How to Become an Anesthesiologist

To become an anesthesiologist, you must be ready for hard work and long hours. At the end of your training, you’ll be rewarded with a high salary and the opportunity to make a difference in your community by helping patients. Because the path to become an anesthesiologist is so long, it’s important that you start planning your educational career now.

Best Bachelor’s Degree to Become an Anesthesiologist

You can’t practice anesthesiology with only a bachelor’s degree, so no matter what subject you study in college, you’ll need additional education. You might take advantage of this flexibility by pursuing a degree in your favorite field, like music or social sciences, but you’ll have to plan carefully to find room in your schedule for the science courses you’ll need to get into medical school. You could also pursue the most popular degrees for medical school like Biology, Biochemistry and Chemistry. These fields will give you an advantage to understanding the advanced material of medical school or any other healthcare profession.

Graduate Training for Anesthesiologists

Before you can work as an anesthesiologist, you’ll need to complete four years of medical school. These years will be a mix of classroom and clinical training, and you’ll rotate between many different specialties during short-term experiences at local hospitals and clinics. Many students enter medical school with a pre-chosen specialty but change their minds after seeing new specialties.

How Competitive is Anesthesiology?

Become an Anesthesiologist

Anesthesiology is a highly competitive field of medicine. Alongside Ophthalmology, Dermatology and Radiology, Anesthesiology is part of the “ROAD” acronym for desirable specialties. These four branches of medicine are known for their high pay and work-life balance. Anesthesiologists rarely work weekends or nights because most surgeries are scheduled during business hours, although some anesthesiologists choose to work in emergency medicine with a more hectic schedule. Wherever they work, anesthesiologists do not take after-hours calls from patients. Because anesthesiology is a desirable field, it’s important for medical students to score highly on the required certification tests for all doctors. A high score on these tests translates to a higher likelihood of being matched into a competitive residency.

Required Certifications for Anesthesiologists

As a licensed physician, you’ll need to complete the same tests and certifications to practice anesthesiology that you’d need for any other medical specialization. First, you’ll need to complete the United States Medical Licensing Examination (USMLE) in three different sections. Typically, you’ll take the first portion of the USMLE, called Step 1, after your second year of medical school. This portion tests your scientific knowledge. Because anesthesiology is a highly competitive specialty, you’ll need to score very well on Step 1 to be accepted into later training to become an anesthesiologist.

You’ll take Step 2 of the USMLE between your third and fourth year of medical school. This section of the exam focuses on clinical knowledge, patient care and basic health promotion and disease prevention. You’ll need a broad understanding of many different aspects of clinical care.

Before taking Step 3, you’ll need to start a four-year residency in anesthesiology. These highly competitive training programs immerse you in the world of anesthesiology. You’ll start as an intern, where you’ll have almost no unsupervised contact with patients, and gradually build your skills and knowledge until you’re able to practice anesthesiology without supervision. Your first year of residency is often the most challenging; despite completing medical school, you’re still consider a neophyte and often given tasks that more experienced doctors do not want. While the first year requires long hours and hard work, it’s designed to help you advance your medical education and do well on the final step of the USMLE.

Typically, you’ll take Step 3 of the USMLE after your first year of residency. You’ll be tested on scientific knowledge, diagnostic skills and clinical management skills over a grueling two-day period. If you pass Step 3, you’ll receive a license to practice medicine independently. Some doctors choose to quit residency at this point, but you’ll need to complete another three years of training to become an anesthesiologist.

Optional Anesthesiology Fellowships

If you aren’t tired of training after four years of undergraduate studies, four years of medical school and four years of an anesthesiology residency, you can pursue an optional specialization in anesthesiology through a one-year fellowship. At this point, you’ll be working as an anesthesiology and caring for patients, but you’ll also seek out more knowledgeable anesthesiologists to teach you specialized care. You’ll earn a salary during your fellowship, but compensation varies wildly based on the hospital hosting the fellowship. Some of the most popular anesthesiology fellowship topics include cardiac anesthesia, pain management or obstetric anesthesia, according to the American Society of Anesthesiologists.

Optional Board Certification in Anesthesiology

Once you’ve completed your residency and begun practicing as an independent anesthesiologist, you can purse board certification. You’ll need to submit case reports from real patients, prove that you’re a licensed physician with no disciplinary actions against your license, complete continuing medical education hours and find two currently certified anesthesiologists to recommend you to the board. Although board certification is optional, some hospitals or physician groups are only willing to hire board-certified anesthesiologists.

What Do Anesthesiologists Do?

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The primary job duty of an anesthesiologist is to administer anesthesia and monitor patients under its effects. During surgery, anesthesiologists keep patients’ heart and lungs safe while the surgeon performs the operation. Patients may need general anesthesia, meaning they’re fully unconscious, or localized or IV sedation, which allows patients to stay awake during a procedure without experiencing pain. No matter what type of anesthesia is administered, the anesthesiologist’s duty is to keep the patient alive and healthy.

Most anesthesiologists have limited interaction with patients. They may need to meet with patients before surgery to ensure the patient is healthy and understands how to prepare for the procedure. In some medical settings, Registered Nurses (RN) or other professionals meet with patients so the anesthesiologists can focus on direct clinical monitoring. Anesthesiologists may also meet with patients after surgery to monitor the patients’ recovery from the operation. As with pre-surgical care, oftentimes it is RNs who work directly with patients while anesthesiologists supervise in the background.

