What Does a Career in Anesthesiology Look Like?

With the best-paying job in the U.S., anesthesiologists are highly trained and in-demand physicians who administer anesthesia during surgery.

Updated July 5, 2023

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As one of the highest-paying jobs in the United States, anesthesiologists earn an average annual salary of $302,970, according to the Bureau of Labor Statistics (BLS). These healthcare professionals perform a crucial healthcare function and are in high demand.

Anesthesiologists are highly trained physicians who administer general, local or regional anesthesia to control pain and keep patients appropriately anesthetized during surgery. While surgeons may apply their expertise in the operating room with a scalpel, positive surgical outcomes wouldn't be possible without the collaboration of an expert anesthesiologist.

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What Do Anesthesiologists Do?

Anesthesiologists are physicians who specialize in sensation and pain management. They typically administer and monitor local, regional, or general anesthesia or sedation before, during, or after medical procedures, like surgery.

Other responsibilities include:

There are many anesthesiologic techniques, with local, regional, general, and epidural anesthesiology being the most common. Full sedation is usually provided for patients undergoing major procedures, like joint replacement or open heart surgery. Regional anesthesia is typically provided for childbirth and surgeries of the extremities or the abdomen.

Depending on the technique, anesthesiologists may use tools like masks or needles, along with monitors to track patient vitals. Anesthesiologists typically work alongside surgeons, nurse anesthetists, and other doctors.

Where Do Anesthesiologists Work?

Anesthesiologists typically work in rural and urban hospitals, clinics, private offices, and ambulatory care facilities.

An anesthesiologist's schedule varies considerably, even across similar settings. Some private practices offer traditional Monday-Friday hours, but most anesthesiologists work 40-60 hours per week, either on-call or on rotational, night, and weekend shifts. Anesthesiologists can also work in universities, training the next generation of professionals.

What Skills Do Anesthesiologists Need?

Prospective anesthesiologists must be dedicated and detail-oriented. They also need to work well under pressure and have excellent problem-solving skills. Because patient satisfaction with anesthesia is a key measure of quality healthcare, anesthesiologists also need strong interpersonal and communication skills.

How to Become an Anesthesiologist

Becoming an anesthesiologist involves several stages of training. In general, anesthesiologists must complete:

  • A four-year bachelor's degree
  • A four-year medical degree
  • Four years of residency

Next, they must pass the national board exam, complete a fellowship program or spend two years in private practice, acquire certification, and take a licensing exam.

Once licensed, all anesthesiologists must regularly complete continuing education courses to maintain and update their skills.

Anesthesiology Education

Physicians who specialize in anesthesiology begin their academic careers with an undergraduate degree from an accredited college or university, typically majoring in pre-med or science.

They take courses in biology, calculus, chemistry, and physics, which helps prepare them for the Medical College Admission Test (MCAT) and medical school. However, most medical schools do not require applicants to take these courses or have a bachelor's degree in any of these subjects for admission. Successful physicians could have undergraduate degrees in various fields, including anthropology, English, or pre-law.

The MCAT is required for admission to medical school. Along with evaluating candidates' analytical skills, it tests their knowledge of biology, chemistry, psychology, and sociology. With MCAT scores in hand, prospective anesthesiologists can apply to medical school, where they must earn either a doctor of medicine (MD) or doctor of osteopathic medicine (DO).

At the end of two years of coursework, students take a test called Step 1 — often referred to as "Boards." Boards are required by the United States Medical Licensing Examination (USMLE) for MDs and by the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) for DOs to obtain a medical license and practice medicine.

After the Boards, anesthesiology students must complete two years of clinical training, working with patients with a variety of conditions under the supervision of an experienced physician.

Clinical training concludes with the Step 2 test, which has two parts:

  1. A written test on internal medicine, gynecology, preventive medicine, and surgery
  2. An assessment of clinical skills, including communication and interpersonal skills and proficiency in English

Anesthesiology Residency

To enroll in a residency program, prospective anesthesiologists must:

  • Complete an application that highlights their competitive USMLE or COMLEX-USA scores
  • Perform well during anesthesiology rotations
  • Provide strong letters of recommendation

On an annual Match Day, a computer program aligns candidates with residency programs based on their preferences and performances.

Once a match is made, residency programs for anesthesiologists take four years to complete. The first year is a "base year" of non-anesthesia training, followed by three years of focused clinical anesthesia training.

Residents take the final Boards exam or Step 3 at the end of their base year. This exam involves both a written portion and case simulations, which test whether physicians can apply their training in ambulatory settings while treating a wound or diagnosing a patient.

