrations Required:

Must have and maintain ONE of the following:

A. Surgical Technologist Certification

  • CST – Certified Surgical Technologist through the National Board for Surgical Technology and Surgical Assisting (NBSTSA) (formally the Liaison Council on Certification for the Surgical Technologist) OR
  • TS-C- Tech in Surgery, Certified through the National Center for Competency Testing (NCCT)

B. Surgical First Assistant certification

  • SA-C – Surgical Assistant, Certified through the American Board of Surgical Assistants (ABSA)
  • CSA – Certified Surgical Assistant through the National Surgical Assistant Association (NSAA)
  • CSFA (formally CFA) – Certified Surgical First Assistant through the National Board of Surgical Technology and Surgical Assisting (NBSTSA)

C. LSA- Licensed Surgical Assistant through the Texas Medical Board

Essential Job Functions:

1. Functions as a surgical first assistant at the direction of and under the appropriate supervision of the attending surgeon; always practices within the limitations of preparation and experience and within the scope allowed by the hospital.

2. A. Consistently functions at the direction of and under direct supervision (physical presence of the attending surgeon in the procedure/treatment room) of the attending surgeon. The surgical assistant scope includes:

  • Providing visualization of the operative site through appropriate placement and securing of retractors with or without padding, packing or sponges; digital manipulation of tissue; suctioning, irrigation or sponging; manipulation of suture materials; proper use of body mechanics to prevent obstruction of the surgeon's view.
  • Utilizing appropriate permanent and temporary techniques to assist with hemostasis. Permanent hemostasis techniques include clamping and/or cauterizing vessels and tissue, tying and/or ligating clamped vessels or tissue, applying hemostatic clips, or placing hemostatic agents. Temporary hemostasis techniques include applying tourniquets and demonstrating awareness of the indications/contraindications for use with knowledge of side effects of extended use; applying vessel loops, non-crushing clamps, or direct digital pressure.
  • Administering post-operative subcutaneous local anesthetic injection
  • Utilizing running or interrupted sutures with absorbable or non-absorbable material of wound layers, including muscle and fascia.
  • Assisting with placement of implants
  • Robotic procedures only: Insertion of subsequent (not initial) trocars. Must have documented training and competency validated (initially within by MHS Medical staff member privileged to perform robotic surgery. The documentation must include directly supervised trocar insertions on a minimum of 5 patients completed within a 12 month period with good patient outcomes.
  • Saphenous Vein Harvesting only: May harvest saphenous vein through endoscopic or open technique. Must have documented training and competency validated by a MHS Medical staff member privileged to perform Cardiothoracic surgery. The documentation must include directly supervised saphenous vein harvests on a minimum of 10 patients completed within a 12 month period with good patient outcomes.

B. Under direct or general perioperative supervision (surgeon/proceralist presence in the perioperative area (pre-op department, perioperative suite, PACU, OR/procedure waiting room) and is immediately available), the surgical assistant scope includes closure of body planes and applies wound dressings per the method indicated by the attending physician:

  • Utilizing sub-cuticular closure technique with or without adhesive skin closure strips
  • Skin closure with suture, staples and/or spray occlusive material/skin adhesive strips
  • Securing drainage systems to tissue
  • Application of immobilizing dressing

3. Consistently assists with maintaining the patient's expected physiologic responses to surgery including infection prevention (SCIP measures and practices, maintaining effective disinfection practices, instrument processing, and sterilization).

4. Demonstrates effective communication and works collaboratively with all members of the perioperative team to include active consistent participation in Universal Protocol and timely and accurate sponge and sharp counts to include initiating corrective action as appropriate.

5. Consistently applies a working knowledge of patient pre-operative deficits, risk for intraoperative injuries, and possible post-operative outcomes to assist in optimal patient outcomes. Demonstrates principles of safe patient positioning for best exposure in collaboration with the surgical team using appropriate positioning equipment to ensure padded pressure points, protection from nerve damage and unimpaired circulation.

6. Functions in the role of a Surgical Technician as needed by the department; however, does not concurrently perform as the surgical first assistant and surgical technologist. Wears proper surgical attire, opens sterile packs, instruments, and supplies for each procedure, scrubs, gowns, gloves, and drapes according to established aseptic technique and protocols. Monitors sterile field during procedure and takes appropriate measures to insure integrity of sterile field and maintenance of sterile techniques. Initiates corrective action for any break in technique.

Additional Job Functions

1. May handle, pick up, deliver and/or stock non-controlled medications as directed by a licensed team member.

2. Acts as a preceptor to help with the education of other Surgical First Assistants.

3. Maintains appropriate knowledge and training to use any equipment necessary for care of the patient and ensures it is in working order prior to use.

4. Supports the mission and vision of the Methodist Healthcare System and demonstrates excellent customer service at all times.

5. Understands and is committed to helping the Methodist Healthcare System and its associated facilities achieve its goals

6. Must learn and comply with System and facility safety policies and rules; must use appropriate safety equipment and procedures at all times; must immediately report all unsafe conditions to supervisors; must be familiar with all safety features of equipment, tools or materials encompassed by job duties; and must check with supervisors (prior to job performance) if there is a question as to the safe procedure to be used for any job function.

7. Adheres to the MHS Code of Conduct and demonstrates ethical behavior as expected by our patients, colleagues and the community. Understands the personal obligation to report any activity that appears to violate applicable laws, rules regulations or the Code of Conduct itself.

8. Must learn and comply with System and facility safety policies and rules; must use appropriate safety equipment and procedures at all times; must immediately report all unsafe conditions to supervisors; must be familiar with all safety features of equipment, tools or materials encompassed by job duties; and must check with supervisors (prior to job performance) if there is a question as to the safe procedure to be used for any job function.

9. Completes other duties as assigned

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