How to become

How to become a Anesthesiologist

How to become a Anesthesiologist


Physician anesthesiologists are highly skilled medical doctors (M.D. or D.O.) who specialize in the field of anesthesiology.

As physicians with significantly longer and more extensive training than other classifications of anesthesia practitioners, physician anesthesiologists are the most qualified to make anesthesia related perioperative medical decisions. Physician anesthesiologists are primarily responsible for the safety and well-being of patients before, during and after surgery. This may include placing them in the state of controlled unconsciousness called “general anesthesia,” the provision of “regional anesthetics” where only a portion of the body is made numb, or administering sedation when indicated for the relief of pain or anxiety. These anesthetics provide continuous pain relief and sustain patients’ critical life functions as they are affected throughout surgical, obstetrical or other medical procedures. A physician anesthesiologist is the director of the Anesthesia Care Team.

What does an Anesthesiologist do?

Anesthesiologists must be well-versed in not just anesthetics, but also Pharmacology, Physiology, and other topics related to providing Anesthesia to patients and monitoring them throughout the surgery. During a medical procedure, they must be able to monitor a patient’s blood pressure, airways, and respiration rates, as well as their pulmonary and cardiovascular health. If any of these areas fail, an anesthesiologist must be able to revive the patient or use other methods to ensure the patient’s recovery.

The role of the physician anesthesiologist extends beyond the operating room. He or she is responsible for the preoperative assessment of the patient, an evaluation process that carefully considers both the patient’s current state of health and the planned surgical procedure that allows physician anesthesiologists to make judgments about the safest anesthesia plan for each individual patient. The physician anesthesiologist is also responsible for the well being of the patient postoperatively while the patient emerges from the effects of anesthesia. They are often involved in the management of acute postoperative pain, as well as chronic and cancer pain; in cardiac and respiratory resuscitation; in blood transfusion therapies; and in respiratory therapy.

Skills Required to Become an Anesthesiologist

The following abilities are required to be a successful anesthesiologist:

Like all doctors, anesthesiologists must demonstrate high intelligence and strong technical skills. Here are some of the most important skills that anesthesiologists must have:

Critical Thinking

Anesthesiologists must be able to analyze which type of medication is best for the patient based upon their age and medical history. Additionally, particular procedures often require specific anesthetics or variations of an anesthetic type.

Attention to Detail

The smallest detail in a patient’s medical history could signal major warning signs that a patient should avoid certain kinds of medication. Anesthesiologists must be able to detect early signs of adverse reactions to medication prior to, during, and after a major medical procedure.


 As a medical professional, you will be responsible for tracking any changes in vital signs and the patient’s condition during anesthesia.

Problem Solving 

Should something not go according to plan with your patient, you must be prepared to deal with any crisis that should arise. It is not uncommon for anesthesia to cause unexpected reactions in the patient during the procedure, thereby requiring intervention by the anesthesiologist.

Verbal Communication

You would be required to communicate clearly and concisely with both doctors and patients. Most importantly, because there are usually risks associated with certain kinds of medication, it is up to you to make sure that the patient (and their family) fully understands those risks.

Anesthesiologist Duties & Responsibilities

Anesthesiologists have a specialty in pain management, along with a wide array of responsibilities.

  • Administering pain relief before, during, and after medical procedures
  • Monitoring patients’ vital signs during procedures
  • Supervising anesthesia assistants and certified registered nurse anesthetists
  • Approving general, sedative, regional, or local anesthetics
  • Reviewing medical files and lab results
  • Informing patients of risks associated with anesthesia
  • Complying with medical and hospital procedure policy
  • A patient may feel discomfort for a period of time after certain procedures have been completed, so the anesthesia should help the patient transition into, though, and out of the procedure with relative ease. This is known as perioperative medicine, the specialty of anesthesiologists.

If you’ve done your job well as an anesthesiologist, the patient will usually have no complications stemming from the anesthesia or pain medication during or after the procedure.

