How to become an anesthesiologist

Anesthesia is an extremely important part of any serious medical procedure, because it enables the patient to be put to sleep (total anesthesia), and to numb small areas of the body (local and regional anesthesia). Medical experts who specialize in administering anesthesia are known as anesthesiologists.

What does an anesthesiologist do

It is a very responsible job upon which the success of any surgical procedure depends. Although it may seem that the only thing the job entails is releasing the anesthetic, the process is far more complex than that. In general, the anesthesiologist’s work with a patient can be divided into three stages: 

• Preparation for surgery – the anesthesiologist gets acquainted with the patient and their general condition. During the assessment, anesthesiologists conduct interviews so as to learn as much detail on the patient’s health and specific medical conditions that could affect the operative and postoperative process (e.g. diabetes or asthma). It is also important to learn if the patient takes any medications or supplements. In addition, parameters such as weight and age are important to make a plan for administering the anesthetic during surgery. 

• Operating room – anesthesiologists monitor the patient’s parameters, dosing the anesthetic to control the pain. In the case of total anesthesia,  anesthesiologists monitor the patient’s vital signs to keep them stable during the procedure. In case of complications, the anesthesiologist must react quickly, never losing sight of the patient’s health condition (high blood pressure, heart rate, asthma, etc.). During surgery, an anesthesiologist works alone, or in a team where he/she is usually assisted by a nurse anesthetist.

• Postoperative process – in case of total anesthesia, it is necessary to wake up and stabilize the patient, after which he is transferred to the recovery unit and monitored by an anesthesiologist in order to assess the postoperative recovery process and the effects of anesthesia.  

Even after the patient’s release from hospital, an anesthesiologist can be involved in the recovery process, recommending pain medicine and pain relief treatments. 

How long does it take to become an anesthesiologist?

Due to the complexity and responsibility of the job, it takes about 14 years for a person to become a licensed anesthesiologist. The education process involves a four-year college or university study program, after which one needs to enrol in medical school. Upon graduation, a student becomes an anesthesiologist, but they still cannot work without supervision, because they have yet to improve their skills and acquire the necessary experience. 

Formal education is followed by a four-year residency, and a one-year fellowship program, or two-year private practice. During the entire process, future anesthesiologists are required to take certain tests after each step so as to prove that they have successfully mastered each stage of their education and training.  

Best schools for anesthesiology

Anesthesiology is a complex field of medicine, which is why one needs to acquire the best possible knowledge. Many U.S. universities are known as excellent schools of anesthesiology, especially: 

• University of California -San Francisco
• Harvard University
• Johns Hopkins University
• Columbia University
• Stanford University
• The University of Washington

There are many other universities and colleges that offer great programs of this kind, and one should not neglect highly regarded universities abroad. Whichever school you pick, keep in mind that obtaining a license for practicing anesthesiology demands a lot of effort and determination.  

Anesthesiologist degrees, certifications and licenses needed for a successful career

Many anesthesiologists realize what they want to do only during medical studies, because before that, they are primarily interested in medicine as a whole, or a specific area such as surgery. Given that the road to a license is very long, it is perfectly normal for a student to change their mind during this time. What is important, however, is to take the education process seriously, to possess the desire to help others, and to be prepared for all the specifics of medical practice. 

1. Undergraduate studies

The first step in this process is obtaining a bachelor’s degree. Although the bachelor program one needs to complete to become an anesthesiologist is not strictly defined, it is logical to focus on sciences, i.e. courses such as mathematics, physics, biology and chemistry, regardless of the chosen major. The knowledge of these subjects is necessary to pass the Medical College Admission Test (MCAT) which is required to enrol in medical school after obtaining a bachelor’s degree. Although students usually choose this path toward medical school, there is a shorter way, but it demands great commitment to one’s studies. 

BS/MD programs

After finishing high school, it is possible to apply for direct medical programs, i.e. BS/MD programs. These study programs enable students to obtain a bachelor’s degree, immediately followed by a doctor of medicine degree. Although the program usually lasts eight years, the same as when one obtains a bachelor’s degree and then goes to med school, there are significant differences.  

For starters, by enrolling in this study program, one needs to make a definite decision on choosing medicine as their profession much earlier than they would normally have to. However, the benefit of enrolling in this program is the fact that students do not have to apply for medical school and go through the enrollment process again. In addition, this program offers numerous benefits and greater freedom of education (because by enrolling in this program, students automatically “reserve a spot” in medical school). 

Although it does seem fantastic, this program comes with a few requirements that must be met. First – enrollment. Direct medical programs are reserved only for the best students who are ready to meet very strict educational standards. Suffice to say that the acceptance rate is 1-10%, meaning that competition is very stiff. 

