CRNA vs. MDA - pros and cons

Trauma Tom · Apr 21, 2005

I am presently a SRNA so I have not worked as a CRNA or as an MDA. I would advise you to spend some time working with a CRNA and a MDA. While they both administer anesthesia, you will note than more often than not the MDA is involved in the supervision of multiple anesthetists, whether CRNA or AA. I find the idea of working with one patient at a time, and the ability to follow them from the initial assessment to the end of their surgery and carry them through to discharge very rewarding. MDA's can certainly do this as well if practicing in areas where they are giving direct patient care instead of supervision. In spending time with MDA's you will get some idea of the time they spend in their training and you can determine if the sacrifices are worth the benefits. CRNA school is no day in the park either, and will require sacrifices as well. I think you are wise to consider both at your age. One of my reasons for pursuing the CRNA route as opposed to MDA route was my age. I did not feel that at my age, 50, that it made sense to invest in the extra time and cost to go the MDA route as I did not feel that I could recoup my investment. Nor did I see the advantage in supervision when I preferred to be doing direct patient care. As a CRNA I will have the opportunity to practice independently. A big plus for an advanced practice nurse. For you, since nursing school is behind you, the decision will be about 1 year+ of ICU time along with 24-36 months of anesthesia school. In the future I think you will see many if not all CRNA schools increasing the time for school to 36 months for a Doctorate of Nurse Anesthesia Practice. Either way you will be looking at close to 4 years before becoming a CRNA. For the MDA route you have another 8 years four years of medical school and four years of residency. It also may also be beneficial for you to work a year or two as a nurse before deciding as you may see you either love or hate being a nurse. Keep in mind though the difference in your practice as an ICU nurse and the difference in practicing as a CRNA are worlds apart. Good luck whichever way you decide to go.

Trauma Tom

I am going to graduate with my BSN in December at age 22. It has been my goal for years to become a CRNA. I have thoroughly researched the profession (with help from some great posts on this forum) and I have fallen in love with it. Lately, though, I've been contemplating attending medical school. Reasons include: 1) I currently have no constraints (single, no children, geographic freedom, funds available) to attending medical school 2) The desire to further my education to a higher level 3) To "be all that I can be" 4) I am interested in many medical specialties including anesthesia, emergency medicine, surgery, orthopedics, and radiology
I love nursing and everything that it represents. I am just at a crossroads in my life and I am trying to make the best decision possible for my future. I've had doctors tell me that CRNA is a wise decision and to not become a doctor. I have also read about CRNA's that proceeded to return to school and become MDA's.
My primary concern is that I do not want work to completely overwhelm my life...I would prefer a fair balance between work and other aspects of life such as family.
In the following questions I refer to only MDA's, but feel free to answer the questions regarding MD's in general.
1) What would you say were some advantages/disadvantages of being a CRNA over an MDA (ex. lifestyle, respect, work opportunities, etc.)?
2) If a person has the opportunity to become either a CRNA or a MDA, which one would you recommend?

LNsrna · Apr 21, 2005

You mentioned other areas that you may be interested in such as surgery, etc. Medicine would certainly be the way to go in this regard. You also mention that you want balance in your life. I would stay away from surgery and the like if this is a priority. Anesthesia, whether it is as a CRNA or MDA is the way to go if you want a life. I work at a large level one facility and have seen several people, primarily female, switch from surgery to anesthesia because of the flexibility it affords them. As for CRNA vs MDA, you can find alot of material by doing searches with key words on this forum. Good luck to you on your great adventure!

rn29306 · Apr 21, 2005

I work at a large level one facility and have seen several people, primarily female, switch from surgery to anesthesia because of the flexibility it affords them.

Very true that ALOT of docs switch from surg to gas. I challenge anyone to find some doc who has switched from gas to surgery. THAT is a very rare change indeed.

AWDC · Apr 23, 2005

I am going to graduate with my BSN in December at age 22. It has been my goal for years to become a CRNA. I have thoroughly researched the profession (with help from some great posts on this forum) and I have fallen in love with it. Lately, though, I've been contemplating attending medical school. Reasons include: 1) I currently have no constraints (single, no children, geographic freedom, funds available) to attending medical school 2) The desire to further my education to a higher level 3) To "be all that I can be" 4) I am interested in many medical specialties including anesthesia, emergency medicine, surgery, orthopedics, and radiology
I love nursing and everything that it represents. I am just at a crossroads in my life and I am trying to make the best decision possible for my future. I've had doctors tell me that CRNA is a wise decision and to not become a doctor. I have also read about CRNA's that proceeded to return to school and become MDA's.
My primary concern is that I do not want work to completely overwhelm my life...I would prefer a fair balance between work and other aspects of life such as family.
In the following questions I refer to only MDA's, but feel free to answer the questions regarding MD's in general.
1) What would you say were some advantages/disadvantages of being a CRNA over an MDA (ex. lifestyle, respect, work opportunities, etc.)?
2) If a person has the opportunity to become either a CRNA or a MDA, which one would you recommend?

