CRNA VS anesthesiologist MD - page 5

I am trying to decide weather I should become a CRNA or anesthesiologist. Can anyone help with the pro's and con's of each What do CRNA do that is different than a anesthesiologist? What can... Read More

  1. by   BCRNA
    AA's are not PAs. You do assist a physician, but your an AA. PA credential is different. That's like a crna saying they are an AA it vice versa. The surgical PAs I work with are very quick to point this out. Also, exactly how is your education better? I would agree that the anesthesia portion is the same. But if it is so much better, why do you have a smaller scope of practice and NO autonomy. The MDs I work with tell me that technically AAs aren't suppose to make ANY decisions on their own. The reality is that they do, but if a bad outcome occurs the AA is hung out if the MD says they didn't make that decision and was never informed. And by smaller scope of practice I mean you can not function independently in private practice, I know your technical skills are the same.
  2. by   BCRNA
    All the CRNA's need to check out www.anesthetist.org , it's good for a laugh. I kept saying "wow" as I was reading about the profession. I have respect for AA's and do believe that an experienced CRNA and an AA can provide the same level of care. Though, how many times and in how many different ways can they say that an AA must be supervised and only "assists" with anesthesia on their website. It even goes as far to say the anesthesiologist has to determine the type of anesthetic, though fortunately the AA can "assist". Check out the practice statements, talk about trying to gain control and a monopoly by the MD's. I would welcome AA's with open arms if they weren't so controlled by MD's. I will be honest and just say that I think MD's created AA's in an attempt to further their monopoly and try to push CRNAs down. I don't have anything against AA's. I just don't want them used to control my pay or try to push me out of practice. If AA's proliferate then that is what is going to happen. MD's will hire the people they have total control over and then dictate what you get paid keeping most of the money for themselves. It isn't a patient safety issue, anesthesia is extremely safe regardless of the provider used.

    And what good is bragging about starting the graduate program having completed a pre-medical background. I checked out all the prereq's required to get into AA programs. Every CRNA I know has those. The only difference is that most CRNA have a BSN instead of a BS. Most RN's do not have the scientific background, but CRNA's do. We take the same organic, biochemistry, and biology classes. And specializing in nursing, in my opinion, better prepares for anesthesia. I started off with an enormous knowledge base on pathophysiology, pharmacology, and vasoactive drugs. Not to mention IV starting skills and intubation skills (I worked in a place where the RN's did it). Does knowing advanced physics or advanced molecular knowledge make you any better at anesthesia? No. The prereq's listed teach you everything you need to know to get started. People who want to get into a CRNA program take advanced science classes to get in. And having to take the MCAT doesn't make you any better or smarter. The MCAT shows that the person has a good grasp on the sciences. You would be very hard pressed to show how alot of what is in the test could be translated into use in anesthesia. I can't remember having to use any thermodynamics or physics equations of any kind in order to provide anesthesia.

