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How to Become an Anesthesiologist

April 7, 2022
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How Hard Is It to Become an Anesthesiologist?How Long Does It Take to Become an Anesthesiologist?Steps to Becoming an AnesthesiologistThings to Consider Before Starting the ProcessFAQs: Becoming an Anesthesiologist

How does one become an anesthesiologist in the first place? Is it harder than other specialties? What’s the lifestyle of a typical anesthesiologist? Read on below to learn more about this specialty and what you need to do to follow this career path. 

In 2021, a study revealed how anesthesiologists rose under the shadow of the pandemic. The authors acknowledged how “anesthesiologists, having a vast skill set, are extremely valuable to the COVID-19 management team.”

Anesthesiologists, who are used to working with patients requiring ventilators, have been so central in the handling of the pandemic that “even freshly passed anesthesia residents are coveted, which only accentuates the importance of the specialty.”

Pre-med and medical school students often wonder about a career in anesthesia. So, in this article, we pave the road leading to success as a future anesthesiologist. You will learn how to get to the finishing line and what aspects of the career you should be considering, step by step.

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How Hard Is It to Become an Anesthesiologist?

According to the 2021 Main Residency Match statistics, 2706 candidates competed for the 1460 available positions in anesthesiology residency programs (PGY-1 entry). 

Aspiring anesthesiologists should therefore expect almost 1 out of every two applicants to be matched in their specialty, with a rounded ratio (1.85) slightly higher – therefore more competitive – than family medicine (1.55), internal medicine (1.52), and pediatrics (1.37).

Among popular specializations, only neurology (2.01) is slightly harder to get into than anesthesiology. That said, some specializations are significantly more challenging to gain entry into, given the low number of positions offered every year. The very few dermatology programs in the US can only offer 30 positions to 265 applications received. Radiology, too, is among those selective programs that are harder to get into than anesthesiology.

While getting into residency is the hardest part of becoming an anesthesiologist, the career becomes straightforward and relatively easier from there. 

There is a growing number of fellowship programs available to graduating anesthesiology residents. A 2017 study reported how “there has been a steady increase in the number of fellowship-trained anesthesiologists,” with positions in pain management seeing “a 42.9% increase from five years earlier.” 

Another reassuring study for aspiring anesthesiologists reported in 2019 that fellowships in anesthesiology were less competitive than other subspecialties, such as gynecologic oncology, reproductive endocrinology, and pediatric or hand surgery.

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How Long Does It Take to Become an Anesthesiologist?

Like typical careers in medicine, it takes between 12 to 14 years to become an anesthesiologist. Becoming a radiologist requires an additional year, whereas a career in neurosurgery needs three more. 

Therefore, aspiring anesthesiologists have a fairly standard career route: four years of undergraduate studies, four years of medical school, four years of residency, and an optional – yet highly recommended – fellowship component within a subspecialty for one to two years.

Steps to Becoming an Anesthesiologist

To become a successful anesthesiologist, students should expect eight different steps: six required, two optional:   

  1. Get a Bachelor's degree
  2. Study and pass the MCAT
  3. Graduate from medical school
  4. Take and pass the USMLE
  5. Complete a residency program
  6. Become state licensed
  7. Consider a fellowship
  8. Get board certified

1. Get a Bachelor's Degree

There are no specific undergraduate programs aspiring anesthesiologists must enroll in. As long as they check off the course requirements for medical school and pass the MCAT with high grades, they can individualize their own undergraduate career.

Given that pharmacology is an essential component when working with anesthesia, chemistry is a popular choice for aspiring anesthesiologists . Biology, too, is helpful to demonstrate a general appreciation for how the body works.

Students should not limit themselves to traditional undergraduate paths. Psychology, too, can be viewed as essential for the practice of anesthesiologists, who routinely relieve their patients’ anxieties and fears before surgery.

We are also increasingly understanding the central nervous system as a complex machine with comparable input and output circuits. A bachelor’s degree in computer science might therefore also arouse the interest of selection committees in anesthesiology.

Students are encouraged to individualize their undergraduate careers and pick minors and electives that speak to their intellectual interests. With a tailored undergraduate background, students can demonstrate the unique perspective they bring to anesthesiology.

Students torn between different academic interests can check Inspira Advantage’s definitive guide on the best pre-med majors.

2. Study and Pass the MCAT

Most students study for the MCAT during the last stage of their undergraduate career. Flexibility and time management skills are essential since ambitious candidates should maintain a high GPA.

It is not necessary to go from college straight to medical school. Among the matriculated medical students interviewed by the Association of American Medical Colleges, more than half took a gap year. Studying for the MCAT, or improving one’s scores, is a common way to spend time off.