I'm not a nurse nor am I doc yet. (What brought me here is my interest in anesthesiology.) With regards to your dilemma, all I can offer is this little bit.

Medical school will give you the opportunity to sample different fields. If you're like me, there are more fields than you have time to sample in medical school. The flip-side is that once you've chosen a field, it's not very easy to switch out without going through another grueling residency and a significant decrease in income. (Such is the case when you and everyone else around becomes so specialized.) You also mentioned that want to "be all that you can be" and further your education higher. Well, both routes you'll be furthering your education but medical school certainly has those four extra years and there's not much more out there besides a PhD. And as a physician in any field you will invariably be the "go to" person.

Correct me if I am mistaken, but I believe that the four years of medical school and internship year will give you greater insight into your patient's condition perioperatively. Medical school and many anesthesiology programs can also help prepare you to do research as well. There are also further opportunities for subspecialization in pain medicine, pediatric anesthesiology, and critical care medicine (might be more).

As another poster stated, if you want a "better" balance between life and work, general surgery is not the way to go. However, many of the surgical subspecialties are not as intrusive on your life. The other specialties you mentioned provide a decent balance between work and life. However, I'm really not sure how the hours of a MDA compares to that of a CRNA. I'm sure others on this forum are much more knowledgeable in that area.

Bottom line, medicine is a big commitment no matter how it's cut and sliced. Will you be happy going through medical school? Or, would you rather cut to the chase and get to the anesthesia? Obviously, probably the most valuable people to talk to are the CRNA's that decided to become MDA's that you mentioned.

Personally, I really like medicine and I'm really enjoying medical school so with my obvious bias, I would recommend the MDA route. Well, I also get the sense that you're not completely sure which field you want to enter into. Best wishes in your decision.

yoga crna · Apr 23, 2005

While none of us have a crystal ball, someone your age would benefit from reading about health care economics and the future of medicine in this country. I believe that the gap will be narrowing between advance practice nursing and physicians in both income and clinical patient care. Currently, most CRNAs have higher incomes than family practitioner MDs. And, of course, we know that in anesthesia there are very few differences in anesthesia education and experience between the two professions.

That being said, you need to follow your gut and go which direction you think works best for you. Personally, I love being a CRNA because it brings me everything I want--direct patient care, good income, freedom of practice setting and being part of a wonderful professional community. Most physicians I know focus on money, investments, competition and professional jealousy.

Yoga CRNA

AWDC · Apr 24, 2005

Currently, most CRNAs have higher incomes than family practitioner MDs.
Most physicians I know focus on money, investments, competition and professional jealousy.
Yoga CRNA

Aw c'mon... that last sentence was just low blow. How about the physicians you know that don't focus on those things?

But what was really interesting was what you said about income. I knew CRNA's were paid well, I just didn't know they were paid that well. So I did a quick search for salary surveys. Enjoy!

For physicians:

http://www.allied-physicians.com/salary-surveys/physicians/

http://www.cejkasearch.com/compensation/amga_physician_compensation_survey.htm

For CRNA's:

http://www.cejkasearch.com/compensation/amga_midlevel_compensation_survey.htm

http://swz.salary.com/salarywizard/layouthtmls/swzl_compresult_national_HC07000007.html

But to the OP, please don't base your decision on salary, you will be well-paid either way. And there always seems to be someone paid more than you for the same work. Your career choices already put you in a position where you don't have to worry about your finances. You also have to remember that most new physicians have a massive educational debt these days. It's not pretty. With tuition of some med schools over $30K per year and adding on living expenses and interest and capitalization, that figure can easily balloon to over $200K by the time your done with residency. And many with previous educational debts before med school can see their loans amount to practically $300K. However, don't let that deter you if you really want to go the medicine route. Clearly, many docs have gone through it.

gaspassah · Apr 24, 2005

awdc i see your point but if i may make a comment. those starting salaries for crnas are usually based on a 40 hour per week schedule. are the physician salaries the same, ie are most of those based on 40 hours a week or do the doc usually have to spend more than 40 with call and all. i dont know just curious. and one of those web sites you posted noted that with benefits packages crna salaries were about 159 per year. also with 8 hours of OT per week the crna (on a base salary of 121k per year) can earn about 157k not including benefits. i'm not here to argue, just to provide a different perspective.

d

yoga crna · Apr 24, 2005

AWDC,

I notice that you are a medical student and see the world from that perspective. My viewpoint is from sitting in on operating room for over 45 years and being a first hand observer of what goes on in the real (academic and non-academic worlds).

