To become an anesthesiologist in the US, you'll earn a bachelor's degree, complete 4 years of medical school for an M.D. or D.O., finish a residency in anesthesiology and get a state medical license. Board certification through the American Board of Anesthesiology (ABA) means passing a series of three exams: BASIC, ADVANCED and APPLIED.
Anesthesiologists are physicians who focus on the care of surgical patients and on pain relief. They're different from nurse anesthetists, who reach the operating room through nursing rather than medical school.
Figures come from the Bureau of Labor Statistics (BLS) Occupational Outlook Handbook and the American Board of Anesthesiology, both read on 26 October 2026.
Anesthesiologists in numbers
| Measure | BLS figure |
|---|---|
| Median pay, anesthesiologists (May 2025) | $391,490 a year |
| Anesthesiologist jobs, 2025 | 41,500 |
| Projected anesthesiologist jobs, 2035 | 43,000 |
| Projected growth 2025 to 2035 | 4%, in line with all physicians |
| New jobs over the decade | 1,500 |
That pay figure is as of October 2026. Anesthesiologists are one of the larger physician specialties BLS breaks out, with more jobs than psychiatrists or radiologists.
What anesthesiologists do
BLS says anesthesiologists administer drugs (anesthetics) that reduce or eliminate the sensation of pain during an operation or another medical procedure, and adjust the amount during surgery. They work in sterile environments and must follow strict protocol to keep them that way during procedures. Their work extends beyond the operating room to pain relief more widely.
How to become an anesthesiologist, step by step
- Earn a bachelor's degree. Medical school applicants usually study biology, physical science or healthcare, though no major is required.
- Get into medical school. Schools are highly competitive and weigh MCAT scores, transcripts, recommendations, leadership and interviews.
- Complete 4 years of medical school. Classroom science first, then clinical rotations in areas such as internal medicine, pediatrics and surgery.
- Complete an anesthesiology residency. Almost all graduates enter a residency in their specialty, and BLS says residencies last 3 to 9 years depending on the specialty.
- Pass the ABA exam series. BASIC, ADVANCED and APPLIED, on the way to board certification.
- Get your state license. All states require physicians to be licensed, including passing national exams.
- Consider a subspecialty. ABA offers subspecialty certification in multidisciplinary fields, and BLS says fellowships take 1 to 3 years.
The three-exam path
Here's what sets anesthesiology apart from many specialties. ABA certification isn't a single end-of-training exam. The board says anesthesiologists take a series of three exams on the way to certification: BASIC, ADVANCED and APPLIED. Once certified, diplomates can go further with subspecialty certification, and ABA runs a continuing certification program to keep certified anesthesiologists current.
BLS adds that board certification isn't legally required to practice, but it may increase your employment opportunities, which is why most residents treat the exam series as part of the job.
How anesthesiology pay compares
| Physician group | Median pay, May 2025 |
|---|---|
| Pediatric surgeons | $559,030 |
| Cardiologists | $496,010 |
| Radiologists | $420,860 |
| Anesthesiologists | $391,490 |
| Emergency medicine physicians | $335,550 |
| Family medicine physicians | $244,180 |
| All physicians and surgeons | $275,930 |
Those BLS medians are as of October 2026. Anesthesiology sits well above the physician median, and above emergency and family medicine, though below some surgical specialties.
Why demand holds up
BLS expects an increasing number of older adults, who are more likely to have health problems and need complex care, to drive overall demand for physicians. Rising rates of chronic illnesses such as diabetes, cancer and heart disease should also keep large numbers of people relying on physicians and surgeons. BLS projects anesthesiologist jobs to grow at the same 4% rate as physicians overall.
Getting into medical school
BLS says medical schools are highly competitive. Applicants usually submit transcripts, MCAT scores and recommendation letters, and schools also weigh personality, leadership and extracurricular activities. Most require an interview. Some schools offer combined undergraduate and medical programs lasting 6 to 8 years, which can shorten the total route if you know early that medicine is for you.
Anesthesiologist or nurse anesthetist?
| Role | Training route | Who they are |
|---|---|---|
| Anesthesiologist | Bachelor's degree, medical school, anesthesiology residency | A physician (M.D. or D.O.) |
| Nurse anesthetist | Nursing route; BLS lists a master's degree as typical entry education | A nurse; BLS groups them with nurse midwives and nurse practitioners |
Both work in anesthesia care, but the training differs. If the operating room appeals and medical school doesn't, nursing is the other door. For a wider look at clinical careers, our guide to healthcare jobs in demand covers roles across the field, and this guide to starting college helps with the first step.
What the work is like
Physicians may stand for long periods, and anesthesiologists spend much of their time in operating rooms. Most physicians work full time, some more than 40 hours a week, and many work long shifts with irregular or overnight hours or time on call. In group practices and healthcare organizations, physicians coordinate patient care with other professionals.
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My verdict
Anesthesiology is a long, demanding route with one of the highest physician medians: $391,490 as of October 2026. Plan for 4 years of medical school after your degree, a residency and the ABA's three-exam series. It suits people who stay calm under pressure and like precise, hands-on work. If you want the operating room without medical school, look at nurse anesthesia instead.
Frequently asked questions
How long does it take to become an anesthesiologist?
A bachelor's degree, 4 years of medical school and an anesthesiology residency. BLS says residencies last 3 to 9 years depending on the specialty, plus 1 to 3 years for a fellowship.
How much do anesthesiologists make?
BLS reports a median of $391,490 a year for anesthesiologists in May 2025.
What exams do anesthesiologists take?
ABA says anesthesiologists take a series of three exams on the way to certification: BASIC, ADVANCED and APPLIED.
Is an anesthesiologist a doctor?
Yes. Anesthesiologists are physicians with an M.D. or D.O. degree and a residency in anesthesiology.
What is the difference between an anesthesiologist and a nurse anesthetist?
An anesthesiologist is a physician who went through medical school and residency. A nurse anesthetist trains through nursing, and BLS lists a master's degree as their typical entry education.
Is anesthesiology a growing field?
BLS projects anesthesiologist jobs to grow 4% from 2025 to 2035, from 41,500 to 43,000.
Do anesthesiologists need board certification?
It isn't required by law, but BLS says board certification may increase employment opportunities.
Can anesthesiologists specialize further?
Yes. ABA offers subspecialty certification once you're certified, and fellowships take 1 to 3 years.
