What Does an Anesthesiologist Do?
Anesthesiologists are doctors who are tasked with managing a patient’s pain.
Because of their role, they must understand pharmacology. This medical subset studies how living organisms and their internal systems react when medications are introduced to their bodies. An Anesthesiologist’s understanding of pharmacology makes them adept at keeping a patient’s pain at bay.
When someone is slated for surgery, they will talk with an Anesthesiologist. In this meeting, the Anesthesiologist will evaluate their needs and create a medication plan for the individual.
Before medical procedures, like childbirth or an appendix removal, Anesthesiologists oversee the person while they receive local, regional, general, or epidural anesthesia. These are the most common types of medications they order to have administered. If the patient is undergoing a major surgery, such as open-heart surgery or a joint replacement, the Anesthesiologist will fully sedate them.
General anesthesia makes the patient unconscious during a surgery, while a full sedation causes the patient to be fully unaware of the procedure and calms their body, so it doesn’t respond to what’s happening. Regional and epidural anesthesia is a lighter level of pain relief. A numbing agent is injected near a nerve, making the patient not feel their treatment while they’re awake.
What is an Anesthesiologist Responsible For?
Besides managing a patient’s pain, these doctors have other important functions. While their patient is undergoing their operation, the Anesthesiologist is responsible for their medical management.
As the Surgeon performs the procedure, the Anesthesiologist monitor’s the patient’s condition (including their level of unconsciousness and pain), assesses how their body is handling the surgery and prescribes medication as needed, and determines how the organs should be treated.
During the procedure, Anesthesiologist are specifically observing a patient’s:
- Blood pressure
- Body temperature
- Breathing
- Fluid balance
- Heart rate and rhythm
When their operation is over, the Anesthesiologist will direct new drugs to be administered to offset the anesthesia. They also monitor the patient’s condition and work to manage their pain as they recover.
During emergency and critical procedures, when they don’t get the chance to pre-evaluate the patient, the Anesthesiologist will observe their needs during the operation, decrease the likeliness of infection, diagnose the person, and support their breathing and circulation.
Because of their medical degree, they may give airway and cardiac resuscitation, advanced life support, and pain control measures. Anesthesiologists also prep the patient for surgery and help stabilize them.
While they’re working, an Anesthesiologist can expect to have the following responsibilities:
- Talking to patients about what to expect when they receive anesthesia and the process for getting them the medication
- Addressing the patient’s concerns about their procedure
- Reviewing a patient’s medical records and history to select the best anesthesia medication for them
- Creating a personalized anesthesia plan for every patient
- During and after the operation, Anesthesiologists will observe and assess a patient’s condition and breathing
- Communicating with the rest of the medical team about the patient’s wellbeing
Being responsible for this level of patient wellness means that Anesthesiologists have demanding and stressful careers. While they’re working, they must complete their tasks in a diligent and error-free manner — especially because their medications alter the patient’s breathing pattern. Mistakes in dosage and other factors can mean accidentally harming a patient.
Where Does an Anesthesiologist Work?
Any type of business that uses anesthesia requires an Anesthesiologist. This means they are mainly employed in healthcare environments, like hospitals, dentist offices, and private practices.
They aren’t limited to traditional healthcare spaces. With their knowledge, they can also find employment within the military.
The most common places that Anesthesiologists work are:
- Healthcare centers and clinics
- Hospitals
- Emergency departments and critical care
- Intensive care units
- Dentist offices
- Cardiology centers
- Neurosurgical departments
- Obstetrician departments
- Pediatrics
- Plastic surgery facilities
- Military bases and operations
What Career Options are Available to an Anesthesiologist?
When you’re choosing to pursue anesthesiology, you’ll need to decide what kind of subset you want to specialize in. Every type of Anesthesiologist understands their role in surgical situations, but many of these doctors choose to become experts in a certain type of anesthesia.
Some of the most well-known anesthesiology specializations are:
- Cardiac anesthesia: These Anesthesiologists are experts in cardiac operations and medical procedures. They specialize in heart-specific anesthesia and know how to deliver a dose that maintains their patient’s blood pressure and heart function during and after their operation. Besides keeping their patient pain-free and unconscious in their surgery, they understand how to optimize their heart rhythm. This can be tricky for cardiac patients since they may have a compromised cardiac system.
- Pediatric anesthesia: This subset of anesthesiology deals with children who need anesthesia for an operation or pain relief. Pediatric Anesthesiologists understand how to properly medicate children. They are also experts at making these young patients comfortable before undergoing an operation.
- Neuroanesthesia: Anesthesiologists who specialize in Neuroanesthesia are incredibly rare. There isn’t an accredited fellowship training program for this anesthesiologic subset anywhere in the world, so it’s difficult to earn this title. Neuroanesthesiologists are trained to monitor and maintain their patient’s intracranial and cerebral perfusion pressures and their aerobic brain metabolism. They also work to decrease a secondary brain injury during the patient’s surgery.