Job Outlook

According to the U.S. Bureau of Labor Statistics, the number of anesthesiologist jobs is expected to decline slightly by 2030. The broader category of physicians and surgeons is expected to increase 3% over the next decade.3

Work Environment for anesthesiologists

Those that work in anesthesiology typically work under the same conditions as physicians and surgeons. A significant difference from other doctors, however, is that anesthesiologists rarely meet with their patients until the day of the procedure. Typically, they would receive their orders prior to the procedure, along with the patient’s medical records and history.

Work Schedule for anesthesiologists

As with all doctors, your schedule could be highly irregular. Though you may not work as long hours as would a standard doctor or surgeon, due to the general shortage of anesthesiologists in the U.S., you will likely be working full-time hours to keep up with the work.

Subspecialties within Anesthesia

After anesthesiology residency, you can subspecialize further with any number of fellowships. And good news, each fellowship is only 1 year in length.

Regional Anesthesiology and Acute Pain Medicine

Go into regional anesthesiology and acute pain medicine if you enjoy doing light procedures, like ultrasound-guided regional nerve blocks. You’ll see lots of patients pre-op, doing epidurals before labor, or managing pain in post-operative patients.

When we say regional anesthesia, we refer to blocking pain in a specific area of the body, such as doing a knee block for an ACL repair. This way, the patient doesn’t feel anything from the knee down. Alternatively, median nerve blocks are done in the wrist when operating in certain regions of the hand.

Cardiac Anesthesiology

Cardiac anesthesiology is for those who are hardcore, intense, and somewhat of adrenaline junkies. You’ll be assisting with big cardiothoracic cases, such as open-heart surgery, and may be involved in more sophisticated and nuanced techniques. For example, single lung ventilation is sometimes used to allow the surgeon to operate on the heart without interference from the lung.

This is the second-highest compensated anesthesiology subspecialty, second only to chronic pain.

Chronic Pain

Chronic pain anesthesiologists see patients in clinic and prescribe analgesics or administer injections. You can also become a chronic pain physician by pursuing 4 years of PM&R residency followed by a 1-year chronic pain fellowship.

Compensation for chronic pain specialists is quite high. After all, you’re prescribing medications and performing injections and procedures on patients who are highly dependent on your care, and they’ll be coming back for additional treatment.


Neuroanesthesiology is for the brainiacs who are into the esoteric and weird stuff. You’ll assist neurosurgeons who need their patients to be awake during the middle of the case to test brain functions. This subspecialty requires a great deal of planning to execute successfully.

Obstetrics Anesthesiology

OB anesthesiology is strongly female-dominated. These are often anesthesiologists who enjoyed obstetrics but didn’t necessarily want to be the person delivering the baby. You’ll be leading mothers through C sections, and it’s ultimately very rewarding, because at the end of each case you’ll generally have a healthy baby and a happy mom.

Pediatric Anesthesiology

Pediatric anesthesiology is not surprisingly best for those anesthesiologists who love working with kids. Oftentimes, they had surgeries themselves when they were younger and were inspired to help kids because they remember how terrifying it was.

There certainly are big cases in pediatrics, but it’s also not uncommon to be assisting with minor procedures. Young children, after all, are generally less tolerant of certain procedures and may require anesthesia for their own comfort and safety.

Remember, kids are not just little adults, and not only do they have unique physiology, but also require special equipment, like smaller endotracheal tubes and Macintosh or Miller blades.

Critical Care

Critical care anesthesiologists care for patients who are admitted to the ICU. This includes patients who have had major surgery or who suffer from severe infections or trauma. As a critical care anesthesiologist, you will not be working in the OR. Instead, you will be managing the ICU.

Another way to become a critical care physician is 3 years of internal medicine residency followed by a 3-year critical care fellowship. This path will take 6 years, whereas going the anesthesia route will be 5 years. Four years for anesthesia residency, and only a 1-year critical care fellowship.

How To Become an Anesthesiologist – Step-by-Step Guide

1. Complete a Bachelor’s Degree Program

The education process for Anesthesiologists is similar to that of other Physicians. A medical school is critical to your becoming an anesthesiologist but you will need a Bachelor’s degree as a prerequisite to enrolling in a medical school.

