CRNA vs MD

[exrocketscientist]

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Currently a rocket scientist - considering either an 8 year path to CRNA or med school. The latter would cost a considerably greater amount, and take a bit longer. I'm no longer a young buck, so the quicker route to CRNA seems more appealing (something like $100k debt vs $500k). I know there has been some organizational discord between these two groups, and general consensus on this board suggests that CRNAs are significantly encroaching on Anesthesiologists, with the latter viewing the former as intellectually incompetent in many cases. But hey, in my case I'd be able to introduce myself as CRNA - former rocket scientist 😉

Honest thoughts/recommendations?

 

[Wamuu]

When you say you want to take the quicker route as a CRNA, it can be interpreted as you want to do what an anesthesiologist does but faster. I want to let you know that it’s not at all the same thing and out of principle, I would be against being part of a field whose governing body actively shames CAAs (ironic) and acts like doctors are just more expensive nurses.

Plus, med school and anesthesiology residency combined is 8 years. These years are going to pass regardless, so would you rather be a doctor or a nurse?

 

[exrocketscientist]

Yes, I recognize they aren't equivalent. Although, it does seem to be becoming a bit muddied depending on the state; for example, my state does allow CRNAs to practice independently. But, if I was the one receiving treatment, I'd want an MD, not a nurse. Med school would require me to take a couple of pre-req courses and the MCAT, so it'd tack on a couple of extra years over the 8 for a CRNA. I'd realistically prefer to be an MD, but given the bit of extra time and costs, the financially sound decision is CRNA (I wrote a matlab script to project my net worth in both scenarios - MD is behind by a fair amount, and even more-so when I consider the earlier access to sheltering income in tax-free growth vehicles). CRNAs also generally seem to have better work hours than most MDs. So, not only would I earn more over my lifetime, but I'd also essentially have a healthier lifestyle. Because of these, I'm somewhat leaning the nursing route, even though calling myself a rocket surgeon would be entertaining.

 

[Nontrad_FL_LGBT]

Yes, I recognize they aren't equivalent. Although, it does seem to be becoming a bit muddied depending on the state; for example, my state does allow CRNAs to practice independently. But, if I was the one receiving treatment, I'd want an MD, not a nurse. Med school would require me to take a couple of pre-req courses and the MCAT, so it'd tack on a couple of extra years over the 8 for a CRNA. I'd realistically prefer to be an MD, but given the bit of extra time and costs, the financially sound decision is CRNA (I wrote a matlab script to project my net worth in both scenarios - MD is behind by a fair amount, and even more-so when I consider the earlier access to sheltering income in tax-free growth vehicles). CRNAs also generally seem to have better work hours than most MDs. So, not only would I earn more over my lifetime, but I'd also essentially have a healthier lifestyle. Because of these, I'm somewhat leaning the nursing route, even though calling myself a rocket surgeon would be entertaining.

How old are you? My class oldest person is probably early 40s and we have at least 20-30 30+ yos. Age isn't a barrier to this unless you make it one.

 

[exrocketscientist]

How old are you? My class oldest person is probably early 40s and we have at least 20-30 30+ yos. Age isn't a barrier to this unless you make it one.

That's great to hear - still very hesitant to pull the trigger due to the financial implications as well as the associated lifestyle. Nurses, in general, seem to basically have their cake and eat it too (schedules + comp for CRNAs) relative to MD counterparts who appear to be highly overworked (60+ hrs/week) albeit greater comps.

 

[Nontrad_FL_LGBT]

That's great to hear - still very hesitant to pull the trigger due to the financial implications as well as the associated lifestyle. Nurses, in general, seem to basically have their cake and eat it too (schedules + comp for CRNAs) relative to MD counterparts who appear to be highly overworked (60+ hrs/week) albeit greater comps.

It has sucked to go from $100k+ as an engineer to essentially broke, but it's not that bad tbh. I still eat well and get everything I need. It does suck when you really just want to take a trip or go to a show and it's just not in the budget, but that's life.

You'll work like a dog in school and residency regardless, but you can work part time and outearn a CRNA as an attending anesthesiologist if you want. You just have to be okay with living like a student for 4 years, then living (financially, not schedule-wise) like a median American for residency. Good luck making your choice!

