Statement on Students Involved in Anesthesia Care

Developed by: Committee on Anesthesia Care Team
Approved by: ASA House of Delegates on October 13, 2021

Anesthesiology is the practice of Medicine. The World Health Organization (WHO), the World Federation of Societies of Anesthesiologists (WFSA), and the American Society of Anesthesiologists (ASA) as well as other national non-USA anesthesiology societies believe that anesthesia should be provided, led and overseen by a Physician Anesthesiologist.^1,2

In the United States of America, most anesthesia care is either provided by a physician anesthesiologist alone or provided within the context of a physician-led anesthesia care team utilizing one of the following models.^3,4

1. A physician anesthesiologist supervising/directing a physician resident or fellow (a licensed physician in an ACGME accredited anesthesiology residency or fellowship).
2. A physician anesthesiologist supervising/directing a non-physician anesthesia clinician – certified anesthesiologist assistant (CAA) or a certified registered nurse anesthetist (CRNA).

All other anesthesia trainees are students (defined below) and therefore, are not qualified clinicians. Students should provide anesthesia care ONLY in the presence of a physician anesthesiologist, physician fellow or resident, CAA, or CRNA, while participating in one of the models listed above. The use of students in place of qualified anesthesia providers is inappropriate as well as inconsistent with the ASA Guidelines for the Ethical Practice of Anesthesiology.⁵

Definition of Students involved in Anesthesia Care:

1. Medical Student
2. Student Registered Nurse Anesthetist
3. Student Anesthesiologist Assistant

References

1. Gelb A et al. World Health Organization-World Federation of Societies of Anaesthesiologists (WHO- WFSA) International Standards for a Safe Practice of Anesthesia.
2. Anesth Analg 2018; 126:2047-2055 https://journals.lww.com/anesthesia-analgesia/fulltext/2018/06000/ world_health_organization_world_federation_of.39.aspx
3. World Federation of Societies of Anaesthesiologists , World Anesthesiology Workforce Map, https:// wfsahq.org/resources/workforce-map/
4. ASA Statement on Anesthesia Care Team, https://www.asahq.org/standards-and-guidelines/statement-on- the-anesthesia-care-team
5. ASA Statement on Physician Led Anesthesia Care, https://www.asahq.org/standards-and-guidelines/ statement-on-physician-led-anesthesia-care
6. ASA Guidelines for the Ethical Practice of Anesthesiology, https://www.asahq.org/standards-and- guidelines/guidelines-for-the-ethical-practice-of-anesthesiology