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How to Become an Anesthesiologist: Requirements, Degrees and Salary

Degrees, residency, fellowships, licensing and pay for anesthesiology — plus the CRNA and anesthesiologist assistant alternatives.

2026-08-017 min read

Anesthesiologists keep patients alive and pain-free through surgery and manage critical care and chronic pain. US median pay is around $400,000; Switzerland pays roughly $260,000.

Degrees You Must Earn

  • Bachelor's degree (4 years) with pre-med prerequisites — biology, chemistry, physiology, biomedical engineering.
  • MD or DO (4 years); Europe/Turkey: 6-year medicine faculty.
  • Anesthesiology residency (4 years): one intern year plus three clinical anesthesia years.
  • Optional fellowship (1 year): cardiac anesthesia, pediatric anesthesia, critical care, pain medicine, obstetric anesthesia, regional anesthesia.

Admission Requirements

Moderately competitive by surgical standards: Step 2 CK in the 240s is strong, research is helpful but not mandatory, and letters from anesthesiology rotations matter most. Pain-medicine and cardiac fellowships are the competitive bottlenecks.

Licensing and Certification

USMLE Steps 1-3, state license, and American Board of Anesthesiology certification: BASIC exam after CA-1, ADVANCED written after residency, then APPLIED (oral and objective structured clinical exam). Maintenance of certification is continuous (MOCA).

Realistic Timeline

18 → 22 bachelor's → 26 MD → 30 board-eligible attending. This is one of the fastest routes to a $350,000+ income in medicine.

Skills That Decide Success

Vigilance across long uneventful stretches punctuated by seconds of crisis, pharmacology mastery, airway procedural skill, ultrasound-guided regional blocks, and calm crisis leadership.

Shorter Alternative Paths

  • CRNA (Certified Registered Nurse Anesthetist): BSN (4 years) → 1-2 years ICU nursing → Doctor of Nursing Practice in anesthesia (3 years). Median US pay $215,000-$250,000.
  • Anesthesiologist Assistant (AA): bachelor's with pre-med courses → 2-2.5 year master's. Pay $180,000-$220,000, but practice is limited to certain states.

Pay Progression

Resident $65,000-$80,000; first-year attending $350,000-$420,000; partner in an independent anesthesia group $500,000-$650,000; pain-medicine practice owners can exceed that. Locum tenens rates run $250-$350 per hour.

Disclaimer

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