 

[holdthemayo]

Yes, I recognize they aren't equivalent. Although, it does seem to be becoming a bit muddied depending on the state; for example, my state does allow CRNAs to practice independently. But, if I was the one receiving treatment, I'd want an MD, not a nurse. Med school would require me to take a couple of pre-req courses and the MCAT, so it'd tack on a couple of extra years over the 8 for a CRNA. I'd realistically prefer to be an MD, but given the bit of extra time and costs, the financially sound decision is CRNA (I wrote a matlab script to project my net worth in both scenarios - MD is behind by a fair amount, and even more-so when I consider the earlier access to sheltering income in tax-free growth vehicles). CRNAs also generally seem to have better work hours than most MDs. So, not only would I earn more over my lifetime, but I'd also essentially have a healthier lifestyle. Because of these, I'm somewhat leaning the nursing route, even though calling myself a rocket surgeon would be entertaining.

If time and costs are your biggest concern, you should look into certified anesthesia assistant programs as well. The training would be much shorter than either CRNA or MD/Residency and your day-to-day would be very similar to that of a CRNA. The biggest downside is that you would be geographically limited, but I expect that to change over time.

There is a shortage of anesthesia providers of all kinds, so you will not have a problem finding jobs when you are done, regardless of what you pick. I would probably be perfectly happy as a CRNA/AA, but I know a couple of anesthesiologists who went back to medical school and residency after being out and working as a CRNA.

 

[amoxicillin_resistant]

go for MD and be a neurosurgeon so u can be a neurorocketsurgeon scientist

 

[polymerization]

I'll warn you that CRNA isn't necessarily a much shorter path than a physician anesthesiologist from your vantage. I considered it for a hot minute.

Considering you already have a bachelor's degree, it might be easy for you to get an accelerated BSN, granted, there are prerequisites to nursing that differ significantly from programs that draw from the basic sciences (lifespan development, anatomy/physiology for nursing majors, nutrition, etc.).

Once you're done with your BSN, you need specific work experience. Most people get this experience in critical care (MICU/SICU/CVICU/neuro ICU... PICU/NICU won't count). The requirement appears to be ~1 year minimum, but most people get more. Many will then sit for the CCRN (critical care registered nurse) credentialing exam (and I've seen people try the cardiac medicine/cardiac surgery if they had CVICU experience).

Some people have to go back for their general chemistry and CRNA-specific requirements, but I imagine you have those already. You'll have to sit for the GRE.

CRNAs have transitioned out of primarily MSNs toward the DNP, so the education is 3 years long now.

So, if we're keeping a running total, you're looking at 2 years for the accelerated BSN, 1-2 years of work experience, an application year, and then 3 years of CRNA school; and that's assuming you are able to get in right away given the few programs available.

Medical school and residency alone are already going to be ~8 years, granted, but if the difference is a year or two, is time really the biggest factor?

It's fair to think about scope creep, but the AANA has a chokehold on the profession. It's hard to argue nurses can't administer anesthesia when they literally were the first to do so. I think it will be difficult to imagine how it would be possible for the government to completely nullify licensure for a professional-level doctorate degree. The nursing lobby isn't dumb. At the same time, the ASA and AMA have been really hostile and for the most part successful in precluding CRNAs from practicing independently. Time will tell.

 

[bomba]

An important question to ask yourself is whether you want to spend your career in the OR as an anesthetist. Both routes will give you options if you decide anesthesia isn’t for you. Worst case, you could still work as an RN or as a physician in another specialty. Those are very different paths, so it’s worth deciding which one fits you best.

As others have said, if you are truly interested in anesthesia but concerned about the time commitment to become an anesthesiologist, look into the anesthesiologist assistant route. That’s the choice I ultimately made. I had planned on medical school, but changed my mind after shadowing both an anesthesiologist and AAs in an ACT model. For me, having an anesthesiologist available for backup when things go wrong is a feature, not a drawback.

This brings me to my next point. Shadowing could give you more clarity in making your decision. It definitely helped me. I also recommend spending time around high-acuity patients. It will help you decide if healthcare is the right fit. If you spend enough time on this forum, you’ll see Goro recommend volunteering with hospice. That’s exactly what I did, and it was an excellent way to find out if I was comfortable being around sick and dying people. It’s not for everyone, but for some it clicks and feels like a calling.

 

[bomba]

I'll warn you that CRNA isn't necessarily a much shorter path than a physician anesthesiologist from your vantage. I considered it for a hot minute.

