Medical Surgical Nursing Certification

Today’s nurses have made it a point to add more initials after their name in order to show that they possess expert knowledge in their field of nursing specialty. Becoming certified in your area of nursing speaks volumes about your character. It shows you are a dedicated leader in the field of nursing. It shows you consider yourself a professional. You hold yourself to a higher set of standards. Obtaining your Medical Surgical Certification is a great accomplishment and a step forward for your career.

What is the Medical Surgical Nursing Certification?

Certification is a simple process in which a non-governmental standards board confirms your qualifications for practice in a specific clinical area of nursing. This is validation of your qualifications is always based on predetermined standards that have been set by the board. A Med-Surg certification shows that you have the qualifications to provide nursing care and nursing interventions to patients needing post-operative care and patients recovering from acute diseases.

Medical-Surgical nursing certifications are offered by two different organizations:

The Medical-Surgical Nursing Certification Board: The MSNCB is a partner organization within the Academy of Medical-Surgical Nurses, or AMSN.  It is the credentialing board for Certified Medical-Surgical Registered Nurses certification, or CMSRN. By passing the exam, an RN also receives the CMSRN designation. The CMSRN certification is an important credential to identify you as a med-surg specialist. The credential is available to those nurses with a BSN, or an associaties degree, or nursing diploma.

The American Nurses Credentialing Center: The ANCC is a subsidiary of the American Nurses Association, or ANA. It is also the credentialing board for the ANA. The ANCC is another group that offers testing and certification for medical-surgical nurses. By passing their exam you are awarded the designation of Medical-Surgical Nurse-Board Certified, or RN-BC.

Why get the Med-Surg Certification?

These are the top five reasons why you need to get certified:

#1: You will be a happier nurse. Certification validates your advanced clinical knowledge in medical-surgical nursing. Since you constantly learn new knowledge and skills pertaining to the care of patients with medical-surgical problems, you are confident that you know what you are doing. By this, you are able to provide evidence-based nursing care.

#2: Feel a sense of pride and professional accomplishment. It should be your mantra that learning does not stop as long as you live. Upon earning a Med Surg certification in nursing, you exude professionalism in all your dealings.

#3: Increase your earning power and job satisfaction. With a Med Surg certification after your name you are a more attractive job candidate and also can become more valued by your employer. Certified nurses sometimes earn a salary differential over colleagues who aren’t certified. Hospitals and health facilities may pay a certified nurse more if they are working directly in their specialty.

#4: Be rewarded with peer and colleague respect. There is nothing like feeling respected by your colleagues whenever you are around. A certified nurse earns a certain kind of leveling up when it comes to knowledge, skills and practice, and attitude when giving nursing care.  This also holds true when you are being observed by other nurses under your supervision. You become their instant model and they easily become inspired of following your track.

#5: Help protect the public by promoting expert patient care. When you are known to be certified in a nursing specialty, patients and their families (and even hospitals) are confident and at ease that you certainly know what you are doing. You have gained their trust that you are able to provide nursing care within the standard of nursing practice.

Qualifications to take the Med-Surg Exams

To be eligible for the Medical-Surgical Nurse certification test, you must meet these criteria:

  • Hold a current, active RN license within a state or territory of the United States or the professional, legally recognized equivalent in another country.
  • Have practiced the equivalent of 2 years full-time as a registered nurse.
  • Have a minimum of 2,000 hours of clinical practice in the specialty area of medical-surgical nursing within the last 3 years.
  • completion 30 hours of CE in med surg nursing in the past 3 years.

If you are taking the certification offered by the MSNCB, the following criteria are considered:

  • Must hold a current, active RN license in the United States or its territories
  • Must have a minimum of 2 years’ experience (during the last 5 years) as an RN in an adult medical/surgical clinical setting
  • Must have a BSN, associate degree (AD), or diploma
  • Must have a minimum of 3,000 hours of clinical practice as a staff nurse, clinical nurse specialist, clinical educator, faculty member, manager, or supervisor
  • No continuing education required before taking the exam

Application can be done online or by mail; not both. You may apply for this computer-based test year round and test during a 90-day window at a time and location convenient to you.

CMSRN Exam Format

The Med Surg certification exam tests the RN’s knowledge of nursing actions performed upon medical and surgical patients. Other questions will ask about disease processes and complications of these diseases. Additional topics include ethics, professional standards, and educating patients.