Anesthesiology Certification and Licensure

Like all physicians, anesthesiologists must earn and maintain a national Board license and meet any state-specific requirements before they can practice, which generally requires 1-4 years of postgraduate training. To practice within a specialty, anesthesiologists must earn additional specialist certifications.

Anesthesiologists have several options when it comes to earning certifications. One certifying body is the American Board of Anesthesiology (ABA). Its process requires a one-year internship in anesthesia, followed by a fellowship program or two years in private practice and successful completion of three exams.

Prospective anesthesiologists take the first written exam — the basic exam — after the first year of their internship and the second — the advanced exam — at the end of their residency. The final exam is the applied exam, and it has two elements: a standardized oral examination and an objective structured clinical examination.

A second certifying body is the American Board of Physician Specialties (ABPS). To earn this certification, candidates must meet eligibility requirements and complete both a written and an oral exam.

Once licensed, an anesthesiologist's schooling is not over. All physicians must regularly complete continuing education courses to maintain and update their specialized certifications.

To maintain valid certification with the ABA, anesthesiologists must earn 125 continuing medical education credits (CMEs) by the end of their fifth year and another 100 by the end of their tenth year. ABPS license renewal requirements also include CMEs, plus self-assessment questions and medical ethics courses.

What to Consider When Evaluating an Anesthesiology Program

When selecting an MD or a DO, prospective anesthesiologists should only consider accredited programs. Attending an unaccredited program will not qualify you for licensure.

Both MDs and DOs can specialize in anesthesiology. So students should consider whether they want to receive training in whole-person patient care and preventive medicine, as in a DO program, or whether they prefer the conventional Western medicine training in an MD program.

Prospective medical students should also weigh the reputation, location, and cost of potential medical schools, along with the benefits of programs with online components.

Anesthesiology Career Information

Becoming an anesthesiologist is a time-consuming and expensive process, so it makes sense to wonder, "How much does an anesthesiologist make?" The answer varies by location, but all that required training translates into an average anesthesiologist salary of around $300,000.

Salary and Job Growth for Anesthesiologists

Median Salary

Job Growth (2021-2031)

Source: BLS

Similar Careers

Nurse Anesthetists

Certified registered nurse anesthetists (CRNAs) are advanced practice nurses who work alongside anesthesiologists. Typical responsibilities include administering anesthesia or analgesics before, during, and after medical procedures, providing pain management, and offering emergency services.

Becoming a CRNA requires a master's degree from an accredited program, which takes 2-3 years to complete. CRNAs are in high demand, especially in rural areas, and are among the most highly paid healthcare professionals. Depending upon where they work, CRNAs may be their facility's only anesthesia provider.


Like anesthesiologists, surgeons are specialized physicians who perform operations to treat disease or correct injuries. Some work as general surgeons, while others specialize in areas like orthopedics, neurology, or plastic surgery.

Surgeons make diagnoses, perform operations, and provide post-operative care. They often work alongside anesthesiologists, operating room nurses, and physician assistants. The residency period for surgeons typically lasts 3-8 years, and they are among the most highly paid professionals in the medical field.

General Practitioners

General practitioners are also known as family doctors or primary care physicians (PCPs). These physicians have earned either an MD or a DO and completed their residencies, typically while working in family or internal medicine. As a result, they have a broad medical knowledge base.

Like anesthesiologists, general practitioners can work in a variety of settings, including private practice and hospitals. General practitioners see patients for acute or short-term care, preventative medicine, and general health maintenance. They are responsible for making diagnoses, prescribing treatments, ordering tests, and interpreting results, and they often refer patients to specialists after making an initial diagnosis.

Interview With an Anesthesiologist

To understand what a career in anesthesiology looks like, we have interviewed an expert in the field. Learn more about his experiences.

Portrait of Dr. Taylor Graber

Dr. Taylor Graber

Dr. Taylor Graber is an MD with a background in anesthesiology. Born and raised in Arizona, Dr. Graber attended Arizona State University and received a bachelor's degree in biomedical engineering. He completed medical school at the University of Arizona College of Medicine-Phoenix and residency training in anesthesiology at the University of California, San Diego.

Dr. Graber founded ASAP IVs because he wanted to help patients receive the benefits of IVs without the time, cost, and energy of going to the emergency room. When not working, he enjoys staying active by running, golfing, hiking, playing basketball, and enjoying all of the sun San Diego has to offer.

Why Become an Anesthesiologist?

What are some challenges and high points in this role?

Most patients are healthy and perform well under anesthesia. Usually, the patient is "put to sleep," the surgery is started, nothing happens while they are asleep, the surgery is concluded, and the patient is woken up. This process reflects the adage that anesthesiology is 99% boredom and 1% extreme stress.

