Anesthesiologists don't handle surgeries, but they play a key role in the operating room. Anesthesiologists are doctors who stay with the patient for an entire procedure, administering anesthesia and monitoring vital signs. To practice, anesthesiologists typically need at least 11 years of training and education. Those who put in the time and make it through successfully can expect big financial rewards. The field is the highest-paying specialty in medicine, with a median annual income of $407, 292 as of 2010, according to the U.S. Bureau of Labor Statistics.
Anesthesiologists begin their education earning a bachelor’s degree, which typically takes four years of full-time coursework to complete. Most medical schools don’t require a specific major, but they do look for classes and laboratory work in chemistry, physics and biology, as well as classes in genetics and microbiology. Math courses such as calculus and statistics are also important. Students who major in biochemistry, biology and neurobiology automatically take most of the required classes.
Anesthesiologists attend four years of medical school. They spend their first year studying basic sciences such as human anatomy, the biochemical basis of medicine, immunology, pathology and cells, tissues and organs. In the second year, classroom work turns to physiology, including the cardiovascular, respiratory, endocrine, nervous and reproductive systems. The third and fourth years revolve around clinical practice through clerkships in teaching hospitals. Students have to complete clerkships in internal medicine, surgery, pediatrics and neurology, among other practices. They also study clinical pharmacology, cardiac life support and advanced medical sciences.
After they wrap up eight years of college work, anesthesiologists need training. It takes three years to finish an anesthesiology residency, usually set in a teaching hospital’s general operating room. The first year focuses on basic anesthesia skills in routine cases. Residents get training in the second year in subspecialties such as pediatric anesthesia, obstetric anesthesia, regional anesthesia, critical care medicine and cardiovascular anesthesia. The third year includes advanced training in complex cases, such as pediatric cardiac anesthesia or liver transplant anesthesia. By the time they finish their residency, anesthesiologists will have handled more than 1,000 cases. Some anesthesiologists also complete fellowships for additional training in specialties such as neurosurgical anesthesia or multidisciplinary pain medicine. Fellowships typically last a year, though fellows can add a year for research.
Anesthesiologists must earn a state license to practice. To qualify, they have to pass the U.S. Medical Licensing Exam, a three-step test that doctors have as long as seven years to complete. The first step is an eight-hour test with 325 multiple-choice questions. Step two is a nine-hour, 355-question, multiple-choice exam, plus an eight-hour test of 12 patient cases. Finally, step three, which has 475 multiple-choice questions, is administered in two eight-hour segments. In addition to passing the test, state licensing boards require a minimum amount of residency experience. At the high end, Nevada requires three years of post-med school training. Most states, including California, Florida, New York and Texas, mandate one year.