Updated: April 2021

What does a 4N1X1 do?

Participates in, and manages planning, providing, and evaluating surgical patient care activities and related training programs. Organizes the medical environment, performs and directs support activities in patient care situations, including contingency operations and disasters. Assists professional staff in providing patient care for the surgical patient before, during, and after surgery. Performs scrub and circulating duties in the operating room (OR). Assists with post-anesthesia recovery of patients. Processes, stores, and distributes sterile supplies. Participates in planning, implementing, and evaluating management activities related to the OR and Sterile Processing and Distribution (SPD). Performs duties in and supervises the urology, orthopedic, and otorhinolaryngology surgical specialties.

Where and How Long is the Tech School For a 4N1X1?

Tech School

32-46 Days - Ft Sam Houston, TX


Surgical Services Technology

What Does the 4N1X1 Duty Badge Look Like?

Enlisted Medical Badge

What are the Demographics for the 4N1X1 Career Field?







Total: 640

What are the Requirements to Become a 4N1X1?


General: 44


40 lbs

  • For entry into shredouts B, C, and D, prior qualification and possession of AFSC 4N131.
  • No record of emotional instability.

What are the Duties and Responsibilities For a 4N1X1?

Directs, performs, and coordinates administrative functions. In coordination with executive management team, establishes administrative policies for surgical functions and provides input into strategic resource planning. Manages the preparation of correspondence, records, and their maintenance. Determines methods and sources of obtaining data for routine or special reports. Directs, coordinates, and validates budget requirements. Serves as a consultant to MAJCOM Medical Service Manager. Participates or assists in developing and implementing command programs. Conducts staff assistance and consultant visits. Assists the executive management team with developing, interpreting, and evaluating instructions, regulations, policies, and procedures. Oversees development, implementation and evaluation of medical readiness plans and programs. Oversees and participates in implementation of continual quality improvement plans and programs.

Provides, supervises and manages surgical patient care activities. Performs surgical tasks. Acts as team leader and member. Transports patients, and related records to and from the OR and recovery room. Assists nursing staff with preoperative patient preparation activities. Helps with routing medical materiel management activities. Accomplishes routine safety checks and operator preventive maintenance on fixed and moveable medical equipment and fixtures. Performs routine and specialized housekeeping activities. Prepares OR for surgery by setting up and opening sterile supplies and instruments. Assists anesthesia personnel with patient positioning and anesthesia administration. Applies principles of asepsis, infection control, and medical ethics. Assists with terminal cleanup of OR and prepares for follow-up procedures. Receives, decontaminates, and cleans soiled patient care items. Assembles, wraps, and sterilizes instrument sets, supplies, and linen packs. Stores, maintains, and distributes sterile patient care items. Assists the circulating nurse with preparing records, reports, and requests. Prepares specimens for transport to the laboratory. Performs scrub duties in OR. Scrubs hands and arms and dons sterile gown and gloves. Prepares and maintains sterile instruments, supplies, and equipment of draped tables and stands. Counts sponges, needles, instruments, and related items with circulating nurse before, during, and after surgical procedures. Assists the operative team with applying sterile drapes to the surgical field. Passes instruments, sutures, and other supplies to the sterile operative team. Anticipates surgeon’s needs, and provides additional assistance as directed. Cares for surgical specimens on the sterile field. Cleans and prepares instruments and reusable supplies for terminal sterilization and decontamination. Participates in contingency or disaster field training, exercises, and deployments.

Performs recovery room or basic nursing duties. Assists surgeon and nursing staff with monitoring and recording vital signs. Administers oxygen, helps arouse patient, and carries out surgeon’s post-operative orders. Assists with identifying and managing of postoperative complications.

Performs general clinic functions. Schedules and prepares patients and sets up instruments, supplies, and equipment for specialized procedures in the OR and specialty clinics. Assists specialty surgeon during surgical and diagnostic procedures. Assembles, operates, and maintains diagnostic and therapeutic equipment. Orders diagnostic laboratory and radiographic procedures as directed. Performs administrative activities unique to specific surgical clinics.

Provides medical training to agencies and personnel other than medical. Training includes areas such as aseptic technique and self-aid buddy care. Schedules in-service training in new procedures, techniques, and equipment. Provides required basic life support training. Conducts or schedules periodic disaster training, fire drills, and evacuation procedures.

Performs urology functions. Operates special urological radiography equipment. Administers injections, catheterizes patients, performs laboratory tests and procedures, and administers intravesical medications under supervision of the physician.

Performs orthopedic functions. Applies and removes casts and splints as directed by health care providers. Assembles and applies orthopedic traction devices. Administers topical anesthetics under supervision of the physician. Instructs patients in using crutches, canes, and other orthopedic appliances.