Some anesthesiologists prefer more patient-centered care and seek out training in an anesthesiology specialty. Obstetric anesthesiology offers direct contact with pregnant woman during labor, usually via an epidural injection or to prepare for a Caesarean section (C-section). Another popular anesthesiology specialization is pain management; these providers provide outpatient, office-based procedures to help patients manage pain in a controlled medical setting. Pain specialists can provide better options than simply prescribing opioid medications, including steroid injections, spinal cord stimulation and patient education.

How Much Do Anesthesiologists Earn?

Anesthesiologists are highly paid medical professionals. Their mean annual wage in 2019 was $261,730, according to the U.S. Bureau of Labor Statistics. The precise anesthesiology salary varies by region and work site, but most anesthesiologist make between $200,000 and $300,000.

As highly educated professionals, anesthesiologists enjoy many employment options. You can choose to work as a traveling anesthesiologist through a staffing firm. You’ll earn a high hourly wage and have your travel expenses fully covered. You might also work directly for a hospital or through an independent physicians’ group. You can decide to work long hours or look for part-time or swing shifts for more flexibility.

However, anesthesiologists in training earn far less. During the four years of required residency, doctors earn between $75,000 and $100,000 in exchange for working 80-hour weeks. A one-year fellowship pays slightly more than residency. Many doctors struggle to work long hours for little pay during their training period. Because anesthesiology pays a high salary, residents and fellow can look forward to financial rewards after completing their training.

What Kind of Job Prospects Do Anesthesiologists Have?

As with most medical professions, anesthesiologists can rely on steady job demand and high salaries. As long as patients need surgeries, they will also need anesthesiologists to keep them alive during sedation. Because the overall age of the American population is growing, and because new surgical techniques are constantly being invented, more and more patients need surgical intervention to live a happy, healthy life. More surgery means more need for anesthesiologists. Job growth will likely be highest in urban settings, where multiple hospitals can attract patients. However, rural and suburban communities often pay very high salaries to attract medical professionals and also offer a low-cost of living. Many anesthesiologists plan to work in a rural setting for several years to pay off student loans before moving to an urban environment. Board-certified anesthesiologists can also find work as professors at medical schools or physician-officers in the armed forces. Additionally, American-trained physicians are able to practice in almost any country in the world, so anesthesiologists can enjoy the beaches of Thailand or the mountains of New Zealand while still earning a respectable salary. With so much demand for healthcare on a global level, it is highly unlikely that the need for anesthesiologists will ever decline.

Certified Registered Nurse Anesthetist (CRNA)

In addition to anesthesiologists, many patients receive anesthesiology care from nurse anesthetists. These highly trained nursing specialists provide the same services as physician anesthesiologists but are more likely to work in rural and underserved areas. According to the American Association of Nurse Anesthetists, you’ll need at least seven years of training to become a nurse anesthetists. While you’ll only save a few years compared to becoming an anesthesiologist, you’ll have more flexibility during your education.

The first step to becoming a CRNA is to earn a degree in nursing. You can pursue a bachelor’s of science in nursing (BSN), a master’s of science in nursing (MSN) or an accelerated nursing degree program. Once you’re a Registered Nurse, you’ll need to work for at least one year. Many nurse anesthetists choose to gain more experience before advancing their careers. While you’re working, you’ll earn a regular salary, so you can pay off student loans or save for the next step in your education.

Once you’ve earned a degree in nursing and at least one year of experience, you’ll be ready for a master’s of science or doctor of nursing practice (DNP) degree specializing in nurse anesthesiology. These programs take two to four years to complete and will provide you with classroom and clinical experience. When you graduate, you’ll be ready to start working as a nurse anesthetist.

Compared to physicians, nurses have less student loan debt but lower lifetime earnings. Some students prefer nursing because it allows them to start working much more quickly than medical school. There’s no right or wrong answer to the question of whether you should be a CRNA or an anesthesiologist. Both career paths have strengths and weaknesses.

Physician Assistants in Anesthesia


Another way to become an anesthesiologist without completing medical school is to train as a Physician Assistant (PA). While you won’t be allowed to use the title “anesthesiologist,” you will perform the same activities and patient care as a physician anesthesiologist.

Physician Assistants require far less formal training than physicians because this career focuses more on an apprenticeship model. Once you finish a two- or three-year master’s degree and become a licensed Physician Assistant, you’ll likely work directly with one or two doctors to grow your medical skills. This means you might start off assisting on simple surgeries with low-risk patients before you’re able to practice anesthesia on your own.

The downside of a career as a PA is that you face more barriers than a licensed physician. For example, many countries outside of the United States do not recognize PA licensure, so you won’t be able to work or volunteer overseas as a PA. Additionally, your scope of practice will be limited by your supervising physician or employer; some hospitals do not allow PAs to work in trauma surgery or cardiac care.

For many PAs, the benefits outweigh the drawbacks. Unlike physician anesthesiologists, who must complete four years of medical school plus a four-year residency in anesthesiology and an optional one-year fellowship in advanced anesthesiology, a PA can be working in less than four years. This means less student debt, higher salary potential early on and fewer hours in the classroom. PAs are highly valued in underserved populations, including rural, Native American and low-income communities.

Whether you want to work as a physician anesthesiologist or pursue an alternate career as a CRNA or PA, you’ll earn a great income and enjoy your work. With the right planning, you can fulfill your dreams and become an anesthesiologist.

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