How to Become an Anesthesiologist

February 23, 2024


Reviewed by:

Akhil Katakam

Third-Year Medical Student, Lewis Katz School of Medicine at Temple University

Reviewed: 2/23/24

How does one become an anesthesiologist in the first place? Is it harder than other specialties? Read on below to learn more about how to become an anesthesiologist. 

A recent study revealed how anesthesiologists rose under the shadow of the pandemic. Anesthesiologists, who are used to working with patients requiring ventilators, were central in handling the pandemic: “Even freshly passed anesthesia residents are coveted, which only accentuates the importance of the specialty.” 

Pre-med and medical school students may wonder if anesthesia is right for them. We'll discuss the path to becoming an anesthesiologist, outlining the necessary steps, exploring job prospects, and helping you determine if this specialization aligns with your aspirations.

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Steps to Becoming an Anesthesiologist

To become a successful anesthesiologist, students must complete six steps (and 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 (optional)
  8. Get board certified (optional) 

Let’s dive into the steps to becoming an anesthesiologist.

1. Get a Bachelor's Degree

There are no specific college programs aspiring anesthesiologists must enroll in. As long as they meet med school course requirements and perform well on the MCAT, they can choose any bachelor’s degree.

However, some majors are particularly helpful for students interested in becoming anesthesiologists: 

  • Chemistry: Pharmacology is essential to an anesthesiologist’s role 
  • Biology: Helps students understand the systems of living things 
  • Psychology and other “unrelated” degrees: Anesthesiologists work with patients and routinely relieve their fears or anxieties

However, you should pick whichever major interests you most. You can supplement your major with minors and electives to meet med school requirements. 

2. Take the MCAT

Most students spend at least three to six months studying for the MCAT. Many students take the MCAT in the same academic year they plan to apply to medical school. 

However, going from college straight to medical school is unnecessary. A recent AAMC study shows more than 44% of matriculants took a gap year. Many students use this time to study for the MCAT or improve their scores. 

It’s crucial to develop an excellent MCAT study plan to succeed. Many students may find seeking an MCAT tutor’s help worth it! 

3. Graduate From Medical School

Medical school prepares students to become physicians. You’ll explore different specialties throughout your four years at med school. The first half of med school is perfect for networking and building foundational scientific knowledge. 

You can apply for elective rotations once you’re confident anesthesiology is right for you. These take place at an affiliated hospital or elsewhere. For example, Johns Hopkins University offers an Anesthesia Clerkship for Medical Students to students, pairing them with a senior anesthesia resident. 

Similarly, Weill Cornell Medicine offers a Clinical Anesthesiology Elective open to candidates worldwide. 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

Medical students should also prepare to pass the United States Medical Licensing Examination (USMLE). Here’s a recommended timeline medical students can work with:

Step Exam Duration When Should I Take It?
Step 1 1 day Preferably at the end of your second year of med school
Step 2 2 days Preferably in your fourth year of medical school
Step 3 2 days Preferably after your first year of residency

5. Complete a Residency Program

Once you match, you can finally work up close with anesthesiology. In the early stages, residents can do 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 perioperative phases of surgery. According to Yale University’s calculations, each resident in their anesthesiology program “will be involved in approximately 400-500 anesthetics per year.” 

You’ll complete your residency under a doctor’s supervision. Your residency provides the tools you need to become a fully-fledged anesthesiologist. 

6. Become State Licensed

To practice medicine in the U.S., anesthesiologists must obtain licensure in the state they wish to work in. Requirements can vary by state. For example, to receive a California license, candidates can complete an online application to provide a full record of their medical education.

7. Consider a Fellowship

While not a mandatory anesthesiology education requirement, the American Society of Anesthesiologists strongly recommends residents pursue a fellowship.

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 CV of anesthesiologists, making them attractive job candidates.

Fellows can choose among various anesthesiology subspecialties. Some specialties include

  • Adult Cardiac Anesthesiology 
  • Clinical Informatics 
  • Critical Care Medicine 
  • Obstetric Anesthesiology 
  • Pain Medicine 
  • Pediatric Anesthesiology 
  • Pediatric Cardiac Anesthesiology 
  • Regional Anesthesiology, And Acute Pain Medicine

Consider a fellowship for additional schooling anesthesiologists use to level up their skills and knowledge. 

Universities and hospitals seek anesthesiologists who think long-term and have specialized skills. Anesthesia is dependent on new technologies. Anesthesiologists with impressive fellowships and research output can understand and foresee shifts in trends within their specialty.

8. Get Board Certified

Another optional step an anesthesiologist can take is getting board certified. The American Board of Anesthesiology clarified 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 requires you to sit for three exams. After completing a subspecialty fellowship, you can sit for a final exam and receive full certification.

What Does an Anesthesiologist Do? 

Anesthesiologists are doctors who “specialize in anesthesia care, pain management, and critical care medicine.” They care for patients before, during, and after surgery by ensuring they’re fit it, monitoring them while unconscious, and caring for them post-op. 

Anesthesiologists are in charge of handling care, including: 

  • General anesthesia: Used for major operations, this type of anesthesia renders patients unconscious through an IV or mask. 
  • Monitored anesthesia or IV sedation: Used for “minimally invasive procedures” such as colonoscopies, these types of anesthesia can simply make you drowsy or unable to remember your procedure. 
  • Regional anesthesia: Typically used in surgeries of arms, legs, abdomens, and during childbirth, this type of anesthesia numbers a large portion of your body. 
  • Local anesthetic: this type of anesthesia is used in procedures such as stitching a laceration or setting a bone – it numbs a small portion of your body. 