Inspira Advantage offers 1:1 personalized MCAT tutoring for ambitious students aiming to get into top medical schools.

3. Graduate from Medical School

Medical school offers students a holistic understanding of health. Given the general nature of the curriculum, it is natural for aspiring anesthesiologists to muse over different career paths.

One medical student explained to the Association of American Medical Colleges how he changed specialties right before Match Day. “I’ve come to view uncertainty as an opportunity to pursue emerging interests and to embrace shifting perspectives,” he told AAMC.

Therefore, aspiring anesthesiologists are encouraged to keep an open mind as they navigate medical school. The first two years of medical school are a good time for students to network with medical professionals at their respective institutions. 

Once confident about their career path, students may apply for short-term elective rotations relevant to an anesthesiologist’s skillset. These can take place at the hospital affiliated with their university or elsewhere. Johns Hopkins University offers an Anesthesia Clerkship for Medical Students open to visiting students, pairing them with a senior anesthesia resident. 

Similarly, Weill Cornell Medicine offers a Clinical Anesthesiology Elective, open to candidates from around the world. The program “welcomes fourth-year medical students for a dynamic and educational month-long experience” and exposes them to “the full breadth of anesthesiology practice.”

4. Take and Pass the USMLE

Undergraduate students had to make room for the MCAT within their four-year program. Likewise, newly-matriculated medical students should also prepare to pass the United States Medical Licensing Examination (USMLE) within the next four to five years. Here is a recommended timeline medical students can work with:

Table outlining when matriculated med students should take the USMLE

5. Complete a Residency Program

Once matched into a residency program, aspiring anesthesiologists can finally work up close with the specialty they’ve been pursuing.

In the early stages, residents can be provided with simulation-based training. For example, at the UCLA Simulation Center, “residents benefit from simulator experience at least four times during their first month of training in anesthesiology, and multiple times throughout their residency for practice in handling critical incident scenarios.”

Later on, residents are exposed to the full spectrum of the perioperative phases of surgery. According to Yale University’s calculations, each resident in their anesthesiology residency program “will be involved in approximately 400-500 anesthetics per year.” 

That said, residency programs are not just about clinical work. At the Department of Anesthesia and Perioperative Care of UCSF, residents are “relieved from all clinical duties once a month to participate in a full day dedicated to a combination of didactics, problem-based learning, simulation, mindfulness, and mentoring.”

The emphasis on continued learning is meant to provide aspiring anesthesiologists with avenues to develop their own research interests within anesthesia. At the Department of Anesthesiology & Pain Medicine within the University of Washington, residents can choose the Resident Research Track. The final-year component provided “training in research techniques and scientific methods to residents interested in academic careers.”

Students can also pair anesthesia with other medical interests prior to entering residency. For example, Johns Hopkins University offers a Combined Emergency Medicine Anesthesiology Residency Program. Spanning over six years, residents are exposed to both specialties and will be approved by both the American Board of Emergency Medicine and the American Board of Anesthesiology. 

Likewise, Stanford University offers a five-year Combined Internal Medicine/Anesthesiology Residency.

6. Become State Licensed

To practice medicine in the US, anesthesiologists must receive their medical license from the state they wish to work. Applications are straightforward, and requirements vary from state to state.

For example, to receive a license in California, candidates can complete an online application to provide a full record of their medical education.

7. Consider a Fellowship

Though optional, the American Society of Anesthesiologists strongly recommends residents pursue a fellowship following the completion of their anesthesiology program.

A fellowship is a great way to “get a foot in the door in a competitive job market, and serves as a springboard for those seeking an academic career.” It also boosts the curriculum vitae of anesthesiologists, making them attractive candidates for hiring hospitals.

Fellows have the chance to choose among a variety of subspecialties in anesthesiology. The Duke University School of Medicine offers ten anesthesiology fellowships:

Given the difference between neurosurgical anesthesiology, concerned with the brain, and hyperbaric treatment, concerned with oxygen transport, prospective fellows should be sure about their intellectual interests before narrowing them down.

The choice of fellowship is important as it might gear your career toward the proposed subspecialty. For example, if you are applying to the University of Chicago’s one-year Pediatric Anesthesiology Fellowship, the application process expects you to explain how the “completion of a pediatric anesthesiology fellowship allows you to further your goals.”

Universities, and hospitals, look for anesthesiologists who think long-term. Anesthesia is dependent on new technologies. Anesthesiologists with impressive fellowships and research output are able to understand and even foresee shifts in research trends within their specialty.

8. Get Board Certified

Another optional step an anesthesiologist can take to further their career is getting board certified.