Considering you already have a bachelor's degree, it might be easy for you to get an accelerated BSN, granted, there are prerequisites to nursing that differ significantly from programs that draw from the basic sciences (lifespan development, anatomy/physiology for nursing majors, nutrition, etc.).

Once you're done with your BSN, you need specific work experience. Most people get this experience in critical care (MICU/SICU/CVICU/neuro ICU... PICU/NICU won't count). The requirement appears to be ~1 year minimum, but most people get more. Many will then sit for the CCRN (critical care registered nurse) credentialing exam (and I've seen people try the cardiac medicine/cardiac surgery if they had CVICU experience).

Some people have to go back for their general chemistry and CRNA-specific requirements, but I imagine you have those already. You'll have to sit for the GRE.

CRNAs have transitioned out of primarily MSNs toward the DNP, so the education is 3 years long now.

So, if we're keeping a running total, you're looking at 2 years for the accelerated BSN, 1-2 years of work experience, an application year, and then 3 years of CRNA school; and that's assuming you are able to get in right away given the few programs available.

Medical school and residency alone are already going to be ~8 years, granted, but if the difference is a year or two, is time really the biggest factor?

It's fair to think about scope creep, but the AANA has a chokehold on the profession. It's hard to argue nurses can't administer anesthesia when they literally were the first to do so. I think it will be difficult to imagine how it would be possible for the government to completely nullify licensure for a professional-level doctorate degree. The nursing lobby isn't dumb. At the same time, the ASA and AMA have been really hostile and for the most part successful in precluding CRNAs from practicing independently. Time will tell.

Nobody is arguing that nurses shouldn’t be involved in administering anesthesia. The real points of contention are independent nurse anesthetist practice, title misappropriation, and the intellectually dishonest claims of physician equivalence.

I also see it brought up often that nurses were the first to give anesthesia. That simply isn’t true. By all accounts, the first was a dentist. And even if it were true, the field has advanced far beyond the days of ether soaked rags. That point becomes especially meaningless when you consider that modern anesthesia has been shaped through decades of research and innovation led by physicians.

 

[polymerization]

Nobody is arguing that nurses shouldn’t be involved in administering anesthesia. The real points of contention are independent nurse anesthetist practice, title misappropriation, and the intellectually dishonest claims of physician equivalence.

I also see it brought up often that nurses were the first to give anesthesia. That simply isn’t true. By all accounts, the first was a dentist. And even if it were true, the field has advanced far beyond the days of ether soaked rags. That point becomes especially meaningless when you consider that modern anesthesia has been shaped through decades of research and innovation led by physicians.

It is certainly a contentious issue. We can spend forever debating semantics.

The only claim I'm making here is that nurse anesthesia predated physician anesthesia. It took time for that activity to be recognized as a medical specialty and nurses were doing that work in the interim. The circle has widened to CAAs and we are grateful for the role you play in our operating rooms.

For what it's worth, I share some of your concerns... and I see it your way now that I am on track toward medical school... but I also can't deny that I once believed the opposite when I was considering the nursing route. I can understand your vantage as a CAA has its own vested interests as well.

We are all trying to feel insulated from the frustrations this industry carries with it, feed our families, and have enough energy left in the tank to do something fun every once in a while. It's hard to do that when you're already in debt, have a nontransferable skill set, and are watching policies written by non-professionals dilute your practice.

I can't blame you for not wanting strangers to take a piece of your pie.

 

[exrocketscientist]

If time and costs are your biggest concern, you should look into certified anesthesia assistant programs as well. The training would be much shorter than either CRNA or MD/Residency and your day-to-day would be very similar to that of a CRNA. The biggest downside is that you would be geographically limited, but I expect that to change over time.

There is a shortage of anesthesia providers of all kinds, so you will not have a problem finding jobs when you are done, regardless of what you pick. I would probably be perfectly happy as a CRNA/AA, but I know a couple of anesthesiologists who went back to medical school and residency after being out and working as a CRNA.

Unfortunately, while my state allows AA, no one is currently hiring them (might be linked to the lack of schools offering the degree, which is currently 0 in my state).

 

[exrocketscientist]

go for MD and be a neurosurgeon so u can be a neurorocketsurgeon scientist

hahaha tempting

 

[exrocketscientist]

I'll warn you that CRNA isn't necessarily a much shorter path than a physician anesthesiologist from your vantage. I considered it for a hot minute.