Anesthesiologists participate in all types of procedures and surgeries, from open-heart surgery to getting stitches. 

How Hard Is It to Become an Anesthesiologist?

According to Main Residency Match statistics, 2,691 candidates competed for the 1,509 available anesthesiology residency program positions(PGY-1 entry). Data from other specialties can show you how hard it is to become an anesthesiologist in comparison: 

Specialty Available Positions Number of Applicants % Filled
Anesthesiology 1,609 2,959 99.8
Family Medicine 5,088 6,927 88.7
Internal Medicine (Categorical) 9,725 14,231 96.1

Source: National Residency Match Program 

While dermatology and neurology are more competitive than anesthesiology, the other specialties on this list are less competitive. 

How Long Does It Take to Become an Anesthesiologist?

Like typical medical careers, it takes between 12 to 14 years to become an anesthesiologist. Future anesthesiologists have a fairly standard career route: 

  • Four years of undergraduate studies
  • Four years of medical school
  • Four years of residency

However, how long it takes to be an anesthesiologist depends on whether or not you pursue a fellowship. 

Anesthesiologist Salary & Job Outlook

According to the Bureau of Labor Statistics, the mean annual wage for anesthesiologists is $302,970. However, the annual wage you can expect to earn can be higher or lower depending on where you work. 

For example, anesthesiologists working in physician offices make $428,676  on average annually, while those working in outpatient care centers make $373,720. Between now and 2031, the employment growth for anesthesiologists is estimated to increase by 1%. 

According to U.S. News, these are the top-paying cities for anesthesiologists: 

City Average Salary
Greenville, South Carolina $440,750
Tallahassee, Florida $432,590
Portland, Oregon $411,680
Fort Wayne, Indiana $406,220
Omaha, Nebraska $389,310

Source: U.S. News

Is Anesthesiology Right for You?

How can you be sure that anesthesiology is right for you? Before starting the process, it’s recommended to consult with anesthesiology residency programs. The med school curriculum is broad – evaluating residency programs can offer a glimpse into life as an anesthesiologist.

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

Obstetric Anesthesia
Pediatric Anesthesia
Cardiac Anesthesia
Anesthesia for Thoracic and Vascular Surgery Neuroanesthesia
Ambulatory Anesthesia
Orthopedic Anesthesia
ENT Anesthesia Critical Care Medicine
Pre-Surgical Evaluation Clinic
Integrated Pain Management
Chronic Pain
Regional Anesthesia Non-Operating Room Anesthesia
Post Anesthesia Care
Obstetric Anesthesia
Pediatric Anesthesia
Cardiac Anesthesia
Anesthesia for Thoracic and Vascular Surgery Neuroanesthesia
Ambulatory Anesthesia

Notice the diversity offered within the program. However, don’t let the idea of specialization intimidate you. Medicine remains an interdisciplinary effort and anesthesiology leaves room for professionals to develop other interests.

As the Department of Anesthesiology at Johns Hopkins University puts it: “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 how to become an anesthesiologist? We’re here for you. 

1. Is Becoming an Anesthesiologist Hard?

The process is long, and residencies can be somewhat competitive. You’ll also need to gain extensive skills and knowledge to succeed. Becoming an anesthesiologist can be considered difficult, although certainly doable! 

2. How Long Is an Anesthesiology Residency Program? 

Anesthesiology residency programs are typically four years long. 

3. Is Becoming an Anesthesiologist Worth It? 

If you’re passionate about anesthesiology, pursuing it is worth it. If you’ve considered how long you’ll spend in school, the cost, and other factors and still want to become an anesthesiologist, you should go for it!

4. How Much Do Anesthesiologists Make?

According to the BLS, the average anesthesiologist’s salary is $302,970

5. Are Anesthesiologists Doctors? 

Yes: the educational requirements to become an anesthesiologist include attending medical school and obtaining an MD or DO. 

6. What Are the Requirements to Become an Anesthesiologist?

Anesthesiologists must finish college and medical school before completing a residency program and earning state licensure. Although not a requirement, you can pursue a fellowship, but this influences how long it takes to become an anesthesiologist.

7. Do You Need a Lot of Math to Become an Anesthesiologist? 

Anesthesiologists use math to calculate dosages for patients. However, you must also have an excellent command of science (and math) to get into medical school. 

8. Is It Stressful to Be an Anesthesiologist?

Any position in medicine can be a stressful profession – however, the responsibility of a patient’s life, long hours, and short staffing can make an anesthesiologist’s job quite stressful. However, these stresses are worth it if you’re invested in the specialty. 

9. What College Has the Best Anesthesiology Program?

According to U.S. News, Johns Hopkins University has the nation’s best anesthesiology program. 

10. What Are the Skills Needed to Be an Anesthesiologist?

Anesthesiologists must have excellent technical skills to perform their roles. They must also be compassionate, honest, and excellent communicators. 

Final Thoughts 

Anesthesiology is an exciting field, both clinically and academically. Becoming an anesthesiologist is a long process, but it’s worth it if you’re passionate about the specialty. If your dream is to work in anesthesia, book a free consultation with Inspira Advantage to discuss how we can help you achieve your goals!

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