CRNA vs. Anesthesiologist: What's the Difference?

Key Takeaways

• CRNAs are advanced practice nurses with a DNP. Anesthesiologists are physicians with an MD or DO who complete an anesthesiology residency.
• CRNAs earn an average of $223,210 a year; anesthesiologists earn $336,640, reflecting longer training and more complex cases.
• Becoming a CRNA takes about eight years versus 12 for an anesthesiologist. The BLS projects 9% growth for nurse anesthetists and 3% for anesthesiologists through 2034.

Certified registered nurse anesthetists (CRNAs) and anesthesiologists both administer anesthesia and keep patients safely sedated through surgery. The difference is their background: CRNAs come from nursing, anesthesiologists from medicine. This guide breaks down the two roles, their pay, outlook, and education.

Key Similarities and Differences

CRNAs and anesthesiologists perform many of the same duties, caring for patients before, during, and after procedures that require anesthesia. They differ in education, salary, practice authority, and setting. Anesthesiologists earn more, but CRNAs are in higher demand.

A CRNA works with physicians and surgeons to manage anesthesia care. CRNAs often work in rural hospitals, on routine cases, and outside the operating room. They hold a doctor of nursing practice (DNP) degree and national CRNA certification. Depending on their state's practice authority, they work independently or under an anesthesiologist's supervision.

An anesthesiologist attends medical school, completes a four-year residency, and holds an MD or DO. They handle more complex cases and larger hospital systems, can practice independently anywhere, and supervise CRNAs and anesthesia assistants. Both roles commonly work in physicians' offices, hospitals, and outpatient centers; CRNAs lean toward other practitioners' offices, while anesthesiologists are more likely to hold teaching roles.

Duties and Responsibilities

In 16 states, CRNAs must be supervised by an anesthesiologist for care to be reimbursed by the Centers for Medicare and Medicaid Services. The other 34 states have opted out of that requirement and grant CRNAs independent practice authority.

Both CRNAs and anesthesiologists take patient histories to confirm anesthesia can be given safely, collaborate with physicians, educate patients on the treatment plan and answer their questions, administer local and general anesthesia, manage pain, deliver emergency care, cover patients before, during, and after surgery, and monitor and report vital signs. The main difference is that anesthesiologists can supervise CRNAs and anesthesia assistants.

Education and Certification

CRNAs train for about eight years; anesthesiologists for about 12.

To become a CRNA, you earn a BSN, pass the NCLEX-RN, get your RN license, and work full-time in critical care for at least a year. You then enroll in a DNP program. Some programs admit you with a BSN and combine the MSN and DNP; others require an MSN first. After the DNP, you sit for the CRNA National Certification Exam (NCE) from the National Board of Certification and Recertification for Nurse Anesthetists. To qualify, you need an unrestricted RN license and completion of an accredited CRNA program within the last two years. The application requires a recent digital photo, your RN license details for every active state, an electronic record of your academic and clinical experience, and a signed application.

To become an anesthesiologist, you complete a bachelor's degree, pass the MCAT, finish four years of medical school, and complete a four-year anesthesiology residency. You can sit for the final step of the licensing exam after at least one year of residency. Once licensed, board certification through the American Board of Anesthesiology is optional but common; nearly 75% of anesthesiologists are certified, per the American Society of Anesthesiologists.

CRNA path: four-year bachelor's, NCLEX-RN, DNP program (two to three years), state practicum hours, and the CRNA National Certification Exam. Total time is about seven to eight years.

Physician path: four-year bachelor's, MCAT, a four-year MD or DO program, a four-year residency, the USMLE or COMLEX licensing exam, and recommended American Board of Anesthesiology certification. Total time is about 12 years.

Salary and Career Outlook

CRNAs earn an average of $223,210 a year (BLS, May 2024). Earnings vary by experience, location, facility, and negotiating leverage. The BLS projects 9% growth for nurse anesthetists from 2024 to 2034, much faster than the 3% average for all occupations, with about 4,600 openings projected over the decade.

Anesthesiologists earn an average of $336,640 a year (BLS, May 2024). The BLS projects 3% growth from 2024 to 2034, in line with the national average, with about 1,400 openings over the decade.

Which Career Is Right for You?

The choice comes down to practice authority, salary, education, outlook, and case type. If you want the higher salary, the most complex cases, and the ability to practice independently anywhere, become an anesthesiologist. If you want to enter a fast-growing field sooner and with less debt, become a CRNA.

Education timeline: about seven to eight years for a CRNA versus at least 12 for an anesthesiologist. Outlook: the BLS projects roughly 4,600 CRNA openings over the decade against about 1,400 for anesthesiologists. Debt: CRNAs typically finish with about $100,000 less student debt. Salary: anesthesiologists earn about $113,000 more a year.

Frequently Asked Questions

Anesthesiologists earn more, averaging $336,640 a year versus $223,210 for CRNAs.

Anesthesiologists can work independently anywhere in the U.S. and supervise the anesthesia team. CRNAs can practice independently in 34 full-practice-authority states, Guam, and the U.S. Army, Navy, and Air Force.

Which role is better depends on your goals around salary, practice authority, and how long you want to train. CRNAs need a doctor of nursing practice degree to enter the field.