While you are free to apply for medical school with any kind of undergraduate degree, your degree should cover courses in biology, physics, chemistry, and mathematics. These courses are also prerequisites to medical school. Because your undergraduate degree should contain these courses, we strongly advise that you get a pre-med degree.

2. Get into Medical School

After your four-year undergraduate degree, you will have to apply to a medical school. The medical school also take four years to complete. On completion of the medical school, you will get a Doctor of Medicine (M.D) or a Doctor of Osteopathy (D.O) degree. You should know, however, that gaining admission into medical school is not easy.

Medical schools in the USA takes a few numbers of prospective medical students out of the pool of applicants they receive yearly. Medical schools will consider your GPA, letters of recommendation, and Medical College Admissions Test (MCAT) scores.

3. Complete Medical School

The race does not end on gaining acceptance into a medical school. You will have to complete your four years of medical school education as an anesthesiologist to proceed to the next stage of your career.

You will spend the first two years of medical school in the classroom receiving instruction in core medicine subjects. These subjects include microbiology, biochemistry, physiology, pharmacology, pathology, medical ethics, and anatomy.

For the remaining two years, however, your education will be more practical. You will gain hands-on experience in treating patients at medical facilities through clinical rotations.

A veteran Physician will supervise you during your clinical rotations and through their assistance, you’ll explore several specialties in the field. Some of these specialties include pediatrics, gynecology, cardiology, and geriatrics.

You should check out these scholarships for medical students to help you navigate through medical school with ease.

4. Complete a Residency Program in Anesthesiology

The residency program takes place after graduating from medical school. It is another four years of intense learning for you, only this one is more specialized than the previous set of four years. Your residency must be in anesthesiology.

Hence, one year of the program will still be clinical rotations and/or internship in general medicine areas such as internal medicine, pediatrics, and emergency medicine. The remaining three years, however, will be pure anesthesiologist education.

5. Consider a Sub-Specialty Fellowship

A fellowship program in a subspecialty in anesthesiological lasts for a year or two and allows for specialization in the field. You can purse this fellowship option only after residency but it is not a compulsory education you must get to become an anesthesiologist.

The anesthesiology sub-specialty fellowship is simply a thing of choice. If you’ll be choosing to take part in one, however, the sub-specialties in anesthesiology you can choose include neurosurgery, pediatric, transplant or dental anesthesiology.

6. Gain Licensure

Licensure is an important educational requirement for most medical-related disciplines. It is the same too for Anesthesiologists. You will need a license to be able to practice the Anesthesiology profession in the United States.

This licensure is state-dependent, which means that you must gain it in the state you wish to practice. Meanwhile, gaining an Anesthesiologist license requires you to pass a two-part examination as well as fulfill additional state requirements.

7. Get Board-Certified

You can get board certified after gaining your license by either The American Board of Anesthesiology (ABA) and the American Board of Physician Specialties (ABPS). To become board certified by any of these boards, all you need to do is pass their certification exam.

Meanwhile, becoming board certified is not a compulsory educational path to an anesthesiologist career. It gives professionals in the field some sense of accomplishment when they use the title, “Board Certified Anesthesiologist,” and employers prefer Anesthesiologists who are board-certified. Also, it is the norm. Close to 90 percent of anesthesiologists are board-certified.

Best Programs and Courses to Become Cardiologist

A career as an anesthesiologist starts by completing four years of medical school followed by an anesthesiology residency. Students don’t pay for residency, but rather they receive an annual salary. For the program below, a starting pay is listed instead of tuition. Here is a list of medical schools with top anesthesiology residency programs.

  • Stanford University – School of Medicine

The anesthesiology residency at the Stanford University School of Medicine takes place in the prestigious Stanford Hospital. In addition to regular residency training, doctors in this program have the opportunity to complete training in pediatrics, internal medicine, global health, and more. There is even an opportunity to complete research through the Stanford Fellowship in Anesthesia Research and Medicine (Stanford FARM) program.

