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How to Become an Anesthesiologist


Overview

Playing an essential role in the operating room, an anesthesiologist does much more than administer the drugs that send you into a slumber before undergoing a surgical procedure. As a highly trained physician who specializes in the field, an anesthesiologist should not be confused with an anesthesia practitioner, who does not possess the same number of years and depth in training, knowledge and authority as someone with a medical school degree.

What is an Anesthesiologist?

An anesthesiologist is a doctor who is largely responsible for the safety and well-being of patients before, during and after surgery. These physicians are trained on how to properly administer anesthesia to a patient – the medicine primarily used to control pain during a surgery and other medical procedures. Not only does anesthesia block pain, but it also causes relaxation, and helps control a patient's breathing, blood pressure and heart rate.

To ensure the safety of a patient, an anesthesiologist is trained to monitor the use and effects of anesthesia on a case-by-case basis, and also takes into account a patient's past and present medical history. In the operating room, they make the kinds of decisions that protect and regulate the essential life functions of a patient. When any medical issues develop during surgery or recovery, an anesthesiologist is generally the first physician to identify and treat the problem.

Anesthesiologists are primarily trained to:

  • Conduct in-depth interviews with patients prior to their surgery; they then determine the correct anesthesia and pain management plan for a patient.
  • Possess a deep understanding of the side effects and dangers that certain pain-killing drugs and anesthesia can cause in a patient with a pre-existing medical condition.
  • Manage the health and recovery of a patient during a surgery and post-op.
  • Provide pain relief in many different situations, from women giving birth to cancer patients undergoing surgery.
  • Monitor outpatient conditions, such as regulating pain and overseeing the aftereffects of surgery.

Anesthesiologists administer anesthesia in the following three ways:

  • General Anesthesia places a patient in a state of controlled unconsciousness, and is delivered through a mask, breathing tube, or IV. This type of anesthesia affects both the brain and the body.
  • Local Anesthesia is usually delivered by way of injection and is used in minor procedures to numb a small part of the body, such as along the gumline for dental extractions. A patient is usually awake during the procedure.
  • Regional Anesthesia is administered through a shot, and is used to block pain to a larger part of the body, such as the knee or legs. Patients usually stay awake during their procedures. An example of regional anesthesia is an epidural, a shot given near the spinal cord of pregnant women to ease anxiety and block pain to the abdomen and hip region.

Anesthesiologists pay attention to the medical condition of their patients after administering anesthesia. During surgery, they monitor a number of vital signs – from body temperature to heart rate and rhythm. Throughout a procedure, an anesthesiologist will adjust anesthetics to meet the progress and changes of a patient's physical state. Anesthesiologists also return a patient to a conscious state when necessary, continue to monitor vital signs, and oversee any pain management. A patient does not leave the recovery room until an anesthesiologist gives the OK.

Educational Track

A doctorate degree is the entry-level educational requirement for an anesthesiologist.

Step by Step Educational Path of an Anesthesiologist

  1. Earn a bachelor's degree. Since medical school does not require a candidate to enter a designated pre-medical degree program, earning an undergraduate degree in any field is acceptable for an aspiring anesthesiologist. However, there are still a handful of courses that an undergraduate may take to become fulfill the prerequisites associated with medical school, such as biology, physics, chemistry and mathematics.
  1. Apply to medical school. In order to become an anesthesiologist, individuals must gain a four-year medical school education to earn a doctor of medicine (M.D.) or doctor of osteopathy (D.O.) degree. The application process is highly competitive, and takes into account the overall GPA, letters of recommendation, and MCAT scores of an applicant. The Medical College Admissions Test is a standardized, multiple-choice exam used by medical schools to assess an applicant's knowledge of science concepts, as well as their problem-solving and critical thinking skills. The examination is generally taken during the junior year of undergraduate school.
  1. Complete a medical school program. The first two years of medical school are primarily spent in the classroom, studying subjects like microbiology, biochemistry, physiology, pharmacology, pathology, medical ethics, and anatomy. During the remaining two years of medical school, students begin to gain hands-on experience caring for patients in medical facilities, such as hospitals and clinics. These clinical rotations are supervised by seasoned physicians, and allow students to explore a variety of specialties that include pediatrics, gynecology, cardiology, and geriatrics.
  1. 4. Complete a residency in anesthesiology. Upon graduating from medical school, physicians undergo four years of specialized training that include one year of rotations and/or internship related to general medicine (such as internal medical, pediatrics and emergency medicine), followed by three years of a rigorous anesthesiologist education.
  1. Pursue a fellowship in a sub-specialty. Post-residency fellowship programs are optional. Typically lasting one to two years, physicians concentrate on a specific area of anesthesiology of their choice, such as neurosurgery, pediatric, transplant or dental anesthesiology.
  1. Obtain a license. In order to work in the United States as an anesthesiologist, a doctor must become licensed in the state where they wish to gain employment. In addition to passing a two-part examination, physicians must also fulfill additional requirements set by the state.

Upon completion of an anesthesiology residency, a doctor then becomes eligible to sit for the American Board of Anesthesiology (ABA) exam. Although this step is optional, nearly 90 percent of anesthesiologists are board-certified says Jason Begalke, D.O. in What Does an Anesthesiologist Do?.

Career Path

Anesthesiologists find employment in work environments where surgical procedures and the need for patients to receive pain relief take place, such as hospitals, outpatient medical facilities, academic medical centers, private and group practices, urgent care centers, and the military. Some anesthesiologists hold positions directly in the emergency room of a hospital, where they provide immediate care to individuals with traumatic injuries, chemical burns, and other serious health issues. Anesthesiologists are also hired to work in dentist offices, where surgical procedures (such as wisdom teeth extractions) are performed.

