Nurse Anesthetist (CRNA) vs. Anesthesiologist

Those studying for healthcare careers have a wide variety of options to choose from. Some of the roles may seem similar, so it can be tricky to know which option to pursue. For example, you may wonder how a nurse anesthetist and anesthesiologist are different, since they both deal with anesthesia.  

Certified registered nurse anesthetists (CRNAs) are advanced practice registered nurses who administer anesthesia and provide anesthesia-related care. Depending on state law, facility policy, and their employer’s care model, CRNAs may practice independently or collaboratively with anesthesiologists, surgeons, dentists, and other healthcare professionals.

Anesthesiologists, on the other hand, are physicians who specialize in anesthesiology, including anesthesia care, pain management, and the medical care of patients before, during, and after surgery.

While the responsibilities overlap in some areas, the major difference between these two professions is their educational and professional background: An anesthesiologist completes medical school and physician residency training, while a registered nurse anesthetist follows an advanced nursing pathway and completes a doctoral-level nurse anesthesia program.  

This guide compares the responsibilities, education requirements, salary, job outlook, and career paths of both CRNAs and anesthesiologists so you can understand which option better fits your goals.

CRNA vs. Anesthesiologist: Key Differences

Both CRNAs and anesthesiologists are highly trained anesthesia providers. The right career path for you will depend largely on whether you want to follow an advanced nursing pathway or a physician pathway.

What Is a Nurse Anesthetist?

A nurse anesthetist, also known as a CRNA, is an advanced practice registered nurse who has completed specialized graduate education in nurse anesthesia.  

What Does a CRNA Do?

Nurse anesthetists are critical members of medical care teams. Their actual role and responsibilities may vary but often include:

• Assisting with anesthesia administration.

• Evaluating patients before a procedure.

• Reviewing medical histories, allergies, and current medication use.

• Overseeing patient recovery from anesthesia.

• Performing epidurals or spinal blocks.

• Providing care before, during, and after anesthesia.

• Discussing potential risks and side effects with patients.

• Monitoring vital signs during surgery and other procedures.

Registered nurse anesthetists may work in hospitals, surgical centers, outpatient care centers, pain clinics, military medical facilities, dental offices, or plastic surgery centers. They are responsible for patient safety during important procedures. CRNA work in anesthesia and pain management can be vital to successful patient outcomes.

CRNAs are typically supervised by physicians; however, the requirements for CRNA practice are not identical throughout the country. The allowed scope of nurse anesthesia practice may be affected by state law, education, professional experience, facility policy, and the care model used by an employer. The Council on Accreditation of Nurse Anesthesia Educational Programs provides additional information about the factors that shape a CRNA’s scope of practice.

CRNA Salary and Career Outlook

Nurse anesthetists are highly trained and skilled, which means they are generally well compensated. According to the detailed occupational wage data from the U.S. Bureau of Labor Statistics (BLS), demand for nurse anesthetists is projected to grow 9% between 2024 and 2034. The median annual wage of nurse anesthetist is $223,210, as of 2024. But, of course, actual earnings may vary based on location, experience, work setting, schedule, and other factors.  

How to Become a CRNA

The first step toward becoming a CRNA is to complete a qualifying nursing education program and become a registered nurse practitioner. Many future CRNAs earn a Bachelor of Science in Nursing, or a BSN. Some nurses may begin with an Associate of Science in Nursing degree and later complete an RN-to-BSN program or another qualifying educational pathway.

Admission requirements for CRNA programs vary, so prospective students should review the requirements of each program they are considering.

The typical pathway includes:

1. Earn a BSN or another qualifying nursing degree.
2. Pass the NCLEX-RN exam and obtain a RN license.
3. Gain relevant professional nursing experience, generally in an acute or critical-care setting, such as an intensive care unit. CRNA programs set their own admission standards, but this type of experience is often required.
4. Complete an accredited doctoral nurse anesthesia program.
5. Pass the National Certification Examination administered by the National Board of Certification and Recertification for Nurse Anesthetists.
6. Meet state licensure requirements and maintain the CRNA credential through ongoing certification requirements.

The journey requires substantial education, clinical experience, and preparation, but it can lead to a rewarding nursing specialty that allows you to support patients through surgery, treatment, and recovery. You can also read WGU’s guide how to become a nurse anesthetist.

What Is an Anesthesiologist?

An anesthesiologist is a physician who specializes in anesthesia care, pain management, and perioperative medicine. These physicians care for patients before, during, and after procedures but they also supervise CRNAs and anesthesia assistants as well which means leadership experience can help with this role as well.  

What Does an Anesthesiologist Do?