As a teaching and research hospital, innovation and exploration are at the core of the anesthesiology residency. Students are required to complete a one- to three-month rotation in research with a faculty mentor. Other highlights of this program include a mock Objective Structured Clinical Examination (OSCE), a perioperative rotation, short lectures at convenient times, and the opportunity to take international medical trips.

Location: Palo Alto, CA

Duration: Four years

Accreditation: Liaison Committee on Medical Education (LCME)

Pay: Starting at $66,393.60 per year

  • Johns Hopkins Medical School

The Johns Hopkins Medical School anesthesiology residency is ranked number one in the nation by US News & World Report. This prestigious program takes three years to complete and starts with an intensive one-month orientation. During orientation, residents will work one-on-one with a dedicated faculty member to learn intraoperative techniques.

Upon completion of orientation, residents then participate in one-month rotations in obstetrics, intensive care, general surgery, pediatrics, and pain management. There are also several months of elective rotations to allow residents to focus on their interests. If an area of interest isn’t available at Johns Hopkins, it is not uncommon for residents to travel to partner hospitals to complete their rotations.

Location: Washington DC

Duration: Three years

Accreditation: Liaison Committee on Medical Education (LCME)

Pay: $58,470 per year on average

  • Duke University – School of Medicine

Not only is the Duke University School of Medicine anesthesiology program ranked number four in the nation by US News & World Report, but it also has some of the top faculty in the country teaching in its program. Residents of this program can choose a three-year standard, a four-year advanced, or a five-year research residency. Rotations in years one and two in pain management and perioperative medicine can help standard residency students determine what, if any, specialty they will choose.

All residents will have the opportunity to participate in research, should they so choose. In addition to hands-on training, residents also participate in lectures, seminars, and presentations to further their knowledge of anesthesiology. As Duke is always looking to improve their program, residents are encouraged to submit feedback about the lecturers and instructors to ensure sessions remain relevant.

Location: Durham NC

Duration: Three years

Accreditation: Liaison Committee on Medical Education (LCME)

Pay: Starting at $58,020 per year

  • Columbia University – Vagelos College of Physicians and Surgeons

Interns in the anesthesiology residency at Columbia University are trained in the tradition of patient care, education, and research that is a hallmark of this program. Residents explore three primary areas throughout the program: preoperation, intra-operative, and postoperative anesthesia care. Students are encouraged to become self-directed learners who have high ethical standards and strong research skills.

Part of the anesthesiology residency at Columbia includes didactic courses to further a doctor’s education. Grand rounds are every Thursday morning from 7:00 to 8:00 in the morning, prior to rounds. There are also core curriculum conferences once a week in the afternoon. Classes are taught by top Columbia faculty as well as by renowned visiting professors.

Location: New York, NY

Duration: Four years

Accreditation: Liaison Committee on Medical Education (LCME)

Pay: Starting at $73,439

  • University of Michigan Medical School

Ranked number six in the nation, the anesthesiology residency at the University of Michigan Medical School is one of the largest in the country. Because of the high number of students in this program, there is the opportunity for more diverse clinical settings as well as more complex cases. Each resident is assigned a faculty mentor with whom they work throughout their three years in the program. The role of these advisors is to evaluate residents on a daily basis to ensure they are progressing through the program at a satisfactory pace.

In addition to competitive residency pay, the University of Michigan offers residents several other enticing benefits such as a year lump sum payment, conference stipends, paying for exam fees, and a personal iPad.

Location: Ann Arbor, MI

Duration: Three years

Accreditation: Liaison Committee on Medical Education (LCME)

Pay: Starting at $62,083 per year

  • University of California, San Francisco (UCSF)

The University of California, San Francisco (UCSF) has one of the best medical schools in the USA. US News and World Report rank its Anesthesiology program as number three in the USA. The UCFS School of Medicine began in 1864 and has over 1,428 medical students while housing the UCSF Medical Center.

Through its Department of Anesthesia and Perioperative Care, UCSF offers one of the finest Anesthesiology Residency Programs in the USA.

