Certified Endoscope Reprocessor (CER)

A certification for endoscope reprocessing.

CER certification is designed to recognize individuals who have demonstrated the knowledge and skills necessary to pre-clean, test, decontaminate, inspect, disinfect and/or sterilize, transport, and store endoscopes in accordance with industry standards, guidelines and regulations, and manufacturers’ instructions for use. CERs are crucial members of the healthcare team who are responsible for endoscope preparation—a critical role in patient safety for a healthcare facility.



The CER is a standalone certification. CRCST certification is NOT required in order to apply or test.

To earn CER certification, candidates are required to successfully demonstrate skills through completion of three months of hands-on work experience, as well as the successful completion of an examination developed to measure the understanding of endoscope care and handling and infection prevention. CER certification holders are required to recertify annually through the completion of continuing education requirements.

Required Hours of Experience

How many hours of hands-on experience are required?

A minimum of three months of experience must be completed, on a paid or volunteer basis, reprocessing endoscopes on a regular basis  in a medical center, hospital, surgery center, or independent endoscope center. These hours must be completed at the time of application and must have been accumulated within the past three years. Because of the complex nature of endoscopes, firsthand experience is essential to supplement an individual’s understanding of the necessary knowledge and concepts of reprocessing, and to illustrate their practical use. This experience must include the pre-cleaning, testing, decontaminating, inspecting, disinfecting and/or sterilizing, transporting, and storing of endoscopes.

Please be aware that HSPA does NOT provide placement services. It is your responsibility to find a department in which to complete your hours.

If you are unsure whether your department is authorized to sign off on your hours, please complete our form request using the button below:


What is the rationale for requiring these hours?

HSPA believes that both training and experience contribute to the delivery of quality patient care.

The hands-on experience requirement provides an invaluable resource with which to better understand the standards, knowledge, and practices needed to be successful in a Sterile Processing department and on the CER Exam.

Verification of Requirements

Hands-on experience is required for your examination, and documentation of that experience must be provided on the exam application as indicated. No other documentation is necessary or acceptable.

The sections of your application documenting your experience must be completed by your department’s immediate manager/supervisor. An individual may never document their own experience.

Provided they are in a position above your own then experience hours can be documented by:

  • Lead technicians, coordinators, or supervisors
  • Managers, chiefs, directors, or administrators
  • Hospital-based educators or trainers

Hours cannot be documented by technicians or private instructors. In order to verify experience, all contact information provided for the manager or supervisor documenting your hours must be current or your application will be rejected.

Hands-on hours can be accumulated on a paid or volunteer basis and you need not be currently employed or volunteering with a facility in order to test.

Applications requiring hands-on experience may be subject to verification before processing. Once selected for verification an application cannot be processed further until the manager/supervisor documenting the applicant’s hours of experience can be contacted and the experience confirmed. If the listed manager/supervisor cannot be reached for confirmation the application will be returned, unprocessed. If the manager/supervisor is reached but refutes the information submitted in any way, the application will be sent to the Certification Council for further investigation and review.

Applicants who have submitted a completed application and who are notified that they do not meet the eligibility requirements may appeal this decision by sending a written notice of the appeal to the Certification Council within 30 days of the time stamp on the eligibility decision. Appeals that cannot be resolved to the applicant’s satisfaction will be forwarded by the Certification Manager to the Certification Council for review along with any relevant information from the initial review of the application. Written notice of the final decision will be sent to the applicant within 30 days of the review. The decision of the Certification Council will be final.

Exam Preparation: Self-Study vs. Work Experience

Option 1: Self-Study

You may purchase reference materials and choose to study on your own to prepare for the CER exam. The following were used as reference materials in creating the CER exam:

  • HSPA’s Endoscope Reprocessing Manual (2nd ed.)
  • ANSI/AAMI ST91 (2022 ed.)
  • CDC’s Essential Elements of a Reprocessing Program for Flexible Endoscopes (2017 ed.)
  • Articles by the Society of Gastroenterology Nurses and Associates (SGNA): Standard of Infection Prevention in the Gastroenterology Setting (2019), and Standards for Infection Prevention in Reprocessing Flexible Gastrointestinal Endoscopes (2018)
  • SGNA’s Guidelines for Use of High-Level Disinfectants & Sterilants in the Gastroenterology Setting (2017 ed.)

Option 2: Work Experience

You may take the exam based on your personal knowledge from experience in the field. It is not required that you take or pass a preparatory course or study materials on your own. Applicants can apply directly to take the exam without purchasing study materials or enrolling in a course.


  • You can order the HSPA and ANSI/AAMI publications through the HSPA store (select to sort by Category = CER or AAMI) and download the above articles from the SGNA website.
  • Online/distance learning courses are not available for the CER. HSPA’s Education department developed some of the materials above as an optional method to assist individuals in preparing for the CER exam. They were developed and produced independently by the HSPA Certification Council, which does not develop, require, approve, or endorse any specific training materials.

Content & Composition of the Exam

Exam Content Outline

The CER exam will test your proficiency in the following areas:


Each of the seven knowledge domains listed above is comprised of a series of sub-domains which are explained in further detail in the CER EXAM CONTENT OUTLINE (updated June, 2021). The Content Outline also describes further detail on the type and amount of content covered in each section, as well as its weight on the certification exam.

Exam Structure

  • The exam is computer-based and no writing instruments are needed (a written version of the exam is not available)
  • The current version of the test is comprised of 150 multiple choice questions
  • You will have three hours in which to complete the exam
  • Questions can be marked for review and answered or changed later in the exam
  • A 15-minute tutorial describing how to take the exam on the computer precedes the test and is also available online, below



Validate that you meet the eligibility requirements detailed above and in the HSPA Certification Handbook and apply today.

Required Experience Documentation

  • CER Exam: 3 months

Application Fees

  • Initial Exam: $140
  • Retake Exam: $140

Application fees include the application processing and one exam attempt (in-person at a Prometric Testing Facility). Additional fees are required for each exam retake, as shown above. Please allow 3-4 weeks for processing.

*Any requests for cancellations or refunds must be made within 30 days of payment. If made within 30 days, your payment will be refunded in full, minus a $25 non-refundable processing fee.