Performs otolaryngology functions. Performs minor diagnostic and therapeutic ear, nose, and throat (ENT) procedures. Administers topical anesthetics under supervision of the physician. Performs diagnostic hearing evaluations and vestibular function tests. Makes ear mold impressions for hearing aids.

Performs management and training functions within surgical services. Plans and schedules workloads and duty assignments. Establishes work methods and standards. Evaluates work capability and proficiency of subordinates. Plans and conducts training. Interprets policies and instructions. Inspects and evaluates activities and procedures to ensure maintenance of asepsis and proper environmental, equipment, and facility safety conditions. Analyzes requirements and supervises requisition, storage, maintenance, and issue of equipment and supplies. Supervises, prepares, and maintains reports and records.

What Are the Specialty Qualifications for a 4N1X1?

Knowledge. The following knowledge is mandatory for award of AFSC indicated:

  • 4N1X1/X1X. Fundamentals of anatomy and physiology; principles of asepsis and sterile techniques; preparing and storing surgical sets and packs, surgical instrumentation, and equipment; OR and anesthesia procedures; pathology as it applies to specimen care and handling; basic microbiology and infection control principles; basic surgical pharmacology; sterilizing and disinfecting procedures; surgical and anesthesia complications and their treatment; Medical Treatment Facility (MTF); and OR environmental hazards and safety procedures; handling and storage of compressed gases; basic medical material procedures; basic medical administrations procedures; legal aspects of preoperative care and medical ethics; roles and qualifications of surgical team members; and basic clinical functions.
  • 4N1X1B. Anatomy and physiology of the genitourinary system and its disorders, genitourinary system terminology, and radiology techniques in urological procedures.
  • 4N1X1C. Anatomy and physiology of the musculoskeletal system and its disorders; musculoskeletal system term-inology; common practices, techniques, and principles of fracture immobilization including plaster and other casting materials; methods and principles of traction application; and common orthopedic complications and their management.
  • 4N1X1D. Anatomy and physiology of the head and neck; disorders of ENT; medical terminology related to the ENT specialty; and special audiometry testing.

Education. For entry into this specialty, completion of high school is required with courses in general science, biology, chemistry, hygiene, and psychology desirable.

Training. The following training is mandatory for award of the AFSC indicated:

  • 4N131. Completion of the surgical service resident and clinical course.
  • 4N131B. Completion of the basic urology course.
  • 4N131C. Completion of the basic orthopedic course.
  • 4N131D. Completion of the basic otolaryngology course.

Experience. The following experience is mandatory for award of the AFSC indicated:

  • 4N151/51X. Qualification in and possession of AFSC 4N131/31X. Also, experience in functions such as general care and treatment of patients; assisting the operative team and nursing staff in surgery; preparing patients for surgery; and performing sterile, unsterile, and related surgical activities.
  • 4N171/71X. Qualification in and possession of AFSC 4N151/51X. Also, experience supervising and performing functions such as assisting surgeon and supervisor.
  • 4N191. Qualification in and possession of AFSC 4N171/71X. Also, experience managing functions such as medical, surgical, and related patient care and administrative activities.

What Are the Different Specialties (Shredouts) for 4N1X1?

B             Urology

C             Orthopedics

D             Otolaryngology

NOTE: Suffix B, C, and D applies to 1-, 3-, 5- and 7-skill levels only.

For more information on AFSCs and Shredouts check this article out!


Watch the entire 12 part series on the 4N1X1 career field on Daniel Fitzpatrick's YouTube channel! Great job to everyone that helped put these videos together! You're really helping the next generation Airman!!! Amazing.

Other Links

What Are the Possible Assignments for 4N131?

  • Eglin, Florida
  • Fort Sam Houston, Texas
  • JB Andrews, Maryland
  • JB Elmendorf-Rich, Alaska
  • JB Langley-Eustis, Virginia
  • JBSA Lackland, Texas
  • Keesler, Mississippi
  • Lakenheath, United Kingdom
  • Landstuhl, Germany
  • Misawa, Japan
  • Nellis, Nevada
  • Travis, California
  • USAF Academy, Colorado
  • Wright Patterson, Ohio
  • Yokota, Japan

What Are the Possible Assignments for 4N131B?

  • JB Andrews, Maryland
  • Keesler, Mississippi
  • Travis, California
  • Wright Patterson, Ohio

What Are the Possible Assignments for 4N131C?

  • Eglin, Florida
  • Fort Sam Houston, Texas
  • JB Andrews, Maryland
  • JBSA Lackland, Texas
  • Keesler, Mississippi
  • Travis, California
  • Wright Patterson, Ohio

What Are the Possible Assignments for 4N131D?

  • JB Andrews, Maryland
  • JBSA Lackland, Texas
  • Travis, California

Questions and Comments:

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