Considering you already have a bachelor's degree, it might be easy for you to get an accelerated BSN, granted, there are prerequisites to nursing that differ significantly from programs that draw from the basic sciences (lifespan development, anatomy/physiology for nursing majors, nutrition, etc.).

Once you're done with your BSN, you need specific work experience. Most people get this experience in critical care (MICU/SICU/CVICU/neuro ICU... PICU/NICU won't count). The requirement appears to be ~1 year minimum, but most people get more. Many will then sit for the CCRN (critical care registered nurse) credentialing exam (and I've seen people try the cardiac medicine/cardiac surgery if they had CVICU experience).

Some people have to go back for their general chemistry and CRNA-specific requirements, but I imagine you have those already. You'll have to sit for the GRE.

CRNAs have transitioned out of primarily MSNs toward the DNP, so the education is 3 years long now.

So, if we're keeping a running total, you're looking at 2 years for the accelerated BSN, 1-2 years of work experience, an application year, and then 3 years of CRNA school; and that's assuming you are able to get in right away given the few programs available.

Medical school and residency alone are already going to be ~8 years, granted, but if the difference is a year or two, is time really the biggest factor?

It's fair to think about scope creep, but the AANA has a chokehold on the profession. It's hard to argue nurses can't administer anesthesia when they literally were the first to do so. I think it will be difficult to imagine how it would be possible for the government to completely nullify licensure for a professional-level doctorate degree. The nursing lobby isn't dumb. At the same time, the ASA and AMA have been really hostile and for the most part successful in precluding CRNAs from practicing independently. Time will tell.

The MD timeline isn't quite 8yrs - since I'd need to take more prereqs ~1.5yrs for med programs vs ABSN or direct entry MSN program. Then, I figured probably about 6 months for MCAT prep + some additional time for application processes, so maybe around 11ish years going the MD route vs a 7 to 8yrs CRNA route.

Your last note is interesting - and I see this ultimately favoring the AANA, given multiple states (including mine) have already granted full autonomy. However, many hospitals have not transitioned into that type of organizational structure - but there are quite a few that have. The AMA is going to have difficulties putting the genie back into the bottle at this point.

 

[bomba]

The MD timeline isn't quite 8yrs - since I'd need to take more prereqs ~1.5yrs for med programs vs ABSN or direct entry MSN program. Then, I figured probably about 6 months for MCAT prep + some additional time for application processes, so maybe around 11ish years going the MD route vs a 7 to 8yrs CRNA route.

Your last note is interesting - and I see this ultimately favoring the AANA, given multiple states (including mine) have already granted full autonomy. However, many hospitals have not transitioned into that type of organizational structure - but there are quite a few that have. The AMA is going to have difficulties putting the genie back into the bottle at this point.

That’s something people have been saying for decades, yet all anesthesia providers, whether CRNA, AA, and MD/DO, still have no trouble finding jobs. The fact remains that both patients and hospitals prefer physician-led anesthesia care, and you even said it yourself. That’s why CRNA only practice is limited to low-acuity, rural, and financially distressed facilities.

Patients are not stupid. When the AANA’s talking points are presented with transparency, people can see through them. On top of that, there is a trend toward insurance companies reimbursing QZ billing at 85% of physician rates. That makes the risk-reward calculation for using independent CRNAs or “collaborative” models much less appealing.

That’s not to say CRNAs are going anywhere—they are here to stay. But the newer generation of anesthesiologists is tired of the AANA’s antics. I know it’s anecdotal, but I’m acquaintances with the director of anesthesia for a large health system in my city. He is actively working toward transitioning to all AAs for exactly that reason. He is sick of the nonsense.

The bottom line is you will be gainfully employed no matter which path you choose.

 

[polymerization]

The MD timeline isn't quite 8yrs - since I'd need to take more prereqs ~1.5yrs for med programs vs ABSN or direct entry MSN program. Then, I figured probably about 6 months for MCAT prep + some additional time for application processes, so maybe around 11ish years going the MD route vs a 7 to 8yrs CRNA route.

Your last note is interesting - and I see this ultimately favoring the AANA, given multiple states (including mine) have already granted full autonomy. However, many hospitals have not transitioned into that type of organizational structure - but there are quite a few that have. The AMA is going to have difficulties putting the genie back into the bottle at this point.

