What Is Medical-Surgical Nursing? (Skills, Education, Salary)

Medical-surgical nursing is often colloquially called “med-surg nursing.” Due to the breadth of settings and subspecialties covered under med-surg nursing, there is a common misconception that med-surg is not a nursing specialty. On the contrary, med-surg nursing is one of the largest nursing specialties.1 As the Academy of Medical-surgical nurses stated, “medical-surgical nursing is what you practice, not where.1

What is Med-Surg Nursing?

Med-surg nursing encompasses the care of acutely ill adults and their families, often encountering patients with complex health challenges. Med-surg nurses need a vast knowledge base due to the various health issues they may encounter. Overall, the med-surg specialty includes care of people with any type of medical issue and people who are preparing for or recovering from surgery. The range of conditions that med-surg nurses may encounter makes med-surg a challenging and dynamic specialty. 

Another common misconception is that med-surg nursing is a specialty that only practices in acute care settings. Med-surg nursing can also include outpatient, community, and tertiary care.2 The variety of settings that med-surg nursing occurs adds to the broad base of knowledge that med-surg nurses need to possess. It also allows nurses to explore many subspecialties within the wider specialty of med-surg nursing.

What Do Medical-Surgical Nurses Do?

Med-surg nurses have a wide skill and knowledge set due to the variety and complexity of health conditions encountered in the specialty. The care setting and the potential sub-specialty that the nurse is practicing will determine specific tasks and skills. For example, a nurse working in a general medicine unit in a rural location requires a different skill set than a nurse working on a specialized neurosurgical hospital ward in a tertiary care setting. Overall, nurses working in med-surg engage in the nursing process as leaders of the interprofessional care team. Med-surg nurses provide care for patients’ basic needs, assess patients, coordinate care, administer interventions, advocate for their patients, and collaborate with the wider interprofessional care team.

The medical-surgical specialty is included in the health system’s effort to shift toward focusing on prevention and health promotion rather than simple downstream treatment of illness or “sick care.”3 Therefore med-surg nurses are being encouraged to step into roles to enhance nurses’ role in comprehensive health care. This role includes patient education, patient advocate, care coordinator and potentially research.4

Is Med-Surg Nursing Challenging?

Med-surg nursing encompasses every body system and all people who require medical or surgical management. The sheer scope of this knowledge base makes med-surg nursing a challenging specialty. Med-surg nurses also care for adults throughout their lives, from early adulthood to the end of life. Although typically, med-surg patients tend to be older adults due to the increased prevalence of chronic disease as people age. Therefore, a strong background in gerontology is helpful.4 However, this will depend on the practice setting, as some med-surg areas may have a stronger focus on younger populations. The upside of this breadth of scope is that med-surg nursing is a highly diverse specialty, often with the option to try different sub-specialties. There are often many learning opportunities to work in various settings and with different patient populations.

What Education is Required for Med-Surg Nursing?

There are different roles for nurses in med-surg depending on the nurses’ educational background and experience. The minimum amount of education required for most med-surg roles is the completion of either a vocational nursing program such as a licensed practical nurse or registered practical nurse or to have completed a Bachelor of Science in nursing which fulfills the requirement to take licensure exam to become a registered nurse. While it is common for new graduate nurses to start their careers in med-surg, many practice settings will require new nurses to complete some practice setting-specific education, including unit-specific orientation and education.

What Exams do Med-Surg Nurses Need to Pass?

In addition to completing an accredited nursing program, nurses require active licensure to practice in a medical-surgical setting. To apply for licensure in North America and Australia, nurses must pass the National Council Licensure Examination – Registered Nurses (NCLEX-RN) exam.

To attain board certification in the med-surg nursing specialty, which is offered in the US through the American Nurses Credentialing Center (ANCC) or Medical-Surgical Nursing Certification Board (MSNCB), nurses must’ve worked in a med-surg setting for at least two years and have 2,000 hours of practice. This certification is only offered to registered nurses. If these requirements are met, nurses can write the certification exam to receive certification in medical-surgical nursing. There are career benefits to being certified in the med-surg specialty, although it is usually not a requirement to work on in a med-surg setting.

Med-Surg Nurses Salary

There is a great deal of variation in med-surg nursing salaries depending on the nurse’s education, experience, and location of the work. In the US, the national average salary for a med-surg RN is $76,492, with significant variation depending on which state they are located in. The highest state has a yearly average salary of $84,865. In contrast, the lowest state has a yearly average salary of $53,581.5 Nurses who work in med-surg leadership positions such as advanced practice nurses, clinical leadership or management, or education will have higher salaries. Whereas nurses who are not bachelor’s degree prepared or are new graduates will tend to have lower salaries.


  1. Academy of Medical-Surgical Nurses. What Is Med-Surg Nursing? Accessed February 22, 2023. https://www.amsn.org/about-amsn/what-med-surg-nursing
  2. Goodridge D, Lewis SM, Goldsworthy S, Barry MA. Medical-Surgical Nursing in Canada: Assessment and Management of Clinical Problems. 3rd Canadian. Elsevier Canada; 2014. https://go.exlibris.link/60wQwtmC
  3. Fani Marvasti F, Stafford RS. From Sick Care to Health Care — Reengineering Prevention into the U.S. System. N Engl J Med. 2012;367(10):889-891. doi:10.1056/NEJMp1206230
  4. Books@Ovid Purchased eBooks. Medical-Surgical Nursing Made Incredibly Easy. Lippincott Williams & Wilkins; 2023.
  5. Zip Recruiter. What Is the Average Surgical Nurse Salary by State. Accessed February 22, 2023. https://www.ziprecruiter.com/Salaries/What-Is-the-Average-Surgical-Nurse-Salary-by-State
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Alex Lukey is a registered nurse and researcher. Alex earned her bachelor's and master's degrees in nursing from the University of British Columbia Okanagan. She is now working on a Ph.D. in Public Health as a Killam Scholar at the University of British Columbia. Alex's research has spanned health policy, patient education, and oncology. She is currently working on ovarian cancer prevention using machine learning. Her clinical practice experience includes cardiology, cardiac surgery, and pediatric homecare. Alex is passionate about science communication and education.