American Society of Anesthesiologists - Learn More - AAs

Certified anesthesiologist assistants are highly trained master’s degree level non-physician anesthesia care providers whose function is similar to a specialized physician assistant for physician anesthesiologists. The certified anesthesiologist assistant profession was established in the late 1960s by physician anesthesiologists. After studying the educational pathway for physician anesthesiologists and nurse anesthetists, physician anesthesiologists created a new educational paradigm for a mid-level anesthesia practitioner emphasizing a science/pre-medical – rather than nursing – background in college. This person would perform the same job as nurse anesthetists but could seek admittance to medical school if appropriate. The founders recognized early the advantage of a strong pre-medical background in comparison to the nursing education background of the nurse anesthetist profession.

To date, CAAs may practice in 17 jurisdictions and Guam:
• Alabama
• Colorado
• District of Columbia
• Florida
• Georgia
• Guam
• Kentucky
• Indiana 
• Michigan (delegatory authority)
• Missouri
• New Mexico
• North Carolina 
• Ohio
• Oklahoma
• South Carolina
• Texas (delegatory authority)
• Vermont
• Wisconsin

The federal government, specifically the Medicare Program, and numerous states recognize certified anesthesiologist assistants and nurse anesthetists as being qualified anesthesia providers who have identical clinical capabilities and responsibilities while working in the Anesthesia Care Team model. For decades, the Anesthesia Care Team has safely and effectively delivered anesthesia care with either an certified anesthesiologist assistant or nurse anesthetist as the non-physician anesthetist member of the team.

It is the position of ASA that both certified anesthesiologist assistants and nurse anesthetists have identical patient care responsibilities and technical capabilities – a view in harmony with their equivalent treatment under the Medicare Program. Certain differences do exist, however, between certified anesthesiologist assistants and nurse anesthetists with regard to educational program prerequisites, instruction, and requirements for supervised clinical practice. For example, nurse anesthetist programs require a nursing degree and one year of critical care experience, while certified anesthesiologist assistant programs require a bachelor's degree emphasizing pre-medical, science-based coursework. Additionally, certified anesthesiologist assistants must practice under the supervision of a physician anesthesiologist. In no way is this a mark of inferiority but rather a realistic recognition that non-physician anesthetists must work within the relationship of a physician anesthesiologist to best ensure patient safety and optimal delivery of care.

To learn more about the importance of the patient centered, physician-led anesthesia care team, visit or contact

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