I'll mention that nursing programs can be predatory and lead you astray. You should know that, like medicine, a master's is not required to apply to doctoral-level programs.

A new grift (in my opinion) is taking advantage of non-nurses and implying that a master's level nurse will fare better in the job market or help bolster your application to a doctoral program. Neither is true. Some schools, like Columbia, even encourage you to apply to the doctoral program at the same time. If the bottleneck in the process is getting the RN license, what's the point of the master's at all—except paying beaucoup bucks to Columbia for no reason other than that they asked?

It's true that accrediting bodies like the ANCC require a certain percentage of nurses working at a Magnet-certified hospital to be BSN-RN trained at minimum... but that encourages hospitals to recruit BSN nurses, not MSN nurses, who would presumably command a higher salary for the same license. The calculus here feels paradoxical in that sense: more education for less opportunity.

I agree with your statement that the AANA will likely win the battle, if not the war. If we are chasing medical professions for "stolen valor" through proximity to the "doctor" title, I think looking toward CRNAs (who are THE most educated nurses) is a little rich. I would first investigate acupuncturists/naturopaths and god, the chiropractors, who regularly make medical conditions much worse while calling themselves neurologists. Psychologists regularly allow their patients to call them doctor relatively uncontroversially, as do optometrists, veterinarians, and even PAs with the DMS.

What I think the argument is really about is hedging bets on future earning potential/role legitimacy. CRNAs intend to push for full practice to bill at the level of a physician anesthesiologist, which will bolster their value in the market (given that they will be cheaper than physicians but work at a higher "level" than CAAs given that they can practice independently). I think CAAs are placing their bets on physicians given that they will never get full practice authority by design and would like to be viewed as equal to CRNAs, even as they are objectively not the same, in education, training, licensure, or salary. It wouldn't make sense for CAAs to ally with CRNAs in any way; it would be more protective for them to push to suppress CRNAs alongside physicians, if only to narrow their own professional differences and avoid being edged out of the industry like cardiac perfusionists.

Ultimately, it's really hard for any allied health profession that views itself as a shortcut to any autonomous medical role with good job security and compensation to do so for long. The "easier/more flexible" the path, the more these professions realize that saturation can happen quickly, just like it did for pharmacists. We watched a whole profession go from relatively well-respected to widely unrecognized within a generation. We see it with FNPs today, more and more often. For most people, the realization is that they've invested so much into something they didn't realize was fleeting, and the only possible move is trying desperately to pull up the ladder. Sadly, I don't know how successful that really ever is.

 

[bomba]

I'll mention that nursing programs can be predatory and lead you astray. You should know that, like medicine, a master's is not required to apply to doctoral-level programs.

A new grift (in my opinion) is taking advantage of non-nurses and implying that a master's level nurse will fare better in the job market or help bolster your application to a doctoral program. Neither is true. Some schools, like Columbia, even encourage you to apply to the doctoral program at the same time. If the bottleneck in the process is getting the RN license, what's the point of the master's at all—except paying beaucoup bucks to Columbia for no reason other than that they asked?

It's true that accrediting bodies like the ANCC require a certain percentage of nurses working at a Magnet-certified hospital to be BSN-RN trained at minimum... but that encourages hospitals to recruit BSN nurses, not MSN nurses, who would presumably command a higher salary for the same license. The calculus here feels paradoxical in that sense: more education for less opportunity.

I agree with your statement that the AANA will likely win the battle, if not the war. If we are chasing medical professions for "stolen valor" through proximity to the "doctor" title, I think looking toward CRNAs (who are THE most educated nurses) is a little rich. I would first investigate acupuncturists/naturopaths and god, the chiropractors, who regularly make medical conditions much worse while calling themselves neurologists. Psychologists regularly allow their patients to call them doctor relatively uncontroversially, as do optometrists, veterinarians, and even PAs with the DMS.

What I think the argument is really about is hedging bets on future earning potential/role legitimacy. CRNAs intend to push for full practice to bill at the level of a physician anesthesiologist, which will bolster their value in the market (given that they will be cheaper than physicians but work at a higher "level" than CAAs given that they can practice independently). I think CAAs are placing their bets on physicians given that they will never get full practice authority by design and would like to be viewed as equal to CRNAs, even as they are objectively not the same, in education, training, licensure, or salary. It wouldn't make sense for CAAs to ally with CRNAs in any way; it would be more protective for them to push to suppress CRNAs alongside physicians, if only to narrow their own professional differences and avoid being edged out of the industry like cardiac perfusionists.