The American Board of Anesthesiology clarified on its website the appeal of certification: “Physicians, healthcare institutions, insurers and quality organizations look for board certification as a measure of a physician’s ability to provide quality healthcare within a given specialty.”

Initial certification will require anesthesiologists to sit three exams. Only after completing a subspecialty fellowship will they be able to sit a final computerized exam and receive full certification.

Things to Consider Before Starting the Process

How can one be sure that anesthesiology is right for them? 

Before starting the process, aspiring anesthesiologists are recommended to consult residency programs in anesthesiology. The curriculum in medical school is too broad to understand the specificities of work in anesthesia. The websites of residency programs can offer a glimpse into life as an anesthesiologist.

Pay close attention to the type of rotations involved and ask yourself if it is something you see yourself doing. For example, here is a table with subspecialty rotations within the anesthesiology residency program at Yale-New Haven Hospital:

Table outlining the subspecialty rotations within the anesthesiology residency program at Yale-New Haven Hospital

Notice the diversity offered within the residency program. These fields should appeal to aspiring anesthesiologists more than typical rotations found in radiology (Mammography, Advanced Cardiothoracic, Emergency) or neurology (Epilepsy, Neuromuscular Diseases, Psychiatry).

That said, don’t let the idea of specialization intimate you. Medicine remains an interdisciplinary effort, and anesthesiology leaves ample room for medical professionals to develop other relevant interests.

For example, Columbia University prides itself in the fact that its “pain team offers a broad exposure to multidisciplinary interventions, with behavioral therapy and other holistic modalities such as nutritional care and acupuncture.”

The question “what is pain?” is, after all, as much a general philosophical question as a specialized medical one, and there are exciting debates about whether pain can be considered a pathologic entity in its own right. Anesthesiologists primarily work against pain, showing how far-reaching their specialty can be.

As the Department of Anesthesiology at Johns Hopkins University tells us: “Whatever interests you within the field of medicine, there is a way to incorporate it within a career in anesthesiology.”   

FAQs: Becoming An Anesthesiologist

Still have questions about your dream career path? We’re here for you. 

1. Is It Boring To Be an Anesthesiologist?

Not at all. That’s a popular misconception about being an anesthesiologist. While every specialty has its attending routines, anesthesiology is an exciting research field. Given its close relationship with anatomy and technology, an anesthesiologist constantly learns and applies something new to their field.

2. Is Anesthesiology a Dying Field?

The growing number of Certified Registered Nurse Anesthetists has made some aspiring anesthesiologists worried about the future of their career. One anesthesiologist predicted technology will reduce workload and the need for “minute-to-minute manual fine-tuning” by anesthesiologists. 

Despite the general shortage of CRNAs, aspiring anesthesiologists should remember that being an expert in a specific subspecialty can make them indispensable for hospitals. Anesthesiology is more than clinical work, and many anesthesiologists become crucial focal points in interdisciplinary teams in neurology, emergency medicine, and pediatrics.

3. Does Anesthesiology Come With a Balanced Lifestyle?

Yes, anesthesiologists generally have a balanced lifestyle. Padma Gulur, an anesthesiology and pain medicine specialist interviewed by the American Medical Association, chronicled her past fellowships, and she thinks in anesthesiology, “training programs provide adequate work-life balance.” 

She has also described her day-to-day life: she “usually arrives at the hospital around 7:30” and the day ends when the work is done, usually by 5 p.m.”

4. Will I Be Able to Get International Experience On My Way to Becoming an Anesthesiologist?

Absolutely. Besides studying abroad during college and taking electives or clerkships in different countries, aspiring anesthesiologists can also add global components to their residency experience. 

UC San Diego described the open nature of its anesthesiology residency program and even noted how “one resident lectured on regional anesthesia in Vietnam with one of our faculty members.”

5. What Level of Math Do You Need to Become an Anesthesiologist?

Anesthesiologists must often take the role of pharmacists and nurses, so dosage and calculations are a crucial component of their work. Careers in radiology or neurosurgery would require a more advanced level of mathematics than an anesthesiologist.

6. Is an Anesthesiologist Highly Paid?

Definitely, in 2020, Forbes compiled a list of how much anesthesiologists make in every US state. Whereas the average annual salary is $261,730, the highest earners in anesthesiology come from Wyoming ($281,070).

Final Thoughts 

Anesthesiology is an exciting field, both clinically and academically. Becoming an anesthesiologist is a long process, but it is not more difficult than the average career in medicine. 

If your dream is to work in anesthesia, book a free consultation with Inspira Advantage to succeed every step of the way.

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