    Looking at the requirements to get into an AA program on their website, correct me if I am wrong, but it is possible to have just a few science classes and a degree in philosopy, history, or art and get into an AA program.
  3. by   DEMARRTAA-C
    Bryan AA-C programs in the US are PA programs. Hence I had gone to Emory. Bryan I think you are thinking of the Anesthesia Assistant Technologist which is totally different. It like comparing the CRT to a RRT of you in your field a LVN,LPN to a RN.
  4. by   stanman1968
    AA classes are not far more complex, they are not better trained one can make an excellent argument that there training is inferior, they are taught to be dependent and many are taught little to no regional, that kind of limits what one can do, better only if inability or under training is "better".
  5. by   core0
    Quote from DEMARRTAA-C
    Bryan AA-C programs in the US are PA programs. Hence I had gone to Emory. Bryan I think you are thinking of the Anesthesia Assistant Technologist which is totally different. It like comparing the CRT to a RRT of you in your field a LVN,LPN to a RN.
    AAs are not PAs. They are not trained in general medicine. They are trained in a specific area of medicine. Only in Georgia are they referred to as PAs. This is a result of Georgia adopting an already outmoded concept of PA practice in the late 1960s which referred to specialty PAs as type B PAs. This was quickly abandoned. To reiterate all PA programs in the US are accredited by ARC-PA. Can you please show any AA program that is accredited by ARC-PA? If you don't graduate from a PA program you are not a PA.
  6. by   BCRNA
    My statements were based on what I have heard from surgical pa's say. Sorry if it isn't right, you can set me straight. What they said is that AAs may go to school alongside PAs but they aren't PAs, their certification and licensure is AA, they have a completely different scope of practice. It would be like a crna claiming to be a NP. Just because we went to school together doesn't make us the same. Are you a PA-c and a AA-c. I checked out your schools website, why is there a 19 month track for PA-c holders and a 24 month track for just a bachelors degree? Can the PA-c be earned with just five months extra? The site said both groups are eligible for AA certification. From my perspective it would seem more logical that if an aa was equal to pa, then your credential would be pa behind your name. Would like to hear your explanation, would be interesting. And is there another anesthesia provider one step under AA's?
    I was shocked to see an anesthesia program only 19 months long. Technically we only are required 24, but most are 28 to 34. What websites would be good to learn about AAs? I don't work with any and would like reliable info about them.
  7. by   nomadcrna
    The shorter 19 month track is for PAs who want to become anesthesia assistants. You must already be a PA.
    Even the PAs who do this program and become AAs are not "better" than CRNAs. Speaking as one who is BOTH a FNP and CRNA. The PA/FNP does not help much in giving better anesthesia care.
    The fact remains that AAs must function supervised(by MDA)not any physician and are only allowed to practice in certain states. I can practice in any state and do not have to work with MD anesthesiologist. I can also practice totally independently, can do chronic pain if I want and BTW, have prescriptive authority. I can also do everything the MDA can do, blocks, lines etc.
  8. by   core0
    Quote from BryanCRNA
    My statements were based on what I have heard from surgical pa's say. Sorry if it isn't right, you can set me straight. What they said is that AAs may go to school alongside PAs but they aren't PAs, their certification and licensure is AA, they have a completely different scope of practice. It would be like a crna claiming to be a NP. Just because we went to school together doesn't make us the same.
    The schools that I am directly familar with have completely separate programs for PAs and AAs. They might share a few classes such as anatomy, but most PA schools use a systems based approach which wouldn't be very useful for AAs. One way of looking at it, is that an AA is a limited scope PA. This is the licensure method that Georgia uses. It basically dates from a time in the 1960's when there were a bunch of experimental models which had type A - generalist PAs, type B limited scope PAs (Anesthesia, surgery, OB-GYN, psych among others) and type C PAs which were technical PAs (ortho PA is probably the best example of this). Both the profession and organized medicine rejected this fairly quickly after the experiment started and with the exception of AAs most of the other type B PA programs were absorbed into the mainstream PA programs. There exist PA programs which have a specific focus such as surgery or primary care but all PA programs have to have the same broad training in general medicine with exposure to all areas of medicine (generally). For that matter in most states there is nothing that directly prevents a PA from doing general anesthesia. There are lots of PAs in perioperative medicine, pain medicine and even a few doing general anesthesia.

    The other way of looking at it is that they are two separate professions which happen to have common methods of training. One in specific area of medicine and one in general medicine. This is the approach that most states take that license AAs (separately outside the PA practice act).


    Quote from BryanCRNA
    Are you a PA-c and a AA-c. I checked out your schools website, why is there a 19 month track for PA-c holders and a 24 month track for just a bachelors degree? Can the PA-c be earned with just five months extra? The site said both groups are eligible for AA certification. From my perspective it would seem more logical that if an aa was equal to pa, then your credential would be pa behind your name. Would like to hear your explanation, would be interesting. And is there another anesthesia provider one step under AA's?
    I was shocked to see an anesthesia program only 19 months long. Technically we only are required 24, but most are 28 to 34. What websites would be good to learn about AAs? I don't work with any and would like reliable info about them.
    I'm not sure who this is directed at, but I'm a PA-C. Theoretically the reason for the PA to AA track is that PAs have had the didactic portion covered in the first semester of the AA program in their PA program. What I know about this is what I've seen at PA conventions. Other than that its up to Emory to make sure their graduates are trained. For web sites you can look at the certification website:
    http://www.aa-nccaa.org/

    and the AAAA here:
    http://www.anesthetist.org/

    As far as an AA becoming a PA the AA would lack an education in general medicine. In particular outpatient, inpatient, ambulatory, surgical and emergency medicine. The NCCPA requires that a student graduate an ARC-PA accredited program with didactic and clinical education in all of those areas and more. So no you would need more than 5 months of training for an AA to become a PA. Essentially there are no shortcuts for the PA education. The PharmD in my program had to take all of the pharmacology courses.

    Basically to have the credential AA-C behind your name you have to graduate from an AA program and pass the certification exam. If you want the PA-C behind your name you have to graduate from a ARC-PA accredited PA program and pass the PANCE.
  9. by   BCRNA
    I checked Emory's website and the state medical boards. In Georgia and Kentucky it is possible to be both an AA and a PA, but they do differentiate betweeen the two. In all other states I looked at an AA is not allowed to use the title of PA, particulary Texas who actually has a law against it. It just depends on what state they work in. They are fairly new and not widespread yet, so things may change as they progress. Though many sites did refer to AA's as a specialty physician assistants, that is not their credential though in most states.
  10. by   wtbcrna
    Here is everything you ever wanted to know about the differences in CRNAs and AAs. http://everhadgas.com/CRNA-AA_Compar...update_208.pdf
  11. by   remifentanil
    And let us not forget there are no AAs in the military.
  12. by   ssrhythm
    Quote from PageRespiratory!
    OK....Line by line it is............