Employers hiring anesthesiologists typically seek the following qualities in a job candidate:

  • Excellent decision-making skills.
  • Communication and interpersonal skills, for clearly explaining procedures, technical issues, and the different types of anesthesia to patients and their family.
  • The ability to sit and stand for long periods of time.
  • Proficiency in multitasking.
  • Technical skill and a steady hand, needed to execute delicate procedures, such as inserting intravenous lines and spinal catheters.
  • The ability to work well with other physicians and medical staff, including surgeons, nurses, and respiratory therapists.
  • A good bedside manner to make patients feel at ease before, during and following surgical procedures.

In addition to doing well in medical school and fulfilling all requirements to become a physician that specializes in anesthesiology, there are a few things that a job candidate can do to enhance their appeal to potential employers, such as:

  • Become a Member of an Association: The benefits that come from joining an association or society related to anesthesiologists and other medical professionals go beyond providing the valuable networking opportunities, conferences, and access to job leads. For example, members of the American Society of Anesthesiologists (ASA) also receive discounts on educational materials; gain access to medical resources (such as journals and monographs about timely clinical subjects); and can attend scientific meetings.
  • Publish Articles or Original Research: Journal and book publications add substance to a resume. Job candidates who have published pieces under their belt demonstrate a desire to actively contribute to the medical community.

Among all other physicians, anesthesiologists rank sixth in earnings for 2013 with an average income of $338,000, according to the Medscape Physician Compensation Report (2014). Those who were surveyed by Medscape also reported to have earned the same median salary as indicated in the previous year's report.

A few factors that play an important role in assessing the average salary earned by an anesthesiologist include geography, the number of years worked, and their place of employment. For instance, anesthesiologists residing in the South Central and North Central regions of the United States earned the most in 2013 – between $353,000 and $365,000. Those who lived in the Northwest were paid the lowest salaries in the U.S. during this same time period, taking home an average income of $296,000.

An anesthesiologist's work environment and/or employer also influences the amount of money made in a year. Healthcare organizations paid the highest salaries to those specializing in anesthesiology with $360,000, followed by hospitals ($348,000).

Other work environments and average yearly salary figures for anesthesiologists to consider:

  • Office-based multi-specialty practices - $345,000
  • Office-based single-specialty practices -$340,000
  • Office-based solo practices - $294,000
  • Outpatient clinics - $283,000
  • Academic, research, military, and government settings - $264,000

The number of job prospects for anesthesiologists is rising at a faster than average pace than all other occupations in the United States. Overall, the U.S. Bureau of Labor Statistics cites the employment of physicians is projected to grow 18 percent from 2012 to 2022.

Continued development and expansion of healthcare-related industries are some of the primary forces behind the anticipated job growth for anesthesiologists. Other factors that play a role in the promising job outlook for the anesthesiology field include population growth; technological advances; the retirement of older specialists who are leaving behind vacancies; and the increased need to hire more qualified physicians who possess a particular subspecialty.

Starting a Private Practice

The prospect of becoming self-employed and owning a private practice is attractive for many anesthesiologists who wish to enjoy more freedom and flexibility within their career. Before moving forward with establishing a medical business, it is important to weigh the pros and cons.

In addition to the advantage of having more control over job duties and work conditions, a self-employed anesthesiologist also has the potential to earn a higher yearly income. According to Medscape, anesthesiologists in business for themselves earned more ($375,000) in 2013 than those employed in a salaried position ($307,000).

Although they do not get the benefit of paid off-time like salaried employees, the flexibility that self-employed physicians do enjoy also extends to how and when they can spend their free time. For instance, they set how much vacation time they take, and do not have to gain permission from or alert an employer when they choose to take time off.

Additionally, anesthesiologists in private practice do not face some of the demands or expectations that some employers place on their staff, such as teaching fellow medical staff or publishing a scholarly article.

However, an important part of becoming a self-employed anesthesiology is to understand all of the responsibilities that come with managing a business, such as securing adequate office space and purchasing the appropriate office equipment and software.

A few other factors to consider before starting a private practice as an anesthesiologist include start-up costs, increased paperwork, dealing with insurance companies, and the elevated time commitment.

"I was in private practice for 18 years (because of a good opportunity that came my way)," said William Baker, MD, in an interview featured on The Student Doctor Network.

"In private practice you put in more hours but are also paid more," said Baker, who later became a faculty member at the University of Alabama at Birmingham (UAB). "Now I am happy to work less and take home less."

As an employer of UAB, Baker worked around 45 hours per week; a much less demanding week than the up to 80 hours he said he often worked while in private practice.

One of the reasons anesthesiologists tend to put in long hours is because their income is directly connected to the number of cases they handle, which is an incentive to take on extra cases.

Another aspect to recognize when owning a private practice is the type of insurance that a patient possesses. To earn the most as a self-employed anesthesiologist, keeping the percentage of Medicare and Medicaid work to a minimum is a desirable career move.

The American Society of Anesthesiologists (ASA) is a good resource for an aspiring medical entrepreneur, and as a member, physicians looking to start and manage their own practice can gain valuable insight and assistance. The ASA provides resources, such as their Manual for Anesthesia Department Organization and Management (MADOM); a member discount on essential coding resources; and access to their Certificate in Business Administration program.

Anesthesiologists are in high demand, as they play a significant role in a patient's care as it relates to surgical procedures and cases involving pain management. Although a career in anesthesiology requires the completion of up to 13 years of post-secondary education, the field offers a wide-range of rewarding opportunities and fulfilling employment prospects for both salaried and self-employed anesthesiologists.

Additional Resources

  • American Society of Anesthesiologists
  • American Board of Anesthesiology
  • American Society of Critical Care Anesthesiologists
  • Anesthesia Foundation
  • American Society of Regional Anesthesia & Pain Medicine

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