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How to Become an Anesthesiologist in 2023

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by Alec Palmerton, MD in Residency

Do you want to know how to become an anesthesiologist? Are you interested in a medical career that provides not only patient care but also offers unique opportunities for medical research and a chance to be on the cutting edge of modern medicine?

If so, an anesthesiology career may be the perfect choice for you. As a Stanford- and Harvard-trained anesthesiologist, I can tell you that this field offers a rewarding and challenging career path. In this blog post, I will explain what an anesthesiologist does and how to become one, even if you’re only in high school.

how to become an anesthesiologist

The author with his daughter at his Harvard-MGH anesthesiology residency graduation


  • Rather than being the doctor that “puts patients to sleep,” anesthesiologists are masters of physiology and pharmacology
  • Anesthesiology residency training is four years, with the option of fellowship training afterward
  • Going to a top medical school may help a bit. However, how you do on your USMLEs (Board) scores and in your med school class ranking will matter more
  • Non-PhD degrees like MBAs and MPHs appear to have no advantage to becoming an anesthesiologist (and may be a slight disadvantage)

Table of Contents

What Are Anesthesiologists?

Anesthesiologists are often misunderstood in the medical field. Many think of them as doctors who put patients to sleep for their surgery, read a newspaper, and then wake them up. Nothing could be further from the truth.

Instead, anesthesiologists have a remarkable job: they must understand the body and its automatic processes so well that when the patient is unconscious – and those processes stop working – they can step in and replace those functions. It takes tremendous knowledge and skill to do this, and it is something that anesthesiologists take very seriously. It is a privilege to provide the best care possible to patients during their medical and surgical procedures.

Anesthesiologists have to understand the human body and its critical functions deeply. While the patient is unconscious, anesthesiologists must recognize when critical processes stop working and step in to replace those functions. This requires an understanding of how the body works and the ability to recognize subtle changes in the patient’s vital signs. Anesthesiologists must also know the risks associated with anesthesia, such as possible side effects, allergic reactions, and organ damage.

Is an Anesthesiologist a Doctor?

Are anesthesiologists doctors? This question often comes up as people confuse anesthesiologists with CRNAs, or certified registered nurse anesthetists. The answer to this question is yes; anesthesiologists are doctors.

An anesthesiologist is a specialized physician who has completed medical school, usually followed by a four-year residency in anesthesiology. During this time, the anesthesiologist trains to care for and manage patients undergoing sedation, general anesthesia, and regional anesthesia. In addition, anesthesiologists are responsible for patient safety during a procedure and for managing pain and discomfort.

Physician Anesthesiologist vs. CRNA: What’s the Difference?

Certified registered nurse anesthetists, or CRNAs, are medical specialists who administer anesthesia and manage pain. While they are skilled in administering anesthesia and pain management, they are typically supervised by a physician anesthesiologist.

In summary, anesthesiologists are doctors who have completed medical school and a four-year residency in anesthesiology and are experts in the care and management of patients undergoing sedation, general anesthesia, and regional anesthesia. CRNAs are nurses specializing in administering anesthesia and pain management and typically work under the supervision of a physician anesthesiologist.

How Long Does It Take To Become an Anesthesiologist?

Becoming an anesthesiologist is no easy feat and requires considerable time and energy. But if you’re up to the challenge, the results can be gratifying.

At a minimum, it takes a minimum of 12 years after high school to become an anesthesiologist. That includes four years of undergraduate education, four years of medical school, and four years of anesthesiology residency. Along the way, you’ll have to take various standardized exams, including the SAT, the MCAT, and the USMLE Step 1 and Step 2 CK.

Undergraduate (4 Years)

The first step to becoming an anesthesiologist is entering and completing an undergraduate program. This means taking the SATs and doing well enough to be accepted into a college or university. Once accepted into an undergraduate program, you’ll have to complete a minimum of four years of academic coursework. This includes classes in biology, chemistry, physics, English, and other general education courses.

Medical School (4 Years)

The next step is to take the MCAT, a standardized exam that measures your knowledge and skills in biology, chemistry, physics, and psychology. You’ll need to score well on the MCAT for med school acceptance.

You’ll have to complete four years of academic and clinical training during medical school. This includes classes in anatomy, physiology, pharmacology, pathology, and other medical topics. You’ll also have to complete clinical rotations at hospitals and other healthcare facilities to gain hands-on experience.

