Yes, anesthesiologists must complete medical school. Anesthesiologists are medical doctors who specialize in the practice of anesthesiology, a field of medicine that encompasses perioperative care, pain management, and critical care medicine. This physician role requires a lengthy and rigorous educational pathway that begins with an undergraduate degree and continues through medical school, a specialized residency, and ultimately board certification. The training prepares them to manage a patient’s vital functions and safety before, during, and after a surgical procedure.
The Initial Requirements: Pre-Medical Education
The journey to becoming an anesthesiologist begins with a four-year undergraduate degree, which is a prerequisite for medical school admission. While no specific major is formally required, applicants typically pursue a Bachelor of Science in a field such as biology, chemistry, or biochemistry, as these majors naturally incorporate the necessary coursework. Acceptance into a medical program hinges on the successful completion of essential prerequisite science courses, including general biology, general and organic chemistry, physics, and often biochemistry.
A high score on the Medical College Admission Test (MCAT) is also a significant factor in the medical school application process, as the exam assesses problem-solving, critical thinking, and knowledge of scientific concepts. Beyond academics, applicants must demonstrate a commitment to medicine through extensive clinical shadowing of physicians and volunteer experience in healthcare settings. These activities provide foundational exposure to patient care and the medical environment, which is necessary for a successful application.
The Foundation: Medical School Training (MD or DO)
Following the undergraduate degree, aspiring anesthesiologists must complete four years of medical school to earn either a Doctor of Medicine (MD) or a Doctor of Osteopathic Medicine (DO) degree. The curriculum is traditionally divided into two segments, starting with the foundational sciences during the first two years. During this period, students immerse themselves in subjects like anatomy, physiology, pharmacology, and pathology, which form the scientific basis for all medical practice.
The final two years of medical school are dedicated to core clinical rotations where students apply their knowledge in a hospital setting under the supervision of attending physicians. To become licensed to practice medicine, students must pass the required national licensing exams, which are the United States Medical Licensing Examination (USMLE) Steps 1 and 2 for MD students or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Levels 1 and 2 for DO students. After completing medical school, graduates participate in a nationwide process known as The Match to secure a position in an accredited anesthesiology residency program.
Specialized Training: The Anesthesiology Residency
Anesthesiology residency is a four-year postgraduate training program. The first year (PGY-1 or Clinical Base Year) focuses on broad clinical skills outside of anesthesia. Rotations often include internal medicine, emergency medicine, pediatrics, or surgical specialties, providing a foundation in general patient care.
The subsequent three years (CA-1 through CA-3) involve intensive, specialty-specific training focused entirely on anesthesiology. Residents gain hands-on experience in managing patients undergoing a diverse range of procedures, including general surgical anesthesia, neuroanesthesia, and cardiac anesthesia. Rotations provide expertise in subspecialties like obstetric anesthesia, pediatric anesthesia, and critical care medicine.
Responsibility and autonomy progressively increase during the CA years, culminating in the CA-3 year where residents function as leaders of the perioperative care team. Residents prepare for American Board of Anesthesiology (ABA) certification by taking the BASIC Exam at the end of the CA-1 year, which tests the scientific basis of clinical practice.
Advanced Credentials and Practice
After completing residency, the physician is eligible for state medical licensure to practice independently. Board certification is the final step, obtained through either the American Board of Anesthesiology (ABA) or the American Osteopathic Board of Anesthesiology (AOBA). Certification involves rigorous examinations, including a written ADVANCED exam taken after residency and a final APPLIED exam (Standard Oral Examination and Objective Structured Clinical Examination).
Certification requires continuous Maintenance of Certification (MOC). MOC requires ongoing continuing medical education, cognitive assessment, and practice performance assessment to ensure the physician remains current. Physicians may also complete an optional one-to-two-year fellowship to gain subspecialty expertise in areas like pain medicine, pediatric anesthesia, or critical care medicine.
What Anesthesiologists Do
Anesthesiologists manage patients throughout the surgical experience (perioperative care). This begins with the preoperative evaluation, where the anesthesiologist assesses health, reviews history, and formulates a plan to address potential risks. During the intraoperative phase, the anesthesiologist administers anesthesia, monitors vital functions (heart rate, blood pressure, breathing), and makes immediate adjustments.
The scope of practice extends beyond the operating room to include patient recovery and acute pain management. They frequently staff and direct critical care units, using skills in resuscitation and life support to manage critically ill patients. They lead the Anesthesia Care Team, medically directing other providers in settings like surgical suites, pain management clinics, and labor and delivery units.
Understanding Related Anesthesia Roles
The Anesthesiologist (MD/DO) is a physician distinguished from other professionals who provide anesthesia care. The Certified Registered Nurse Anesthetist (CRNA) is an advanced practice registered nurse who has completed a doctoral-level program in nurse anesthesia. CRNAs must have prior intensive care unit experience before beginning their anesthesia training, which is based on the nursing model of care.
Anesthesiologist Assistants (AAs) are healthcare professionals who have completed a master’s degree program in anesthesiology and must work under the direct supervision of an anesthesiologist. The AA pathway includes a strong pre-medical background but bypasses the four years of medical school and full physician residency.