Anesthesia as a Career
What is a Physician 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.
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.
Physician anesthesiologists in the United States complete a four year undergraduate college degree that includes satisfying pre-med requirements. Like other medical doctors, they must follow undergraduate education with four years of medical school. After medical school, a physician specializing in anesthesiology completes a four-year anesthesiology residency program.
Following completion of a residency program, residents are eligible to sit for the American Board of Anesthesiology (ABA) exam. Almost 75 percent of physician anesthesiologists are board certified.
Although physician anesthesiologists complete a minimum of eight years of medical training after college, following residency, many also complete an additional fellowship year of specialty training in specific areas such as pain management, cardiac anesthesia, pediatric anesthesia, neuroanesthesia, obstetric anesthesia or critical care medicine.
Physician anesthesiologists may also seek certification in one of the following subspecialties, which require additional training and examinations: Critical Care Medicine, Hospice and Palliative Medicine, Pain Medicine.
What is an Anesthesiology Assistant?
Anesthesiologist assistants complete a four year undergraduate college degree that includes satisfying pre-med requirements. Anesthesiologist assistants are highly skilled health professionals who have satisfactorily completed an accredited anesthesiologist assistant education program. Upon completion of an accredited AA program, a student may become certified by passing the National Commission for Certification of Anesthesiologist Assistants examination (NCCAA). Performance information for test items and the overall exam are provided by the National Board of Medical Examiners (NBME).
AAs are trained extensively in the delivery of safe and high quality anesthesia care, as well as advanced patient monitoring techniques. As nonphysician anesthetists, AAs work under the direction of licensed physician anesthesiologists to implement anesthesia care plans. An AA may not practice outside the field of anesthesia or apart from the supervision of an anesthesiologist.
What is a Nurse Anesthetist?
A nurse anesthetist is registered nurse who has satisfactorily completed an accredited nurse anesthesia training program. In 1980 the American Association of Nurse Anesthetists mandated that all applicants to nurse anesthetist programs must have a minimum of a Bachelor of Science (but not necessarily a bachelor’s degree in nursing) — a requirement that took effect in July 1987. Nurses must gain at least one year of practice experience before entering an accredited nurse anesthesia training program. Following completion of a 2 to 3 year program they are required to pass a national certification examination.
Nurse anesthetists are nonphysician anesthetists who specialize in the provision of anesthesia care and participate in the administration of anesthesia in a variety of surgical cases. They are frequently supervised by a physician anesthesiologist, but may also work under the supervision of other physicians.
What is an Anesthesia Care Team?
Directed by a physician anesthesiologist, the Anesthesia Care Team consists of physician anesthesiologists supervising qualified nonphysician anesthesia providers and/or resident physicians in training in the provision of anesthesia care.
In an Anesthesia Care Team, physician anesthesiologists may delegate patient monitoring and appropriate tasks to nonphysician anesthesia providers while retaining overall responsibility for the patient.
Members of the Anesthesia Care Team work together to provide the optimal anesthesia experience for all patients. Core members of the anesthesia care team include both physicians (anesthesiologist, anesthesiology fellow, anesthesiology resident) and nonphysicians (anesthesiologist assistant, nurse anesthetist, anesthesiologist assistant student, student nurse anesthetist). Other health care professionals also make important contributions to the perianesthetic care of the patient.
To provide optimum patient safety, the physician anesthesiologist directing the Anesthesia Care Team is responsible for management of team personnel, patient preanesthetic evaluation, prescribing the anesthetic plan, management of the anesthetic, postanesthesia care and anesthesia consultation.
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