Anesthesiology Residency (4 Years)

After you’ve completed medical school, you’ll have to match into an anesthesiology residency. To do this, you’ll have to take the USMLE Step 1 and Step 2 CK exams. These exams measure your knowledge and skills in the areas of clinical medicine. Once you’ve passed these exams, you’ll be eligible to apply for residency.

Once you’ve matched into an anesthesiology residency, you’ll have to complete four years of clinical training to become an anesthesiologist. During this training period, you’ll learn how to administer anesthesia, interpret medical data, and provide pain management services.

Fellowship (Optional; Usually 1 Year)

After completing your anesthesiology residency, you may pursue further training in a specialized area of anesthesiology. Anesthesiology fellowships allow physicians to gain subspecialty expertise. Fellowship choices include pediatric, cardiac, critical care, and regional anesthesiology. Most anesthesiology fellowships are one year in length, allowing physicians to gain additional experience and hone their skills in a specific area of anesthesiology.

After Anesthesiology Residency: Licensing + Board Certification

Upon completing your residency, you’ll be eligible to apply for a medical license, a requirement for practice. You’ll also be able to take the Anesthesiology Board Exam to become a board-certified anesthesiologist. While passing the anesthesiology boards is voluntary, many employers will see this as important – or even necessary – for you to be employed as an anesthesiologist.

Becoming an anesthesiologist takes a minimum of 12 years after high school. It’s a long and arduous process, but if you’re dedicated and passionate about becoming an anesthesiologist, the rewards are worth it.

How Competitive is it to Become an Anesthesiologist?

Anesthesiology is one of the more competitive specialties in matching into a residency program. Each year, thousands of hopeful medical school graduates apply for a limited number of positions in their preferred specialty. The Match system, run by the National Resident Match Program (NRMP), pairs applicants with training programs based on their preferences.

But how competitive is anesthesiology in the US? To answer this question, it is important to look at the unmatched rates of US seniors by specialty. The unmatched rate refers to the percentage of US seniors who applied for a residency program in that specialty but did not get matched. It considers each applicant’s first-choice specialty. So, if you applied to a different specialty as a “backup” but didn’t match because you matched in your first choice, this wouldn’t be included. To learn more about how to maximize your chances at a dream residency through “The Match,” see this article.

In the 2022 Match, graduating US medical school seniors attending MD schools had a 10.5% unmatched rate to anesthesiology. This makes it one of the more competitive specialties, although not of the same competitiveness as specialties like plastic surgery (unmatched % 37.3%), orthopedic surgery (34.2%), or otolaryngology (sometimes called “ENT” for ear-nose-throat; 30.8%).

For more on the competitiveness of anesthesiology relative to other medical specialties, see this article.

Anesthesiologist Annual Compensation

One stereotype of anesthesiologists is that they make a lot of money. Anesthesiologists have an average annual salary of $405,000. However, this can vary dramatically based on practice setting, specialty training, and experience level.

Anesthesiologist Annual Salary

Anesthesiologists make $405,000 per year on average

How Much Do Anesthesiologists Make an Hour?

You may also be wondering, how much do anesthesiologists make per hour? And how is the balance between time inside vs. outside the hospital for the specialty?

While there aren’t perfect data, we’ve compiled data re: hours/weeks worked and annual salary for various specialties, including anesthesiology.

Here are the data:

Average Annual SalaryAverage Hourly SalaryOn-Call ScheduleHours/WeekAvg Weeks Worked/Year
Critical Care$369,000.00$114.9166.9
Diagnostic Radiology$437,000.00$170.46Low5844.2
Emergency Medicine$373,000.00$169.59Medium46.447.4
Family Medicine$255,000.00$101.85Medium52.647.6
General Surgery$402,000.00$141.88High59.447.7
Infectious Diseases$260,000.00$101.44High53.4
Internal Medicine$264,000.00$100.81Medium54.947.7
Interventional Radiology$437,000.00
Neurological Surgery (Assistant Prof. Median)$600,500.00$214.96Medium58.2
Obstetrics and Gynecology$336,000.00$123.26Medium5847
Orthopaedic Surgery$557,000.00$207.91Medium5747
Physical Medicine and Rehabilitation$322,000.00$147.7645.4
Plastic Surgery$576,000.00$230.77Medium52
Pulmonary Med$353,000.00$119.77Medium61.4
Radiation Oncology (Assistant Prof. Median)$393,734.00$158.36Low51.8
Total Average$381,233.35$147.4453.9

And the estimated physician salary per hour by specialty (anesthesiology highlighted in red):

Note: when data were unavailable for weeks worked per year, 48 weeks was used as an estimate to calculate the estimated hourly salary.