    >
    >
    Same here. I admit I come across somewhat abrasive around here sometimes, although justifiable most times. I honestly have a lot of respect for nurses, specifically CRNA's. I just find the nursing agenda, specifically the AANA, full of hogwash propaganda. A good friend from RT school has been an RN for a few years now and was accepted at SUNY Downstate's nurse anesthesia program...ironically he says during his interview they were very interested in his RT experience. Grrr.....

    Page, I am an RRT who is 16 months from becoming a CRNA. I completely understand where you are coming from regarding the "regression" aspect of becoming a nurse. Folks, he has a point here. I have a BS in Biology from Clemson University, and AD in Respiratory Therapy from Shelton State Community College, and a BSN from The University of South Carolina, so I am ultra-experienced in higher education! Any RRT going back to nursing school is going to sit in those classes and want to stab himself in the temple with his pencil as the classes, while different in many ways, are a step below what a RRT has already completed...especially if that RRT has been out practicing for any length of time with any level of autonomy. That is a fact. That said, (take note PageRT) the critical care nursing experience gained as an RN is HUGE! There needs to be some type of RRT to BSN program, but they don't exist. Unfortunately, to go from an RRT to CRNA, you have to take that step backwards (nursing school) to take a very critical step forward (ICU NURSING experience). Sorry if that steps on toes, but there were absolutely no classes in my BSN program that advanced my understanding of patient care. The additional pharmacology was great, and there were aspects of Med-Surg that were helpful, but not until I graduated and started working as a CVICU nurse did I start adding skills and knowledge that have actually been helpful in my CRNA program. When I graduated from my RT program, I understood pathophysiology, IABP, hemodynamics, vasoactive pharmacology etc. at a level that my BSN never touched on; heck, we had IABP, central line, and PAP catherter insertion labs. While RN programs cover a much broader base of material, they do not touch in nearly the detail the aspects of pathophysiology and critical care that my RT program did. So I get where pageRT is coming from. PageRT, there are definite skillsets that RNs have that are critical to being a great anesthesia provider. While there are areas that I've had a huge advantage as an RRT, there are experienced RNs in my program that have a huge advantage over me due to their 10+ years of CC nursing experience. In the anesthesia masters programs, students will be taught everything we learned in RT school to a greater degree except for mechanical ventilation. In those same programs, however, students will not necessarily be taught what you learn when you are a practicing critical care nurse; those skills are expected to be there and be strong. It would be very, very difficult to seamlessly provide great anesthesia care without that nursing experience. Could it be done? Sure it could, but as an experienced RRT, RN and now SRNA, I fully understand why the program is the way it is. I can honestly say that when I need anesthesia services, I want a CRNA taking care of me over any AA with the same experience. Now, If I could have an experienced CRNA that is both an RN and RRT, well that would be ideal. Regardless, the nursing component will be in there if you are going to administer anesthesia to this cat! Anyhoo, I feel you; I was in the same frustrating position five years ago. Most of the BSN process was brutal to deal with, but in the end it was worth it. I thoroughly enjoyed the critical care nursing (did not think I would) and it has helped tremendously in CRNA school. Do what you need to do, but when you look at the +s and -s of both programs, I'd bite the bullet and go CRNA over AA if I were you; I'd do it again without hesitation.
  13. by   SuperSixEightMD
    Quote from keithjones
    CRNA need 1-2 years critical care experience post BSN. and 2-3 years for the CRNA. the MD route will require 1-2 years additional science courses to get into med school for 4 more years followed by 3 years residency and 1-2 more years for fellowship. so post BSN 11 years for MD vs 3-5 for CRNA. Both perform the same procedures in the OR and many hospitals are hiring more CRNAs since they are cheaper. you can still plan on making 160-200k a year as a CRNA though so not shabby.
    Actually, your description of an anesthesiologist's training is close, but not completely accurate.

    We spend four years in undergrad. Four years in medical school. Then four years in residency. The first year of residency is typically devoted to medicine or surgery (although when you're a PGY-1 resident in surgery, you spend a lot more time dealing with medical issues than performing surgery in the OR).

    Following the four-year residency, there are one-year fellowships in various areas of anesthesiology such as obstetrics, cardiac, pediatric, pain management, and critical care medicine (although any anesthesiologist is pretty darn well trained in this). Fellowship is optional, and as I understand it, about half of the anesthesiologists nowadays are doing fellowships.

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