When issues do happen in anesthesia (i.e., the 1% stress), seconds can make the difference between health and irreversible injury or death. The expertise of a physician anesthesiologist comes into play here.

Such issues can happen at many points during the surgery, such as "putting a patient to sleep" (i.e., induction of general anesthesia), placing a breathing tube or ventilating for a patient, maintaining appropriate blood pressure and heart function, or traumatic bleeding. The anesthesiologist needs to monitor the proper function of all systems continuously and be able to swiftly and appropriately react when something is wrong.

As a result, an anesthesiologist needs to be present at all times during a surgical procedure and when anesthesia is administered.

What type of person does well in this role?

Anesthesiologists need to think on their feet and have a robust foundation of medical science to rely upon when analyzing, diagnosing, and treating a patient. They need to be confident.

Anesthesiologists often have much less time to diagnose, decide on a treatment plan, and administer medication. They must rely on themselves for the steps of placing orders and be confident in the decision-making process — able to react on the fly.

Moreover, anesthesiologists ought to be agile and dexterous with their hands. Daily, anesthesiologists place IVs, arterial cannulas, and breathing tubes through endotracheal intubation, and they use ultrasounds for nerve blocks and regional anesthesia. In order to do these tasks correctly and efficiently, anesthesiologists need to have done them many times and be able to rely on their own skill set.

Finally, anesthesiologists need to have charisma and should be able to establish a rapport with patients quickly. For many patients, the unknowns of general anesthesia present one of the most insecure moments of their life. Anesthesiologists often have 10 minutes or less to talk to the patient, gather appropriate information, and establish trust that everything will be done correctly and that the patient will arrive safely in the recovery room.

Who does this role help? How does this role impact others?

Anesthesiologists are often called the "quarterbacks" of the operating room. They help direct timing for the room: when the patient arrives, when s/he goes to sleep, how long s/he stays asleep, and when s/he wakes up.

Successful anesthesiologists ensure the day runs smoothly and on time, and that all patients have the best care possible — including alleviating anxieties, maintaining oxygen and blood flow delivery to tissues, effectively treating pain, and making sure the patient wakes up from anesthesia on time.

How to Get Hired

What was your experience like pursuing certification after completing your degree?

In medical school, you must absorb a wealth of information in a short period of time that you formulate into clinical decision-making skills while working in a hospital with patients. During this time, you also worry about making sure your grades, test scores, and performance will be good enough to get accepted to the specialty of your choice at a suitable residency program.

Residency is as grueling as medical school. You work 60-80 hours a week for a paycheck that frequently amounts to minimum wage or less per hour — when factoring hours worked per month. By the end of this arduous process, you should be adequately trained for something that is exceedingly important: taking care of human beings. There is a reason there is so much training to get to this point.

Two board exams are required for being able to practice as a board-certified anesthesiologist: the basic and advanced anesthesia exams, in addition to the completion of the three-part USMLE Step exams. At this point, the resident physician is fully certified and credentialed for working as an anesthesiologist.

What can students do to make themselves look better to employers?

Residency prepares a medical student to become a competent physician. It can be a grueling 3-7 years of training, depending on the field, but most physicians come out extremely competent on the other side. By graduating from an accredited anesthesiology residency, you signify to employers that you are an exceptional candidate prepared to work in the field. From there, certain attributes like work ethic and charisma can make you shine.

Frequently Asked Questions About Anesthesiologists

How long does it take to be an anesthesiologist?

It can take 12-15 years to become an anesthesiologist. A pre-med bachelor's degree is the first step, followed by four years of medical school, anesthesiology residency, and licensure. Securing a fellowship and earning certification are often optional, although these additional steps can increase marketability and earning power.

Why are anesthesiologists paid so much?

Anesthesiologists are well paid due to a variety of factors, including the length and cost of their education and training and the cost of annual malpractice insurance.

Anesthesiologists also assume a lot of professional risk doing their job by administering anesthetic medications, being responsible for patients' airways, breathing, and fluid balance, and performing pre-and post-surgical patient assessments.

What is the difference between an anesthesiologist and a nurse anesthetist?

One major difference between an anesthesiologist and a nurse anesthetist (CRNA) is that an anesthesiologist is a physician who has been through medical school and residency, while a nurse anesthetist has been through a doctoral nursing program.

Becoming a CRNA takes 7-10 years while becoming an anesthesiologist takes 12-15 years. CRNAs earn an average of about $200,000, while anesthesiologists earn over $300,000, according to the BLS.

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