CRNA vs Anesthesiologist: What’s the Difference & Why It Matters

Curious about the difference between a CRNA and an anesthesiologist? Learn how education, roles, and responsibilities compare—and why both matter in modern anesthesia care.

When it comes to anesthesia care, two highly trained professionals take the lead: CRNAs (Certified Registered Nurse Anesthetists) and anesthesiologists. While they both play vital roles in keeping patients safe and pain-free during surgery, their education paths; and scope of practice differ.

So what’s the difference between a CRNA and an anesthesiologist—and why should it matter to you? Whether you’re a nursing student thinking about the CRNA path, a medical student considering anesthesiology, or just curious about who’s behind the anesthesia mask, this guide breaks it all down.

What Is a CRNA?

A CRNA, or Certified Registered Nurse Anesthetist, is an advanced practice nurse who is trained to deliver anesthesia and manage patients before, during, and after surgical procedures. Nurse anesthetists were the first anesthesia professionals in the US, predating anesthesiologists by decades. Today there are more than 65,000 CRNAs in practice.

Education and Pathway

To become a CRNA, you must:

• Earn a 4-year Bachelor of Science in Nursing (BSN)
• Become a licensed RN and gain 1–3 years of critical care experience
• Complete an accredited doctoral nurse anesthesia program (DNP or DNAP), usually 3-4 years long
• Pass the National Certification Examination (NCE) through the NBCRNA

Most CRNA programs include over 2,000 clinical hours and 600+ cases across a wide variety of surgical specialties. Graduates from CRNA programs have an average of 9,432 hours of clinical experience.

Want to learn more about becoming a CRNA? Read our guide: What Is a CRNA?

Scope of Practice

CRNAs can:

• Independently administer all types of anesthesia (general, regional, MAC, etc.)
• Monitor patients during surgery
• Manage airway and resuscitation
• Provide post-anesthesia care
• Work in any clinical environment where anesthesia services are needed

They are the sole anesthesia providers in many rural hospitals, outpatient centers, and in the military, but often work in major hospitals, trauma centers, and academic institutions.

Learn more: AANA: What is a CRNA?

What Is an Anesthesiologist?

An anesthesiologist is a physician (MD or DO) who specializes in anesthesia and perioperative medicine. There are about 52,000 physician anesthesiologists in the US.

Education and Pathway

To become an anesthesiologist, you must:

• Complete a 4-year undergraduate degree
• Attend 4 years of medical school
• Finish a 4-year anesthesiology residency
• Pass the American Board of Anesthesiology certification exams (not mandatory)

Scope of Practice

Anesthesiologists are trained in:

• Advanced diagnostics and management of critically ill patients
• Supervising anesthesia care teams (including CRNAs and anesthesiologist assistants)
• Preoperative evaluation and post-op ICU care
• Pain medicine and regional anesthesia
• Research and academic teaching

They often work in major hospitals, trauma centers, and academic institutions.

Explore the journey: ASA’s “Roadmap to Become an Anesthesiologist”

CRNA vs Anesthesiologist: Key Differences

Both professionals deliver safe, high-quality care—they just take different educational routes.

The Anesthesia Care Team Model

In many hospitals, anesthesia care is delivered through a team-based model that combines the strengths of both CRNAs and anesthesiologists.

• In some cases, CRNAs practice independently and manage full case loads.
• In other facilities, CRNAs and anesthesiologists work together under the Anesthesia Care Team (ACT) model.
• An anesthesiologist may supervise 2–4 CRNAs simultaneously while maintaining medical oversight.

This collaborative approach helps balance patient safety, access to care, and efficient use of resources—especially in high-volume or high-acuity centers.

Common Myths & Misconceptions

Let’s clear up a few misunderstandings:

Myth 1: CRNAs aren’t as safe as anesthesiologists
Fact: Multiple studies show no significant difference in patient outcomes between CRNAs and anesthesiologists, especially in similar clinical environments.

Myth 2: CRNAs always need supervision
Fact: CRNAs have been practicing independently for over 100 years and still can today.  Some states require collaboration with a physician but those rules are generally considered antiquated and are being revised.

Myth 3: Anesthesiologists don’t provide direct care
Fact: Many anesthesiologists provide hands-on care and take lead on their own cases.

Myth 4: CRNAs and anesthesiologists compete
Fact: While sometimes anesthesiologists and CRNAs might both compete for the same work, everyone wants the same thing: the best patient outcomes. CRNAs and anesthesiologists respect and appreciate each other and work well together.

Real-Life Examples

1. CRNA in a Rural Trauma Center
Kelly, a CRNA in Montana, often manages emergency C-sections and trauma cases overnight—on her own. With no anesthesiologist on staff, she’s the sole anesthesia provider for miles.

2. Anesthesiologist in a Liver Transplant Program
Dr. Singh leads the anesthesia team in a major transplant hospital. He performs pre-op assessments, manages complex intraoperative care, and mentors residents.

3. Team-Based Cardiac OR
In a cardiac OR in Florida, Dr. Rivera works with Logan and Jessica, two CRNAs running simultaneous CABG cases, jumping in to offer an extra set of hands as needed, like at cannulation and bypass management.

Choosing the Right Career Path

If you’re torn between the two professions, ask yourself:

Do you prefer patient-centered holistic care that the nursing profession offers?

• CRNA might be for you.

Do you prefer a medical model, focusing on disease process and diagnoses?

• Anesthesiology may be your calling.

Other things to consider:

• Academic vs hands-on career goals
• Time and financial investment
• Desire for autonomy
• Work-life balance

Final Thoughts

At the end of the day, both CRNAs and anesthesiologists play vital, complementary roles in modern healthcare. They share the same goal: keeping patients safe, comfortable, and cared for during some of life’s most vulnerable moments.

For SRNAs and CRNAs, understanding your scope, educating others, and embracing collaboration is key to growing your practice and your confidence.

At Ollivate, we’re here to support your CRNA journey—from board prep to continuing education and clinical practice insights.

Explore more on:

🌟 What Is a CRNA?—Ollivate Blog
🔍 Ollivate’s SEE & NCE Practice Exams

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References:

American Association of Nurse Anesthesiology. Become a CRNA
American Society of Anesthesiologists. Roadmap to Becoming an Anesthesiologist