- Obstetric anesthesia: When a pregnant person is ready to give birth, one of the most important parts of the process is pain relief. This is where an Obstetric Anesthesiologist comes in. These doctors work as a part of a care team with the obstetrician, perinatologist, midwife, neonatologist and labor and delivery nurse to help the person successfully give birth to their baby.
- Hospice and palliative care anesthesia: Anesthesiologists are an important part of hospice and palliative care. These patients often experience extreme pain. This type of Anesthesiologist is adept at pain reduction. They also are experts at giving the correct doses of sedative and anxiolytic medication and the general treatment of these patients.
There are some Anesthesiologists who choose a more generalized specialty. The most common of these are pain management and critical care.
Pain management involves treating patients with a variety of uncomfortable medical conditions, like migraines or burns. They may also experience a specific kind of pain (such as chest or abdominal) that requires management.
In this field, Anesthesiologists help alleviate a patient’s pain and work as a part of a healthcare team to determine how to treat the person. They may also talk to the patient and their loved ones about what they can expect with their pain levels and functionality.
Anesthesiologists who work in a critical care environment are Intensivists. When they receive a patient, they analyze their condition and determine the best way to manage their patient’s internal systems while providing medical care.
If their patient is unconscious, the Intensivist is trained to manage that condition. Their role is medical management of a patient and communicating with the rest of the healthcare team treating them.
What Degree is Required to Become an Anesthesiologist? What Do They Study?
See our detailed guide on how to become an anesthesiologist.
The first step to becoming an Anesthesiologist is getting an undergraduate degree. Most choose either pre-med or a science-focused major, but medical schools don’t have this as a requirement. As long as they score well on their Medical College Admission Test (MCAT), it doesn’t matter what subject they majored in for their undergrad schooling.
After earning their undergrad degree, students will take the MCAT. This standardized test measures their knowledge of biology, chemistry, psychology, and sociology, and their analytical abilities. The highest possible score is 528. There isn’t technically a passing score, but it’s recommended that students get at least a 506 or higher to have a better chance of getting into med school.
Once they’ve been accepted into med school, prospective Anesthesiologists will complete another four years of studies. This work includes taking another standardized exam, Step 1, better known as “Boards” and completing two years of clinical training, followed by another standardized test, Step 2.
After med school, prospective Anesthesiologists will complete an anesthesiology residency program. This is another four years of practical experience. During this stage, they will take Step 3, their final Board exam.
When they’ve completed their residency, Anesthesiologists must finish any state-specific requirements for training and education, so they can get their license to practice. If they’d like to practice within a specific medical subset, they will also need a specialist certification.
One of the most popular certifying bodies is the American Board of Anesthesiology (ABA). The ABA requires a year of anesthesia internship, then either a fellowship program or two years of working in a private practice.
For their fellowship, the Anesthesiologist can choose to focus in one of these specialties:
- Cardiac anesthesia
- Critical care medicine
- Hospice and palliative medicine
- Neuroanesthesia
- Obstetric anesthesia
- Pain management
- Pediatric anesthesia
During this post-graduate work, the ABA requires the Anesthesiologist to take three exams: the Basic (a written test given after their internship), the Advanced (when they’ve finished their residency), and the Applied (an oral and objective structured clinical exam). If they pass these tests, they will finally earn their license to practice.
Even after their years of work, Anesthesiologists are required to complete continuing medical education credits (CMEs) to maintain their ABA license. After five years of practice, they need to have 125 CMEs and after 10, they must have another 125. They will also take a medical ethics course and submit self-assessment questions.
What Skills are Required in Anesthesiology?
One of the most important skills for Anesthesiologists is being detail oriented. Since they’re responsible for keeping patients unconscious during surgery and are the ones who are pharmacology experts, among other important responsibilities, paying close attention to details is imperative.
They should also work well under pressure and be excellent problem solvers since things can quickly go wrong during a surgery — and in pre- and post-operation too.
Because Anesthesiologists work as a part of a care team, strong communication, along with the ability to listen to what others are saying, are also important skills.
How Much Money Does an Anesthesiologist Earn?
With so much schooling and specialization, Anesthesiologists are well-paid for their efforts (see our anesthesiologist salary guide for more). Once they’ve earned their certification, these physicians can expect a starting salary of more than $300,000. Most established Anesthesiologists make at least $405,000, while those on the higher end of the spectrum make $500,000.
It’s a long path to get there, but the end salary helps lighten the burden of all the tests and years of studying.
Where are Anesthesiologists in Demand?
See also our guide to Which State Has the Greatest Anesthesiologist Shortage?
It’s estimated that the U.S. Anesthesiologist market will increase by 15.5% between 2016 and 2026. There are about 33,000 Anesthesiologists employed in America right now.
The demand for Anesthesiologists is considered moderate, but there are still plenty of opportunities within this subset. Candidates have the best chance of getting into the field if they’re willing to work in a rural region.
The top five states with the largest anesthesia job markets are:
- Texas: 4,440 Anesthesiologists
- California: 3,080 Anesthesiologists
- Florida: 1,570 Anesthesiologists
- New York: 1,410 Anesthesiologists
- Ohio: 1,260 Anesthesiologists