Ultimately, it's really hard for any allied health profession that views itself as a shortcut to any autonomous medical role with good job security and compensation to do so for long. The "easier/more flexible" the path, the more these professions realize that saturation can happen quickly, just like it did for pharmacists. We watched a whole profession go from relatively well-respected to widely unrecognized within a generation. We see it with FNPs today, more and more often. For most people, the realization is that they've invested so much into something they didn't realize was fleeting, and the only possible move is trying desperately to pull up the ladder. Sadly, I don't know how successful that really ever is.

This framing oversimplifies the motives and strategic position of CAAs. The CAA profession is not built on “hedging bets” against CRNAs, but on strengthening the physician-led anesthesia care team model that has consistently proven to deliver the safest and most cost-effective outcomes in perioperative care. CAAs are specifically trained to work in this collaborative model, which is why “full practice authority” is neither a goal nor relevant to our role. Our scope is intentionally aligned with anesthesiologists to maintain a unified standard of care, not to compete with or replace them.

The assumption that CRNAs practicing independently are operating “at a higher level” than CAAs ignores the reality that anesthesia is a high-acuity, rapidly evolving specialty where outcomes are best when anesthesiologists lead care. Independence does not inherently equal higher capability. It simply removes a layer of oversight that serves as a critical safety net. CAAs train under the medical model with intensive anesthesia-specific education, and our clinical competencies are on par with CRNAs in the operating room when working within the ACT framework.

As for the suggestion that CAAs are “objectively not the same” in education, training, or licensure, that is true only insofar as our pathways differ by design. The CAA pathway was modeled directly after physician assistant training but with 100 percent anesthesia-focused didactic and clinical instruction. The result is a provider whose education is specialized, consistent, and highly standardized across all programs, something that cannot be said for nursing-to-CRNA pathways, which can vary widely in pre-anesthesia clinical exposure and academic rigor.

Lastly, comparing CAAs to cardiac perfusionists is a flawed analogy. Perfusionists were displaced in part because their work is confined to a narrow subset of surgeries, and they lacked a strong integration into the broader perioperative care team. CAAs, on the other hand, are fully integrated into anesthesia delivery across all specialties, all surgical environments, and all case complexities. Our alignment with anesthesiologists is not about “avoiding being edged out”. It is about reinforcing a care model that consistently earns the trust of hospitals, surgeons, and patients alike.

 

[bomba]

Regardless, the real question is whether OP wants to be a CRNA or an anesthesiologist. Those roles are objectively not the same. OP needs to decide if they want to be a physician or if they would be content working as a mid-level. It’s still putting the cart before the horse if they haven’t done any shadowing or gotten any real clinical exposure. That experience will make the decision much clearer.

 

[Ho0v-man]

CRNA is certainly tempting. But I think an actual scientist would lose their mind studying nursing. A lot of people teaching in nursing schools couldn’t hack a general bio degree. It would likely be infuriating to try to learn from these people. You’ll probably grow frustrated with the lack of critical thinking in a med school curriculum tbh.

I’d go physician because you have options besides anesthesia. You might hate eating **** from surgeons. And most fields have a floor at or above crna earning.

 

[bomba]

CRNA is certainly tempting. But I think an actual scientist would lose their mind studying nursing. A lot of people teaching in nursing schools couldn’t hack a general bio degree. It would likely be infuriating to try to learn from these people. You’ll probably grow frustrated with the lack of critical thinking in a med school curriculum tbh.

I’d go physician because you have options besides anesthesia. You might hate eating **** from surgeons. And most fields have a floor at or above crna earning.

Agreed. I also think it’s important to consider whether they could realistically see themselves being happy as an IM or FM doctor if they choose the med school route. They’re probably intellectually capable of going into any specialty, but statistically speaking they need to at least think about the possibility of ending up as a generalist.

 

[exrocketscientist]

CRNA is certainly tempting. But I think an actual scientist would lose their mind studying nursing. A lot of people teaching in nursing schools couldn’t hack a general bio degree. It would likely be infuriating to try to learn from these people. You’ll probably grow frustrated with the lack of critical thinking in a med school curriculum tbh.