Anesthesiologists administer medication that reduces or eliminates pain before, during, or after a medical procedure. Their responsibilities may include:

• Administering general, regional, local, or sedative anesthesia.
• Performing epidurals, spinal blocks, and other procedures.
• Reviewing medical files, laboratory results, allergies, and medication use.
• Evaluating a patient’s health and anesthesia risks.
• Creating an individualized anesthesia plan.
• Monitoring patient vital signs during surgery or other procedures.
• Managing a patient’s airway, breathing, circulation, and other critical functions.
• Supervising or collaborating with other anesthesia providers.
• Informing patients about the benefits, risks, and potential side effects of anesthesia.
• Managing acute or chronic pain.
• Complying with medical, legal, and hospital requirements.

Anesthesiologists are responsible for helping reduce and remove pain and prevent complications associated with surgery or medical procedures.  

They may work directly in the operating room, an intensive care unit, a pain clinic, a labor and delivery unit, or another procedural setting. Some anesthesiologists also pursue a subspecialty, such as pediatrics, cardiology, obstetrics, critical care, or pain medicine.

Anesthesiologist Salary and Career Outlook

As medical doctors with extensive schooling and specialized training, anesthesiologists are among the highest-paid healthcare professionals. According to the BLS, anesthesiologists had a mean annual wage of $339,470, as of 2023. Actual compensation can vary significantly based on location, experience, employer, schedule, and area of specialization.

The BLS does not provide a separate long-term employment projection specifically for anesthesiologists. Instead, they are included in the broader physicians and surgeons category. Employment of physicians and surgeons is projected to grow 3% from 2024 to 2034, about as fast as the average for all occupations.

The demand for this role can differ by geographic area and healthcare setting. An aging population and the continued need for surgical, diagnostic, and pain management services contributes to the need for qualified anesthesiology professionals.  

How to Become an Anesthesiologist

Anesthesiologists have extensive educational and training requirements. The typical pathway includes:

1. Earn a bachelor’s degree and complete the prerequisite courses for medical school.
2. Take the Medical College Admission Test, or MCAT, and apply to medical school.
3. Complete medical school to earn an MD or DO degree.
4. Obtain the medical licensure required for postgraduate clinical training.
5. Complete an anesthesiology residency.
6. Complete an optional fellowship for advanced subspecialty training.
7. Meet state medical licensure requirements and pursue board certification, as applicable.

Board certification is a multistep process rather than one final exam. The American Board of Anesthesiology certification pathway includes basic, advanced, and applied exams at different stages of training and practice but other certifying bodies may do things differently. Physicians must also meet the requirements for medical licensure in the state where they intend to work.

Becoming an anesthesiologist requires extensive schooling, residency training, assessment, and study. However, it can be a strong fit for someone who wants to follow a physician pathway and take responsibility for complex medical decision-making throughout a patient’s perioperative care.

Choosing the Right Career Path for You

After learning about both career paths, you may wonder which one is the best fit for you. The difference between anesthesiologist and nurse anesthetist careers involves much more than salary. Consider the following questions:

• What education or experience do you already have? If you are already have critical-care experience, the CRNA pathway may build naturally on your nursing background.
• Do you prefer a nursing or physician pathway? A CRNA is an advanced practice nursing professional, while an anesthesiologist is a physician.
• How much time do you want to devote to education and training? Both paths require advanced education, but becoming an anesthesiologist generally involves a longer sequence of medical school and residency training.
• What type of responsibility interests you? Both professions provide anesthesia care, but their responsibilities, authority, and role within the care team may differ by setting. For example, anesthesiologists typically manage other healthcare professionals.
• What are your salary expectations? While both these positions are high-paying roles, anesthesiologists usually make more. Compensation is important, but it should be weighed alongside educational costs, time in training, work schedule, and long-term career goals.
• Are you interested in a particular specialty? Both paths can involve surgery and pain management, while physicians may pursue additional anesthesiology subspecialty training through a fellowship.

When comparing nurse anesthetist and anesthesiologist careers, neither path is universally better. The better choice is the one that matches your background, interests, preferred professional role, and willingness to complete the required education.

You may also find it helpful to learn more about how a nurse’s role can affect earning power.

Making a Career Game Plan

It’s important to create a clear but flexible plan for your career. Understanding the options you’re interested in—and how they fit into your long-term goals—can help you identify your next step.

Start by considering achievable short- and long-term goals. Revisit your plan as you gain experience and learn more about each profession.

Whatever direction your career takes, a bachelor’s degree in nursing or another relevant field can be an important place to start. A bachelor’s degree can help you identify your strengths and interests and prepare to make informed decisions about your future career goals.