CRNA vs. Anesthesiologist: What’s the Difference?

More than 51 million surgeries are performed every year in the U.S., and certified registered nurse anesthetists (CRNAs) and anesthesiologists help these operations happen. But while both of these clinicians administer anesthesia medications, their schooling and roles differ. Let’s compare CRNA vs. anesthesiologist education, scope of practice, and more.

Both anesthesiologists and CRNAs are essential anesthesia providers, helping patients go through procedures and surgeries safely and with less pain. They can work in clinical areas such as the following:

• Hospital operating rooms and surgical suites
• Labor and delivery units
• Outpatient surgery centers
• Pain management clinics
• Intensive care units
• Emergency departments
• Dental offices
• Endoscopy suites
• Radiology departments
• Cardiac catheterization labs

What Do CRNAs and Anesthesiologists Do?

CRNAs and anesthesiologists may perform any of the following skills depending on where they work:

• Administering general, regional, or local anesthesia
• Performing pre-anesthesia evaluations to assess medical history and risks
• Monitoring and adjusting anesthesia during surgery
• Managing patient airways, including intubations
• Performing spinal blocks, epidurals, and nerve blocks
• Addressing anesthesia-related emergencies

In addition, anesthesiologists manage more complex cases, lead care teams, and may take part in research or academic roles to advance anesthesia science.

CRNA vs. Anesthesiologist Schooling

Educational paths for CRNAs and anesthesiologists differ significantly. Schooling to become a CRNA takes seven years at minimum, but for anesthesiologists, it takes over a decade. Here’s a breakdown of the pathways for both of these roles:

CRNA Schooling:

1. Bachelor of Science in Nursing (BSN) degree — 4 years
2. Intensive care experience requirement — around 3 years
3. Either a Doctorate of Nursing Anesthesia Practice (DNAP) or Doctorate of Nursing Practice (DNP) degree — about 3 years
4. Optional specialty fellowship — 1 year

Anesthesiologist Schooling:

1. Pre-med bachelor’s degree — 4 years
2. Medical school — 4 years
3. Anesthesiology residency — 4 years
4. Optional specialty fellowship — 1 year

CRNA vs. Anesthesiologist Scope of Practice

What can an anesthesiologist do that a CRNA cannot? Because of their additional training, anesthesiologists can lead teams and manage more complex cases. Depending on the state, CRNAs may work independently and perform many of the same procedures without physician oversight, but that doesn’t mean that their roles are the same.

Here’s a breakdown comparing the roles of anesthesiologist vs. CRNA:

CRNA vs. Anesthesiologist Salary Averages

Looking for a role with a high income? Both of these professionals bring home high salaries. A typical CRNA salary is around $214,200 per year, and the average yearly income for anesthesiologists is $339,470.

CRNA vs. Anesthesiologist Pros and Cons

If you’re wondering which career path is right for you, there are several key differentiators that set these roles apart. Depending on how you prefer to work with patients and colleagues, one path might be better for you than the other. Check out some of the benefits and drawbacks of each path below.

Anesthesiologist:

Pros:

• Income: Anesthesiologists earn significantly more than CRNAs because of their advanced training and responsibilities.
• Scope of practice: They can manage highly complex cases, including risky surgeries and critically ill patients.
• Leadership: Anesthesiologists can serve as department heads or in academic roles, contributing to research and medical advancements.
• Autonomy: Anesthesiologists can work independently in any setting without supervision.

Cons:

• Education cost: Along with the additional time they spend in school, some reports show that anesthesiologists graduate school with an average of $241,600 in debt.
• Responsibility: Anesthesiologists bear final responsibility for patient outcomes, which can lead to higher stress levels. And because their cases may be more complex, their role can come with more pressure.

CRNA:

Pros:

• Faster education: CRNAs complete fewer years of schooling, and during their graduate-level education, many work as RNs.
• Less debt: CRNAs tend to finish school with less debt than anesthesiologists, although their loans may still be substantial. Some reports indicate that CRNAs have an average of $150,000 to $200,000 of debt.
• Demand: CRNAs are highly sought-after, particularly in rural and underserved areas where anesthesiologists are less likely to live.
• Income: While CRNAs earn less than anesthesiologists, they’re still some of the highest-paid nurses.

Cons:

• Scope of practice: CRNAs focus on anesthesia delivery and don’t typically manage complex cases independently.
• Opportunities: Academic and leadership roles are less common for CRNAs compared to anesthesiologists.
• Comparatively lower salary: CRNAs generally earn less than anesthesiologists.

Anesthesiology Professional FAQs

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

Anesthesiologist assistants (AAs) are masters-prepared clinicians who work directly under the supervision of anesthesiologists. There are only seven AA programs in the country, and as a result, there are only about 1,800 active AAs compared to over 44,000 CRNAs. There’s less autonomy in this role, and AAs can’t work in every state. Comparatively, CRNAs have more flexibility and independence than AAs.

Can a CRNA replace an anesthesiologist?

The answer is complex and debated. In some states, CRNAs can work independently, while in others, they require supervision by an anesthesiologist. This independence is particularly valuable in rural areas where anesthesiologists are less likely to live. One report found that CRNAs make up more than 80% of anesthesia providers in these areas — showing that independent practice creates essential access for patients.

However, many physician organizations point out that CRNAs lack the extensive training anesthesiologists undergo, and that they’re not prepared to handle certain complex cases. Studies have shown no significant difference in patient outcomes between CRNAs and anesthesiologists, but the controversy around overlapping roles and differences in training remains.

Can a CRNA be called a doctor?

Technically yes, but generally no. CRNAs either hold a DNAP or DNP, and both are doctoral degrees. They may be called doctors in academic settings. However, they are not medical doctors in the way that physicians are, and referring to them as doctors in the clinical setting can confuse patients.

Nursing Roles for CRNAs and More

While there are major differences between CRNA vs. anesthesiologist professions, both are essential in caring for patients. If you’re looking for nursing roles, start receiving personalized job notifications from IntelyCare.