CRNA or MDA

CVmursenary · Oct 13, 2011

I'd say go CRNA for sure. Imagine having to site through the years of school learning about far too detailed cellular crap. Anyways if you start CRNA you will be starting to learn practical information and you can get into difficult cases such as hearts and livers I have heard; as long as your in the right setting.

ImThatGuy, BSN, RN · Oct 13, 2011

Oh, geez, you'd do better off going through the CRNA thing. It's more available, shorter, and cheaper. You're probably going to drop at least a quarter million dollars on medical school alone if not more. Add to that interest on loans. Then you'd go through a residency making about a third (or less) of what you would as a CRNA.

Anesthesiology is a very competitive residency right now, and from what I understand anesthesiologists don't like the whole "MDA" thing. They ARE anesthesiologists. A CRNA is an anesthetist. Sure, they typically have similar roles.

If you did go to medical school there's a chance that something else would pop up since you'd be given the chance to apply to any specialty. With those options on the table you might undergo a residency in anything and specialize in that instead.

Likewise, you might choose a fellowship in anesthesiology and focus on critical care (they are the founders of CCM) or pain medicine (huge reimbursement).

It's a matter of do you want to go the whole way and be the top dog so to speak in your field, or do you want to make a lot of money sooner?

Heck, if it's a money thing pick PM&R. It's the residency for jocks. Nobody shoots for it, it's said to be very student-friendly, and you can still do the same fellowship in pain medicine and make more in less time, lol.

allnurses Guide · Oct 13, 2011

Autonomy all depends on where you work. Some places are going to be heavily supervised as a CRNA and other places are going to CRNA only shops. Bigger more complex cases come with larger hospitals which are usually ACT practices, if you want to do the more complex cases steer clear of hospitals that have anesthesiology residency programs.

I think what most people don't understand is that if you goto medical school it doesn't mean that you are going to get the residency of your choice. Anesthesiology is one of the most sought after residencies. It isn't enough just to want to be MDA. Medical students have to compete for those limited slots.

msn10 · Oct 13, 2011

Anesthesiology is a very competitive residency right now, and from what I understand anesthesiologists don't like the whole "MDA" thing. They ARE anesthesiologists. A CRNA is an anesthetist. Sure, they typically have similar roles.

Very true. Anesthesiologists are MD's, not MDA's. A term that is not recognized by medical schools. You graduate with an MD, not MDA. Just like CRNA's have their own title.

If you go to med school, you have more options. If you go to CRNA school, you are going to be a CRNA when you graduate.

Not only is the medical residency very competitive right now, CRNA's in our area (large metropolitan with satellite rural facilities) having a hard time finding jobs as well. We had 13 applications in 2 days for a prn position. The hospital also just decreased the CRNA pay by 7% and for the first time added 2 AA's.

In other words, make sure you really look into both options because either choice is a huge and competitive commitment.

allnurses Guide · Oct 13, 2011

Very true. Anesthesiologists are MD's, not MDA's. A term that is not recognized by medical schools. You graduate with an MD, not MDA. Just like CRNA's have their own title.
If you go to med school, you have more options. If you go to CRNA school, you are going to be a CRNA when you graduate.
Not only is the medical residency very competitive right now, CRNA's in our area (large metropolitan with satellite rural facilities) having a hard time finding jobs as well. We had 13 applications in 2 days for a prn position. The hospital also just decreased the CRNA pay by 7% and for the first time added 2 AA's.
In other words, make sure you really look into both options because either choice is a huge and competitive commitment.

Anesthesiologists are commonly referred to as MDAs even by other anesthesiologists and physicians or sometimes "ologists" for short. MDA is a term first coined by an insurance company. Otolaryngologists are referred to as an ENTs which you won't find on their degrees either, and gastroenterologists are referred to GI docs etc. It is nothing but a shortened form of their job description just like FP, ortho, OB/GYN etc.

CRNA job availability is highly area specific (I have two other facilities I work prn at now with possibility of working at 2-3 more if I can find the time), and as far as MDAs they usually start looking for a job 6-12mo+ out. One of the major factors to consider with CRNAs is that our average age is 47yr. There are going to be lots of CRNAs retiring in the next 10-15yrs, and with the new possibility of a renewed federal opt-out long term prospects are looking good for CRNAs.

The only thing that AAs are good for is bringing down the overall salaries of CRNAs. They don't expand anesthesia services, and they cannot work outside the ACT model.

msn10 · Oct 13, 2011

Anesthesiologists are commonly referred to as MDAs even by other anesthesiologists and physicians or sometimes "ologists" for short.

Again, that depends on the area. Around here they hate the term and no one uses it. I understand specialists use additional acronyms, but they aren't changing the MD part of their title to differentiate themselves from a nurse.

The only thing that AAs are good for is bringing down the overall salaries of CRNAs.

Sounds like the same thing MD's say about CRNA's. Not trying to stir the pot, God knows the animosity between the 2 fields is well established and deep. It would just be refreshing if cultures could be different.