As an example, on Friday while administering an anesthetic, I heard a surgeon complain about at least three of his colleagues and the quality of their surgery and how hard it is to compete. He also went on, ad nauseum about how hard it is for him to make enough money to maintain the standard of living he wants. I can assure you that no one in the operating room was interested in his "financial problems". These are just a few examples of the arrogance I have personally witnessed by physicians in my professional career. Of course, I generalize, but I am comfortable offering an honest perspective, based on personal experience.

YogaCRNA

foxyhill21 · Apr 24, 2005

Since u r in med school I have a question? Is it really hard or just alot of work? How was the MCAT? How long does it actually take to complete med school? If I am in med, school what will my sched (eg. mond-frid 8-5 at school) Thanks and good luck in finishing med school.

I'm not a nurse nor am I doc yet. (What brought me here is my interest in anesthesiology.) With regards to your dilemma, all I can offer is this little bit.
Medical school will give you the opportunity to sample different fields. If you're like me, there are more fields than you have time to sample in medical school. The flip-side is that once you've chosen a field, it's not very easy to switch out without going through another grueling residency and a significant decrease in income. (Such is the case when you and everyone else around becomes so specialized.) You also mentioned that want to "be all that you can be" and further your education higher. Well, both routes you'll be furthering your education but medical school certainly has those four extra years and there's not much more out there besides a PhD. And as a physician in any field you will invariably be the "go to" person.
Correct me if I am mistaken, but I believe that the four years of medical school and internship year will give you greater insight into your patient's condition perioperatively. Medical school and many anesthesiology programs can also help prepare you to do research as well. There are also further opportunities for subspecialization in pain medicine, pediatric anesthesiology, and critical care medicine (might be more).
As another poster stated, if you want a "better" balance between life and work, general surgery is not the way to go. However, many of the surgical subspecialties are not as intrusive on your life. The other specialties you mentioned provide a decent balance between work and life. However, I'm really not sure how the hours of a MDA compares to that of a CRNA. I'm sure others on this forum are much more knowledgeable in that area.
Bottom line, medicine is a big commitment no matter how it's cut and sliced. Will you be happy going through medical school? Or, would you rather cut to the chase and get to the anesthesia? Obviously, probably the most valuable people to talk to are the CRNA's that decided to become MDA's that you mentioned.
Personally, I really like medicine and I'm really enjoying medical school so with my obvious bias, I would recommend the MDA route. Well, I also get the sense that you're not completely sure which field you want to enter into. Best wishes in your decision.

Tenesma · Apr 24, 2005

yoga - i am impressed that you still do so many big, long cases after 45 years in the OR. That is a really long time!!!! wow!!!

for the original poster: your choice is a tough one. It sounds like you are interested in the practice of nursing (seeing as you are graduating with a BSN), and that is fantastic. But it also sounds like you are trying to make a choice between CRNA and MD... My recommendations (personal bias of course) would be for you to go the MD route since you are in a great situation (single, no children and so young). The MD route has some pros/cons

1) Length: CRNA for you would be 1-2 years of ICU experience followed by 2-3 years of CRNA school so you will be done in 3-5 years from now... MD for you would be 4 years of med school followed by 3-8 years of residency/fellowship (depending on what field you choose) - and for you that would be another 8-13 years from now (i added an extra year, because it is too late for you to apply to med school starting in 2005).

2) Fund of knowledge: what is your desire as far as your depth of understanding of medicine, pathology, physiology etc...

3) Lifestyle: The 3-5 years of training towards CRNA while grueling doesn't compare to 7-12 years of minimal free time, minimal social life and delayed gratification on all fronts

4) Income (i like how yoga says he/she is interested in good income, but physicians are interested in money - what is the difference?): Income for new CRNA grads is anywhere from 80-90k/year to 180k/year (if they do a lot of overtime) - Income for MDs range from 90k/year to 750k/year (depending on the specialty)

5) debt: most MDs finish med school w/ 120-150k debt - and are unable to pay that off during residency and therefore that debt balloons to about 200k by the time they start paying that off...

now if your burning desire is to do anesthesia, and that is all you are interested in go for CRNA (shorter course of education time and less debt load)... now if your burning desire is to find out what else in the medical arts may be of interest to you, or you want to practice anesthesia from an art of medicine point of view with a deeper understanding of medicine than MD is your route.... either way, both are very noble fields and both are very rewarding in many ways

daitheflu · Apr 24, 2005

I earnestly thank all who posted in response to my questions. The replies are much greater than I had hoped. Each poster has a unique perspective on the subject matter, and these multiple perspectives are exactly what I am looking for in order to make an educated decision.

This summer I plan on shadowing both CRNA's and MDA's.

I will work in the ICU upon graduation, while at the same time attending a university to fulfull medical school prerequisites (a couple of organic chems and physics). I believe that this working experience will help me understand what I truly want to do with the rest of my life.