As the number of Ambulatory Surgery Centers increases and the Medicare reimbursements for surgeon first assistants decline, the need for non-physician first assistants grows. 2. Qualifications for a first assistant include knowledge skill, and devotion to this speciality. 3. The first assistant is part of a medical team that consists of the surgeon, the first assistant, the scrub nurse or technician, and the circulating nurse. 4. The role of the first assistant helps to increase efficiency in the operating room and enhance the quality of patient care.