The examiner has the option on which test format to take. The exam can be taken in a paper and pencil (P&P) or a computer-based testing (CBT) format. The P&P exam is offered nationally in May and October, and twice a year at symposiums. The CBT exam is offered year-round during a 90-day testing window at more than 250 sites.

Difference between the P&P and CBT formats are summarized here:

Paper and Pencil: This version of the CMSRN test is given four times a year. Two of these times it is done nationwide at over 50 testing centers, and the other two times are at nursing conventions. Your permit will be mailed to you 2 weeks in advance, and you will want to be certain to bring the permit with you on test day. This version of the test consists of 150 multiple choice questions along with 25 experimental questions which aren’t scored. You have 4 hours to complete the exam. Results are mailed approximately 8 weeks after the test.

Computer Based Testing: This version of the CMSRN is available year round at over 250 testing locations. Your permit to test will be mailed to you 6-8 weeks after your submission, and then you will be given a 90-day testing window. The test if fully computerized with 150 questions. You have 3 hours to complete the exam and the passing score is 71%. Results are provided immediately after you finish the exam.

CMSRN Exam Content

Each test question stems from the exam blueprint and is based on a Patient Problem and a Nursing Role (Domains of Nursing Practice) as listed below. For example, an exam question may ask about instructing a patient with diabetes. The Patient Problem is diabetes and the Domain of Practice is teaching/coaching.

The following tables provide the percentage of exam questions for each Patient Problem and Domain of Nursing Practice areas.

Patient Problems by Physiological Systems

% of Test

Gastrointestinal 18-20%
Pulmonary 18-20%
Cardiovascular 14-16%
Diabetes (types 1 & 2) and other Endocrine 14-16%
Genitourinary, Renal, and Reproductive 11-13%
Musculoskeletal and Neurological 10-12%
Hematological, Immunological, and Integumentary 8-10%


Domains of Nursing Practice

% of Test

Diagnostic and patient monitoring function 24-26%
Administering/monitoring therapeutic interventions 24-26%
Helping role 16-18%
Teaching/coaching function 16-18%
Effective management of rapidly changing situations 9-11%
Monitoring and ensuring quality of health care practices 2-4%
Organizational and work-role competencies 2-4%


Preparation Strategy

#1: COMPLETE YOUR APPLICATION. Step one is a careful review of the eligibility criteria along with the related information that’s available in the official test guide. Next, complete your application.

#2: BEGIN STUDYING. As long as you meet the eligibility criteria, then your application will be accepted. Then C-NET (Center for Nursing Education & Testing) will mail your exam permit to you. For CBT testing you will receive the permit 6-8 weeks after submitting your application. For P&P it won’t come until 2 weeks prior to your test date. But don’t wait for the permit, start studying right away!

#3: REVIEW EXAM BLUEPRINT AND CONTENT.  To pass the exam you will need a “standard score” of at least 95, which equates to about 71%. So be sure to know exactly what is covered and carefully review the blueprint.

#4: FINAL PREPARATIONS.  Make sure you know exactly where your testing center is. Get plenty of rest the night before the exam and then eat a nutritious breakfast when you wake up. Don’t forget to bring your exam permit, a photo identification, and a jacket

Career Options

The health care industry is one of the fastest-growing industries in the country, and registered nursing is the largest occupation in the health care industry. Medical-surgical nursing is the largest professional specialty in the registered nursing occupation, according to the Academy of Medical-Surgical Nurses.

The Bureau of Labor Statistics projects a 26 percent increase in new jobs for registered nurses between 2010 and 2020, with employment opportunities in hospitals, private doctors’ offices, home health care environments and outpatient care facilities.

A certified medical-surgical nurse’s wages vary based on the region of the country where she practices. Certified medical-surgical nurses in the Northeast earned the highest wages, at $49.04 per hour. Those in the Mid-Atlantic and Great Lakes region made $37.41 per hour. In the Southeast, the hourly average was $35.01 per hour and in the Midwest is was $43.27. In the Western United States, Certified medical-surgical nurses earned average wages of $44.80.

Related Exams and Resources:
CMSRN Practice Test
Med Surg Study Guide
Nursing Schools