OP: Good luck to you, but anesthesia is a highly competitive field so study hard and get good experience and may I suggest shadowing each speciality for at least a couple of days each.

allnurses Guide · Oct 13, 2011

Again, that depends on the area. Around here they hate the term and no one uses it. I understand specialists use additional acronyms, but they aren't changing the MD part of their title to differentiate themselves from a nurse.
Sounds like the same thing MD's say about CRNA's. Not trying to stir the pot, God knows the animosity between the 2 fields is well established and deep. It would just be refreshing if cultures could be different.
OP: Good luck to you, but anesthesia is a highly competitive field so study hard and get good experience and may I suggest shadowing each speciality for at least a couple of days each.

As the saying goes anesthesia is the only nursing specialty that physicians practice.

AAs are a political device used by the ASA to try to control CRNA practice. AAs aren't like other non-physician providers,such as PAs, that came about for other reasons. AAs were solely invented for political purposes.

msn10 · Oct 13, 2011

As the saying goes anesthesia is the only nursing specialty that physicians practice.

Again, depends on who you ask. FP/NP, Midwife/OB, etc., all have similarities and historically the 'nursing' counterparts were practicing before the MD's were. Things have changed and our knowledge which comes from research (which is primarily medically funded) and practice has elevated healthcare as a whole. So some could say most MD specialties have come from nursing backgrounds but have morphed the speciality into a medical focus.

AA's may have been established for political reasons, but so far there is no difference in the literature regarding patient care/safety between a CRNA and AA and you are right, they tend to be cheaper. All the more reason the hospitals are hiring them.

PMFB-RN, RN · Oct 13, 2011

Where I work everybody, including Anesthesiologists themselves, calls them MDAs. Totally normal to have an Anesthesiologists call the ICU to talk to a nurse and say "Hi this is Bob the MDA for patient XYZ, how is he doing?". Or to hear an ICU nurse say to the HUC (if it is day shift during the week) "can you page the on call MDA for me".

Also CRNAs & MDA both do all the cases, including the most complicated in our hospital.

We are the flag ship hospital for a large health system. We have both CRNA and MDA here Mon-Fri 8 hour days shift. CRNA only nights and weekends and they do any case, including open heart and neuro surg cases with no MDA in the building. All the rest of the smaller hospitals use CRNAs exclusively and they operate under their own license and are not supervised by any physician.

allnurses Guide · Oct 14, 2011

Again, depends on who you ask. FP/NP, Midwife/OB, etc., all have similarities and historically the 'nursing' counterparts were practicing before the MD's were. Things have changed and our knowledge which comes from research (which is primarily medically funded) and practice has elevated healthcare as a whole. So some could say most MD specialties have come from nursing backgrounds but have morphed the speciality into a medical focus.
AA's may have been established for political reasons, but so far there is no difference in the literature regarding patient care/safety between a CRNA and AA and you are right, they tend to be cheaper. All the more reason the hospitals are hiring them.

No, historically CRNA practice is not like FP/NP or Midwife/OB. Nurses developed with anesthesia in this country, and physicians didn't really start to become interested in anesthesia until the mid-20th century when it became a lucrative practice. Physicians have been around since ancient times. In comparison anesthesia is relatively new speciality.

What makes anesthesia so safe is the technology we use daily. Most of that technology was not invented by anesthesiologists or physicians.

AAs have research that show they are safe in ACT practices. There are no studies directly comparing CRNAs and AAs only different kinds of ACT practices. There never will be a study comparing the two directly, because AAs cannot work without supervision.

AAs do drive down the cost at certain hospitals, but overall they do nothing for access/quality of care or costs of anesthesia care for the public at large. ACT practices are expensive and have shown no benefit to patient safety. AAs are just another political expense that has no real benefit to the public.

msn10 · Oct 14, 2011

Nurses developed with anesthesia in this country, and physicians didn't really start to become interested in anesthesia until the mid-20th century when it became a lucrative practice.

Nurses and doctors developed a lot of things but I wouldn't use the same drugs/technologies they did a century ago. Who cares who invented it? That is also debatable. The first known anesthetic comes from the Inca Shamans. I am not about to go get a Shaman for my next surgery.

What makes anesthesia so safe is the technology we use daily. Most of that technology was not invented by anesthesiologists or physicians.

Most of that technology comes from research which was funded by medical schools. It is no secret that medicine has the money and does most of the research regardless of the discipline. OB, FP, Radiology, etc. It is only recently that nursing has started to do much more research. It is very hard to get funded.

Physicians didn't really start to become interested in anesthesia until the mid-20th century when it became a lucrative practice

CRNA's are the highest paid nurse without a significant amount more of training than their other NP counterparts, and much less the PhD scholars. For many CRNA's its about the money.

Again, we could go round and round. I have to many MD's (2) and CRNA's (4) in my family and class to show either disrespect and I really can't stand the chips on all the shoulders.

OP: There is a difference between CRNA and MD otherwise they would all just have the same title and education. CRNA is less time in school (even with the DNP) and somewhat less money. As I said, if you graduate with a CRNA that is all you can do unless you want to go back to staff nursing. An MD can still practice outside a hospital or surgery center as an MD. They can go into pain management, go on for fellowships and even be a FP. We have a retired anesthesiologist in a rural community that is the family practice doctor and he is wonderful. Good luck to you.