Getting AOA (Med School Honors) Helps in Becoming an Anesthesiologist

Medical school is one of the most challenging aspects of becoming a doctor. Many medical schools have established Alpha Omega Alpha (AOA) branches to recognize top students’ hard work and dedication.

Alpha Omega Alpha (AOA) is the medical school honors society for students who excel in their studies and demonstrate an exemplary commitment to professionalism and leadership. Each medical school may elect up to 20% of their graduating class to be inducted into AOA.

Induction into AOA is a prestigious honor that carries with it a variety of benefits. AOA members may be eligible for special scholarships and fellowships and can often receive priority consideration for residency positions.

The AOA advantage is particularly notable for the most competitive fields and/or residency programs. The 2022 Match data showed that the match rate for US medical school seniors with AOA membership was 10% greater than that of US seniors without AOA membership in anesthesiology. In other words, AOA membership provided a moderate advantage to matching into an anesthesiology residency.

AOA Membership Advantage for Anesthesiology 2022

AOA membership correlated with a 10% match rate advantage for anesthesiology in the 2022 Match

See this article for more on AOA medical schools and the importance of class rank for matching.

Do You Need to Attend a Top School to Become an Anesthesiologist?

When pursuing a career in anesthesiology, attending a top medical school can make a difference in matching into your desired specialty. According to a survey of program directors, over half of those surveyed reported considering applicants’ med school reputation when considering whom to interview, giving it an importance score of 3.8 out of 5.

Moreover, graduating from a school in the top 40 for NIH funding is associated with a 5% increase in the likelihood of matching into anesthesiology as a field. This is potentially because top medical schools have more resources and access to clinical experience, which can help prepare students for the rigors of the specialty.

That said, it is important to remember that the name of the school alone does not guarantee success in any field. While attending a top medical school may have advantages, it is ultimately up to the individual to make the most of the opportunities presented. And while there is an advantage to being from a more prestigious institution, one’s record at the school will matter much more, including things like USMLE scores, class rank, and letters of recommendation.

Top 40 med school anesthesiology match 2022

Graduating from a medical school ranked in the top 40 by NIH funding correlated with a 5% match rate advantage for anesthesiology in the 2022 Match

Does an MPH or MBA Help You Become an Anesthesiologist?

Medical training is long and arduous. Remarkably, many students consider completing other degrees before, after, or even while pursuing their medical studies. Degrees such as Master of Public Health (MPH) and Master of Business Administration (MBA) may seem attractive to potential anesthesiology residents due to their additional qualifications. But do these additional degrees give applicants an edge in the residency application process?

The truth is that having an additional degree may not matter as much as one thinks. We crunched the numbers on the match rate for graduating students from MD schools for those with non-PhD other degrees vs. those that did not have a second degree. In anesthesiology, the match rate was 2% lower for those with degrees like an MPH or MBA. This implies that having a second degree that isn’t a Ph.D. doesn’t appear to help your chances of matching into anesthesiology and may even hurt them (slightly).

Anesthesiology other degree MBA MPH advantage 2022

Having another degree like an MBA or MPH correlated with a 2% match rate disadvantage for anesthesiology in the 2022 Match

It’s important to note that this study only looked at the overall match rates of medical students with another degree. The data doesn’t look at the type of degree, the school it was obtained from, and the quality of the applicant’s experience and credentials.

Having a second degree could open up some additional career opportunities. For instance, having an MPH or MBA may prove beneficial for those looking to go into healthcare administration or research.

Concluding Thoughts

Becoming an anesthesiologist is a challenging but rewarding career path. It is perfect for those who love pharmacology, physiology, problem-solving, and working as part of a team in intense situations. With hard work, dedication, and a desire to help others, anesthesiologists can make a real difference in the world of healthcare.

Looking for an Anesthesiology Residency Advisor?

Looking for an anesthesiology residency advisor? Want help writing your personal statement? Need effective strategies for interviewing? Do you have things on your application – e.g., low USMLE scores, failed USMLEs, no research, IMG status, or others – you need help overcoming?

Be sure to check out our Residency Advisor service.

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Want FREE Cardiology Flashcards?

Cardiology is key for impressive USMLE scores. Master cardiology from a Harvard-trained anesthesiologist who scored USMLE 270 with these 130+ high-yield flash cards. You’ll be begging for cardio questions - even if vitals make you queasy.