You will learn and provide patient care in six different medical centers, including the UCSF Helen Diller Medical Center as a resident at UCSF. Meanwhile, UCSF’s program distinguishes itself through the diversity and challenge of its clinical experiences. Hence, you will graduate to be outstanding in your clinical abilities.

However, UCSF seeks residents who are accomplished academically, loves challenges and opportunities, is enthusiastic, and works well as part of a team.

Meanwhile, if you’ll be attending UCFS School of Medicine for your medical school education, you’ll be paying $41,532 as a California resident and $53,777 as a non-resident.

  • Washington University School of Medicine

Washington University School of Medicine in St. Louis is another school in the USA you should consider for a comprehensive anesthesiologist schooling. This private medical school began in 1891 in Missouri and has consistently raised quality physicians and anesthesiologists.

Washington University’s extensive Anesthesiology program offers training in its categorical (4-year) and advanced (3-year) programs. This starts with a rotating internship in areas including Cardiology, Surgery. Emergency Medicine, Clinical Simulation, Operative Anesthesia, etc. The internship program progresses to the Clinical Anesthesia Training (CA-1 through to CA-3). The clinical rotations here include Ambulatory Surgery, Orthopedics, Nueroanesthesia, Trauma, Pain Management, etc.

When you complete Washington University’s Anesthesiology program, you will be qualified to perform independently in all areas of perioperative care. Also, you will be eligible to enter into the certification process by the American Board of Anesthesiology.

Meanwhile, an Anesthesiologist degree at Washington University in St, Loius will cost you $66,913 yearly for tuition.

  • Weill Cornell Medicine of the Weill Cornell University

Weill Cornell Medicine of the Weill Cornell University is the 10th school on our list of best schools for an anesthesiology program in the USA. Weill Cornell Medicine began in 1898 as a private, nonprofit medical school in New York, USA. However, it has grown to a massive height, drawing over 6,000 medical school applicants yearly. Little wonder it makes US News and World Report’s list of Best Anesthesiology Programs as the number 12th medical school for the field in the USA.

Through the NewYork-Presbyterian Hospital and the Department of Anesthesiology of Weill Cornell Medical College, you’ll receive proper anesthesiology training in patient care, academic medicine, and research. Also, Weill Cornell’s anesthesiology training involves a didactic and clinical curriculum that prepares you for the most competitive and rigorous fellowship programs and academic careers. 

Hence, you’ll take clinical rotations at the NewYork-Presbyterian Hospital and the Memorial Sloan Kettering Cancer Center and Hospital for Special Surgery throughout your four years of the residency program.

And by the time you’re done, you’ll have complete knowledge and experience about regional anesthesia and acute pain medicine, chronic pain management, critical care medicine, neuro anesthesia, global health, etc.

Meanwhile, an MD degree towards an anesthesiologist career at Weill Cornell goes for yearly tuition of $58,760 for four years.

Anesthesiologist Salary

According to the Bureau of Labor, an anesthesiologist earns $261,730 on average every year. This makes these physicians among the best paid professionals in the United States. The leading anesthesiologist earn more than $275,000 annually. This shows that a career in anesthesiology is worth the many years one spends in school. 

The health sector continues to grow each year with demand for physicians being on the rise. It is estimated that employment opportunities for anesthesiologists will grow at 7% between now and 2028. The Bureau of Labor Statistics also shows that the demand for anesthesiologists is growing faster than that of other professions. This is an encouraging factor for those studying to become anesthesiologists and those planning to start the process in future. 


What You’ll Love About Anesthesiology

There’s a lot to love about the field of anesthesiology. It’s one of the ROAD lifestyle specialties, standing for radiology, ophthalmology, anesthesiology, and dermatology. These are specialties with great lifestyles, meaning high compensation and a good work-life balance.

Speaking of work-life balance, you can expect to work regular 9 to 5 hours. And when you’re off, you’re completely off. There’s no need to carry a pager home and be called in during the middle of the night.