I’d go physician because you have options besides anesthesia. You might hate eating **** from surgeons. And most fields have a floor at or above crna earning.

Yes, I've noticed that in some of my pre-reqs already - the emphasis appears to be heavily memorization oriented. I got a question on one of my exams wrong because I didn't utilize the specific terminology they wanted, as I gave them the root cause of the issue (as engineers are trained to determine and mitigate); so it's definitely different.

 

[polymerization]

This framing oversimplifies the motives and strategic position of CAAs. The CAA profession is not built on “hedging bets” against CRNAs, but on strengthening the physician-led anesthesia care team model that has consistently proven to deliver the safest and most cost-effective outcomes in perioperative care. CAAs are specifically trained to work in this collaborative model, which is why “full practice authority” is neither a goal nor relevant to our role. Our scope is intentionally aligned with anesthesiologists to maintain a unified standard of care, not to compete with or replace them.

The assumption that CRNAs practicing independently are operating “at a higher level” than CAAs ignores the reality that anesthesia is a high-acuity, rapidly evolving specialty where outcomes are best when anesthesiologists lead care. Independence does not inherently equal higher capability. It simply removes a layer of oversight that serves as a critical safety net. CAAs train under the medical model with intensive anesthesia-specific education, and our clinical competencies are on par with CRNAs in the operating room when working within the ACT framework.

As for the suggestion that CAAs are “objectively not the same” in education, training, or licensure, that is true only insofar as our pathways differ by design. The CAA pathway was modeled directly after physician assistant training but with 100 percent anesthesia-focused didactic and clinical instruction. The result is a provider whose education is specialized, consistent, and highly standardized across all programs, something that cannot be said for nursing-to-CRNA pathways, which can vary widely in pre-anesthesia clinical exposure and academic rigor.

Lastly, comparing CAAs to cardiac perfusionists is a flawed analogy. Perfusionists were displaced in part because their work is confined to a narrow subset of surgeries, and they lacked a strong integration into the broader perioperative care team. CAAs, on the other hand, are fully integrated into anesthesia delivery across all specialties, all surgical environments, and all case complexities. Our alignment with anesthesiologists is not about “avoiding being edged out”. It is about reinforcing a care model that consistently earns the trust of hospitals, surgeons, and patients alike.

Nor should it be built on that basis. I can admit I am oversimplifying the argument. If we want to go deep, full Marx materialist, I'd say that even this argument overlaps with my reasoning. When you say CAAs provide the most "cost-effective" outcomes, you're not pitching the patient—who doesn't care and if you do your job right, is unconscious—but you are pitching the hospitals and insurers who actually pay your salary.

What you're missing is that CRNAs are making the same point: both professions are cheaper than anesthesiologists. That's why (and I'm speculating here) you'll only find fair-weather friends in physicians. At the end of the day, physicians are themselves interested in protecting their profession from everyone, including CAAs. That they are temporarily tolerating a "middle path" that acknowledges nuances in healthcare delivery today doesn't mean there isn't a tension, the can is just being kicked down the line. A great deal of physicians graduating today were sold promises as kids of a job in which they would be the kings of the castle, and the more "middle managers," the farther away that promise deviates from today's reality. That has created a push to reforge the monopoly over medical practice, carte blanche.

Whether CRNAs or CAAs got to full practice authority almost doesn't matter...whichever the case, that profession would become the larger target. If the trends continue, we should see that we move away from the ACT model in practice anyway as CAAs manage more cases on their own and a single anesthesiologist is assigned to ever more rooms at a time. Combine that with credential inflation, and CAAs with doctorate degrees (it's coming, just wait...) will want a slice of the pie. Again, can't blame them. And both the CRNAs and the physicians know that. It is rational self-interest at work.

At the end of the day, the hospital administrators, the policymakers, the insurance companies—they're all laughing at us. While we fight over who deserves what, they continue understaffing, make your job harder and more emotionally taxing, and then whisper in your ear that your colleagues are the reason for those circumstances. It shouldn't be CRNAs vs CAAs vs anesthesiologists, it should be ALL providers vs the healthcare system broadly and without reservation. THEY are the ones who often studied the least and look at us like annoyingly vocal nerds virtue signaling while they count their cash.