Even after enrollment, it is necessary to maintain a high GPA, and many med schools insist on taking the MCAT so that their students would prove they indeed possess the necessary knowledge (even though by enrolling in a BS/MD program, they are as good as accepted). In conclusion, students of this program do not have to worry about choosing the right medical school after acquiring a bachelor’s degree, provided that they maintain the required GPA during studies. 

2. Medical school

Medical schools are educational institutions that train future doctors, who acquire a medical degree as proof of their knowledge and skill. Taking the MCAT is not the only requirement that a premed student must meet. There are several requirements that should be taken into account when preparing for enrollment. 

Good results in college or university 

The chosen major can play a decisive role in admission, even if it is not directly related to medicine. Given that the competition is stiff, commitment to a field of study other than medicine gives the impression that a student is highly skilled and capable of covering several disciplines at once. Whichever field of study is chosen as a major, top grades are a must, as well as excellent knowledge of the chosen courses in the field of sciences. 

Successfully passing the Medical College Admission Test

It is a standardized, multiple-choice test the purpose of which is to assess the knowledge of candidates for enrollment. Based on it, the school assesses the knowledge of the key areas needed for medical studies, critical thinking, problem-solving skills, etc. The test covers four areas:

• Biological and Biochemical Foundations of Living Systems
• Critical Analysis and Reasoning Skills
• Chemical and Physical Foundations of Biological Systems
• Psychological, Social, and Biological Foundations of Behavior

Tests are organized several times a year, the wait time for the results is about 35 days (the average result is 500), and applying for the MCAT costs about $320. Most medical schools in the U.S. require MCAT test results for admissions. 

Medical licence and board certification

The next step in one’s professional career, after completing med school is obtaining a medical license. The specific requirements depend on the federal state where the candidate applies for the license. When the necessary requirements are met, it is possible to take the Medical Licensing Examination (USMLE) which consists of three steps:

• USMLE Step 1 – checking the necessary knowledge acquired during studies, and needed for practicing medicine. The knowledge of the following areas is tested: Anatomy, Behavioral sciences, Biochemistry, Microbiology, Pathology, Physiology and Pharmacology.
• USMLE Step 2 Clinical Knowledge (CK) – the candidate’s ability to analyze a patient, perform triage, and reach a solution in agreement with the patient and other doctors is tested.
• USMLE Step 3 – final exam where the candidate’s ability needed for unsupervised practice of medicine and monitoring the patient’s care process is tested. This involves seeking lab tests, deciding whether to send a patient to a specific ward for treatment, monitoring treatment, solving crisis situations, and other activities involved in the treatment process. 

Residency program for anesthesiologists

Residency is a training process during which graduates of medicine acquire the necessary experience. Applying for residency is commonly done within The Accreditation Council for Graduate Medical Education (ACGME), an organization that defines and oversees the standards necessary for physician training and their preparation for a professional career in medicine. After medical school, doctors apply for ACGME accredited programs which usually last four years.  

The first year is an introduction to hospital practice and the principles of critical care medicine and problem solving. The next three years are dedicated to specialist training in the field of clinical anesthesia, and these years are designated as CA-1, CA-2 and CA-3. After completing the four-year program, it is considered that the candidate is ready to practice medicine independently. After successfully completing an anesthesia training program, the candidate receives a Certificate of Completion of ACGME accredited program. In order to do that, they need a certificate issued by the American Board of Anesthesiologists. 

However, further training is also available through one-year fellowship programs. A Fellowship program offers additional training and specialization in a chosen field, such as Adult Cardiothoracic Anesthesiology fellowship or Pain Medicine fellowship. In some cases, it is possible to complete this program during residency.   

Subspecialty

Many doctors are interested in continuing education, because they want to focus on particular areas of anesthesiology. Subspecialities they can choose between include: cardiothoracic anesthesiology, critical care anesthesiology, pediatric anesthesiology, etc. Approving a subspecialization requires a candidate to go through all the aforementioned processes of accreditation. After that, they need to pass the exam of the American Board of Anesthesiologists which represents a certificate of acquired knowledge.   

How much does an anesthesiologist make? 

According to the official data of the U.S. Bureau of Labor Statistics, the mean annual salary of an anesthesiologist is $271.440, but, depending on their experience, subspecialization, and position, it can go over $450.000. These amounts primarily illustrate the importance of this profession and the responsibility it entails, as well as the fact that it can be done only by those who truly love working with patients. It should always be borne in mind that being an anesthesiologist demands a lot of effort and self-denial, not only during studies, but also throughout one’s professional career.