If you don’t enjoy clinic, which is a common sentiment, particularly amongst surgeons, know that as an anesthesiologist you won’t have to do clinic at all, unless you want to pursue something like chronic pain.

If you love the OR but don’t want to necessarily be a surgeon, anesthesiology is your best bet. The operating room is a great place to be, where you’ll have an intimate sense of camaraderie with the rest of the surgical team.

What You Won’t Love About Anesthesiology

While anesthesiology is great, it isn’t perfect.

Anesthesiologists are unsung heroes, often not receiving the recognition they deserve. Patients will rarely thank you as the doctor. That gratitude gets directed to the surgeon. And oftentimes, others will consider you the sidekick to the surgeon, the Robin to their Batman.

If you’re not fond of high-stress situations requiring quick decision making, then steer clear of anesthesiology. While it’s often calm and relaxed, things can and will go wrong, and a patient’s life will be in your hands.

And lastly, mid-level encroachment into the field of anesthesiology is a growing concern. Mid-level providers, such as CRNA’s, are lobbying for independent practice rights, although this is controversial and is something I will explore in a future post. Many hospitals are now adopting an anesthesia care team model whereby an MD anesthesiologist simultaneously supervises several CRNA’s, each of whom is in an operating room.

This has raised concerns of decreasing employment opportunities for anesthesiologists. However, there are still many opportunities to work in the OR 1-on-1 with the patient, particularly in larger and more complicated cases that require a physician’s expertise.

Should You Become an Anesthesiologist?

If you were the student in medical school that loved physiology and pharmacology, enjoyed working with their hands, gravitated toward high-stress situations, and values the importance of work-life balance, then anesthesiology may be a good fit for you.

If you love the OR and want to make it the focus of your life, become a surgeon. But if you like the OR, become an anesthesiologist.

At the end of the day, the operating room is the surgeon’s domain, and you have to be ok with that. Those who crave the spotlight and want to be the person in charge would not be happy working in the background as an anesthesiologist. As my anesthesiologist friend says, “If you do your job right, the patient shouldn’t remember you.”

And finally, while anesthesiology is less competitive than some other specialties, it’s still extremely challenging to get into a strong and desirable residency program.

And who better to learn from and be mentored by than anesthesiologists themselves. Big shout out to the anesthesiologists at Med School Insiders that helped me in the creation of this post. If you need help acing your MCAT, USMLE, or other exams, our tutors can maximize your test-day performance. If you’re applying to medical school or anesthesiology residency, our anesthesiologists can share the ins and outs of what it takes and how to navigate the competitive process most effectively.

Is becoming an anesthesiologist worth it?

A competitive wage and ongoing employment.

What GPA do you need to be an anesthesiologist?

GPAs between 3.5 and 4.0.

How many years of school does an anesthesiologist need?

A minimum of eight years of medical school, followed by residency and, for many, a fellowship year of additional specialised study.

What should I major in to be an anesthesiologist?

Biology, the natural sciences, or a closely connected discipline.

Anesthesiologist salary?

A $412,500 base income on average.

How to become an anesthesiologist assistant?

Anesthesiologist assistants must complete a two-year master’s programme in this field. The Council on Accreditation of Allied Health Educational Programs should be accredited programmes.

How to become an anesthesiologist nurse?

After obtaining a four-year bachelor’s degree in nursing and passing the NCLEX-RN, you must finish the DNAP degree.Then pass the National Certification Exam by the National Board of Certification and Recertification for Nurse Anesthetists.

How long to become an anesthesiologist?

Being a licensed anesthesiologist takes 12–14 years.

Anesthesiologist schooling cost?

Varies between $80,000 and $120,000.

How to become an anesthesiologist after high school?

Undergraduate degree, medical degree, and a four-year residency . After that, pass the national Board exam, finish a fellowship programme for two years, get certified, and pass a licensure exam.


Anesthesiologists are medical professionals who focus on providing perioperative care, creating anaesthetic strategies, and administering anaesthetics.

At what age do you become an anesthesiologist?

At the age of 29 years.