 

[exrocketscientist]

Agreed. I also think it’s important to consider whether they could realistically see themselves being happy as an IM or FM doctor if they choose the med school route. They’re probably intellectually capable of going into any specialty, but statistically speaking they need to at least think about the possibility of ending up as a generalist.

Yes, this is the thing - if I went MD i'd have to go Anesthesiologist, Cardiologist, or bust. I don't see myself as a IM/FM. There are also considerations for having children etc. that makes med school a bit more challenging to commit to.

 

[Ho0v-man]

Yes, this is the thing - if I went MD i'd have to go Anesthesiologist, Cardiologist, or bust. I don't see myself as a IM/FM. There are also considerations for having children etc. that makes med school a bit more challenging to commit to.

This is the mentality of someone who doesn’t know much about medicine. There’s plenty of it in every field. And I promise your average IM doc is thinking about things much more complex every day than any crna.

If you think you’d be unhappy in a generalist type field of medicine, you’ll almost definitely feel unfulfilled as a midlevel.

 

[bomba]

Yes, this is the thing - if I went MD i'd have to go Anesthesiologist, Cardiologist, or bust. I don't see myself as a IM/FM. There are also considerations for having children etc. that makes med school a bit more challenging to commit to.

Medical school is definitely an intimidating path. Everyone’s situation is different, but if I had been younger when I decided to leave corporate finance for a career in healthcare, I would have pursued medical school. At the end of the day, the only way to become a medical doctor and build a strong foundation of general medical knowledge is to go to medical school.

You will sometimes hear CRNAs say they have a doctoral-level education. While that is technically true from an academic standpoint, the difference in both content and rigor between the two paths is enormous.

Have you done any shadowing? I’m asking because I’m curious what specifically draws you to anesthesia and cardiology—two very different specialties. It might be worth shadowing IM and FM physicians as well. You might like it more than you expect.

I have a good friend who was completely set on becoming a surgeon but discovered during medical school that they enjoyed the cerebral side of medicine more. They are now a partner at a large hospitalist practice and love their career. It is something to keep in mind.

 

[kidthor]

Personally I think OP needs to clarify for themself why they want to go into medicine. It’s a little spell fix to say they want to go into anesthesia without a more more directed info. The road either through medicine or nursing to the end result is a long one and can change along the way. For example example I went in thinking I’d do EM but now I’m an anesthesiologist… some could go through nursing education and decide they’d rather go the management route than the CRNA route… and so forth.

So I’d try to solidify why medicine, why healthcare, and is it really worth it vs picking another “challenge” after now apparently being over their current job.

Note also the all of anesthesia is living on stipend/subsidy because reimbursement is so poor - and that’s getting worse every year. So it’s not like you can ever own your own practice (which is becoming the case across all of medicine).

 

[exrocketscientist]

Medical school is definitely an intimidating path. Everyone’s situation is different, but if I had been younger when I decided to leave corporate finance for a career in healthcare, I would have pursued medical school. At the end of the day, the only way to become a medical doctor and build a strong foundation of general medical knowledge is to go to medical school.

The science behind anesthesia and cardiac issues are what I find interesting which would serve to keep me engaged in those types of cases. IMs deal with a significant amount of cases that I personally don't find interesting. Definitely a valid point to call out the potential for interests to be in flux while gaining knowledge in the field.

 

[exrocketscientist]

Personally I think OP needs to clarify for themself why they want to go into medicine. It’s a little spell fix to say they want to go into anesthesia without a more more directed info. The road either through medicine or nursing to the end result is a long one and can change along the way. For example example I went in thinking I’d do EM but now I’m an anesthesiologist… some could go through nursing education and decide they’d rather go the management route than the CRNA route… and so forth.

I'd go with a CRNA 100% if I went the nursing route. I am not a fan of the bureaucracy and politics attached with admin/managerial roles. I love the theoretical aspects of my jobs in the aerospace field, but can't stand the essence of corporate america so I will be exiting.

 

[kidthor]

but can't stand the essence of corporate america so I will be exiting.

Noting as an anesthesiologist or CRNA you’ll be employed by a corporation most likely and also work in a bureaucratic hospital enterprise…

 

[exrocketscientist]

Noting as an anesthesiologist or CRNA you’ll be employed by a corporation most likely and also work in a bureaucratic hospital enterprise…

Sort of - it's a bit different than dealing with corpos. I could also choose to work as a 1099 contractor to significantly distance myself from it.