Anesthesiologist

Education and Training: College, medical school, and specialized medical training

Salary: Median—$321,686 per year

Employment Outlook: Very good

Definition and Nature of the Work

Anesthesiologists are physicians who focus on surgical patients and pain relief. They administer anesthetics, which are medicines to prevent patients from feeling pain and sensations; closely monitor patients' vital signs during surgery and adjust anesthetics accordingly; monitor patients through the first recovery stages after an operation; and administer appropriate medications during recovery. In addition to helping patients through surgery, anesthesiologists may also help treat patients with conditions causing chronic pain. Many specialize in specific types of problems, such as respiratory or neurological illness. More than ninety percent of the anesthetics used in health care are administered by or under the direct supervision of an anesthesiologist.

An anesthesiologist's first contact with a surgical patient is usually during a "preoperative interview." At that time the anesthesiologist reviews the patient's medical history and medications, discusses the upcoming surgery, and reviews the options for anesthesia and pain-killing drugs. The anesthesiologist also becomes familiar with the patient's preexisting medical conditions, such as diabetes or heart disease, and plans how to manage those conditions during surgery.

The anesthesiologist is responsible for a patient's life functions as the surgeon and other members of the medical team operate. In the first phase of surgery, the anesthesiologist applies the anesthesia. During the middle phase, as the surgery actually takes place, the anesthesiologist uses sophisticated electronic equipment to carefully monitor the patient's vital signs, including heart rate and rhythm, blood pressure, breathing, and brain and kidney functions. As the surgical procedure progresses, the anesthesiologist may have to adjust the patient's anesthesia to compensate for changes in the patient's physical state.

When surgery is finished, the recovery phase begins. The anesthesiologist administers medications to reverse the effects of the anesthetic, returning the patient to consciousness if a general anesthetic has been used. After surgery, patients are moved to a recovery room, where the anesthesiologist is still responsible for the patient's vital functions. In the recovery room, nurses and other specially trained staff closely monitor the patient under the supervision of the anesthesiologist. Eventually, the anesthesiologist determines when the patient has recovered sufficiently to leave the recovery room.

There are three main types of anesthesia administered during surgery: general, regional, and local. General anesthesia renders the patient unconscious and unable to feel pain or any other sensation. Many general anesthetics are gases or vapors administered through a mask or breathing tube, whereas others are liquid medicines introduced through a vein. Regional anesthesia numbs an entire area of the body requiring surgery. Local anesthesia is used to numb a specific part of the body (such as the foot or hand). Both regional and local anesthetics are administered via injections. In addition to anesthetics, patients requiring regional and local anesthetics often are given sedatives to help them relax during surgery and put them to sleep.

Anesthesiologists work in hospitals or outpatient medical facilities where surgery is performed. Some work in emergency rooms, where they handle victims of heart attacks, shock, drug overdoses, traumatic injuries, and other serious health problems requiring immediate care.

Anesthesiologists work as part of a team. In surgery, the team includes the surgeons performing the operation and the nurses supporting them. Anesthesiologists often work directly with a nurse anesthetist who helps administer medications to the patient during surgery.

The job of the anesthesiologist requires intelligence, perseverance, and years of sophisticated training. Besides great technical skills, an anesthesiologist needs a good bedside manner, especially during the preoperative interview when the anesthesiologist must be able to calm the patient while eliciting important information. Anesthesiologists must themselves keep calm during high-stress situations, and they need to be able to maintain peak levels of concentration during long surgical procedures.

Education and Training Requirements

Anesthesiologists are highly educated medical professionals. They must undergo extensive training in addition to their basic medical education.

Like any other physician, an anesthesiologist must successfully complete a four-year undergraduate degree and a four-year medical school program. After medical school, an anesthesiologist takes an additional four years of specialized training.

During the first year of specialized training, an anesthesiologist serves a general internship and is trained in diagnosis or treatment in other areas of medicine. This is followed by an intensive three-year residency program on the technology and medical aspects of anesthesiology. Besides anesthesiology, an anesthesiologist must also study cardiology, critical care medicine, internal medicine, pharmacology, and surgery. An anesthesiologist may choose to specialize in a particular field, such as neurosurgical anesthesiology, and undergo additional training in that field.

Once an anesthesiologist has completed college, medical school, and residency and specialized training, his or her education is by no means finished. New developments in the field of anesthesiology require anesthesiologists to continually update their knowledge and skills through professional seminars and continuing education courses. All students interested in pursuing anesthesiology need a strong background in physics, chemistry, biology, and mathematics.

Getting the Job

Like all physicians, anesthesiologists must be driven, self-motivated individuals willing to work long hours under intense pressure. In addition, a medical education is extremely costly and requires a huge financial commitment. An estimated 80 percent of all medical students borrow money to cover their education expenses.

Anyone interested in pursuing a career in medicine should consider volunteer work at a local hospital or health clinic. That is a good way to gain firsthand experience in working with patients, doctors, nurses, and health care managers.

Advancement Possibilities and Employment Outlook

Anyone who has made it through medical school and residency training to become a fully licensed and practicing anesthesiologist has already made it to the top of his or her chosen field. He or she may decide to pursue a position as the anesthesiology department head within a specific hospital or health care facility. Individuals wishing to quit their medical practice can often find work as teachers.

In 2003 anesthesiologists accounted for approximately 5.4 percent of the 567,000 physicians in the United States. The growing and aging population will increase demand for physicians' services in the coming years. Employment of physicians and surgeons will grow faster than average for all occupations through the year 2014. Opportunities for individuals interested in becoming physicians and surgeons are expected to be very good.

Working Conditions

Anesthesiologists work in hospitals and medical facilities offering inpatient and outpatient surgery. They divide their time between patients' rooms, operating theaters, and post-operation recovery rooms. The job can be extremely stressful and may demand long hours. Anesthesiologists are often "on call," during which time they must be prepared to show up for emergency procedures at all hours of the day and night.

Where to Go for More Information

American Society of Anesthesiologists
520 N. Northwest Hwy.
Park Ridge, IL 60068-2573
(847) 825-5586
http://www.asahq.org

American Board of Medical Specialties
1007 Church St., Ste. 404
Evanston, IL 60201-5913
(847) 491-9091
http://www.abms.org

Earnings and Benefits

Anesthesiologists are near the top of the pay scale among all physicians. In May 2004 the median annual income for anesthesiologists who had been in practice for more than one year was $321,686.