Med school for experienced CRNA?

[SpouseofChicagoCRNA]

Hi all,

My wife is an experienced CRNA who keeps getting insulting comments from a couple of MDA's. You know, the usual, 'I'm the Anesthesiologist, that's why' comments.

She had to make the tough decision of supporting a family by herself and that is one of the reasons she went the CRNA route and she has enjoyed a most remarkable career thus far.

She does however regret not going to med school.

Is there a (shorter) accredited program for transitioning to an MDA?

I appreciate all the responses!

[loveanesthesia]

Wow, I did not know that CRNA's were not always required to have a Master's or even a Bachelor's.. thats crazy and unbelievable..

It's not crazy if you understand the history of higher education. A certificate did not mean a lower level of education, just that it did not occur in a traditional college environment. I would argue that the 3 year diploma nurse of the past had as good, if not better, education as the Associate degree nurses of today. Educational standards have evolved in most professions. When I graduated from a MS program in 1991, most graduates were at the Master's level. Those at the bachelor's level were receiving their second bachelor's degree because all nurse anesthesia students were required to have a bachelor's degree prior to entering a program. I've worked with anesthesiologists who never had an anesthesia residency. It wasn't required when they started practice.

[FutureOBNurse2118]

Just because things were done differently in the past doesn't mean that it isn't still UNBELIEVABLE.. our education system has definitely changed for the better.

I agree with one of the posts on here.. Someone with a two year RN degree and a 1 year certificate program can't possibly be compared to a BSN and on top of that MSN.. No way. Yes, things were done differently in the past, but that doesn't make it right.

[loveanesthesia]

Someone with a two year RN degree and a 1 year certificate program

When the certificate programs were in operation, there were no 2 year RNs, that's a modern invention. RNs were either 3 year dipoloma-36 months full time, or a BSN graduate. There were BSN programs long before Associate degree RN programs. So there are no CRNAs with a two year RN and a 1 year certificate program and there never were. By the time the ADN programs started awarding the RN, all nurse anesthesia programs were required by accreditation standards to only admit RNs with a bachelor's degree. In 1960 all anesthesia programs were required to be a minimum of 18 months in length by accreditation standards, many were 24 months. There are a few CRNAs with a 3 year diploma RN and an 18 month anesthesia certificate. The implication in the statement above that CRNAs without a Master's degree have a total of 3 years of education is absolutely false.

[loveanesthesia]

a CRNA with 3 years training after high school?

There are no CRNAs with 3 years of training post HS, none anywhere. It is absolutely impossible by accreditation standards.

As for CRNA I, II, etc you are confusing certification to practice with academic degrees, they are different. CRNAs with MS or PhD degrees are differentiated by their degree designation. Certification means you meet the minimum standards to practice, nothing more. Individual institutions may choose to credential me as a CRNA based on whatever criteria deemed relevant. If I have a certain degree, or experience, or whatever, they can base my credentials on that as they see fit. They can decide that I should be a CRNA I, and my collegue should be a CRNA II, and give that whatever significance appropriate. (You see that done with RNs-they aren't credentialed but hospitals will designate different levels based on academic degrees, personally I haven't seen it done with CRNAs)That's as it should be, it should be decided on a local level not by a national certifying body.

[elkpark]

Someone with a two year RN degree and a 1 year certificate program can't possibly be compared to a BSN and on top of that MSN.. No way.

How about someone with a two year RN degree, a 1 year certificate program, and 20 or 30 years of successful clinical practice???? (And, of course, the older CRNAs were predominantly hospital diploma school graduates who were much better prepared as RNs than current ADN or BSN graduates are today to begin with, before they attended a specialty anesthesia program ...)

Nurses were adminstering anesthesia (safely and successfully) long before it became a medical specialty -- the earliest anesthesiologists trained by attending nurse anesthesia programs.

[paindoc]

I would have to vehemently disagree that 20-30 years experience makes a CRNA with inferior training equal to or better than todays BSN or MS or DNP trained nurses. If that were the case, why not just go back to the archaic way of doing things all by guilds of nursing. No, I am afraid after having 25 years of observing nurses having come from different backgrounds the following is true:

1. 2 year or diploma nurses tend to be more adept at clinical skills immediately after graduation since they frequently were effectively working as apprentices in the same hospital or system where they would be eventually employed, however within a few years their deficiencies in fundamental knowledge of pharmacology, anatomy, physiology became apparent. Advances in technology were not embraced by these nurses that preferred instead wrote nursing of repetition....doing it the way they were trained to do. The same has been true in my observations of CRNAS: those with inferior training were the last to let go of gallamine or dTC since that was what seemed to work for them in spite of the advances in neuromuscular blockade advancements. The inferiorly trained CRNAs really didn't have a working knowledge of cardiac physiology even when they were doing cardiac cases....it was routine induction/intubation/gas/wake em up mentality. They were technicians, far inferior to the currently trained nurses with BSN or earned (not grandfathered) MSNs.

2. 30 years experience frequently means blindly doing the same thing over and over again for 30 years, or until changes in technology or practice forces them to change. How many nurses with 30 years experience are frequently conducting studies to advance the field? Or going to TEE courses to enhance their knowledge about TEE even if they may not use it? Where is the thirst for knowledge when the mundane becomes an accepted way of life? Current BSN and MSN nurses (and especially doctoral nurses) will do far more for the field of nurse anesthesia than the technicians role that has been adopted by so many CRNAs, especially those with 20-30 years of experience. The AANA journal needs drastic improvement in content and original research. With over 30,000 CRNAs, why are there so few quality evidence based nursing journal article publications? Is it just not important to the older CRNAs?

I challenge the CRNAs of America to rise to the level of currently trained CRNAs and to do your duty to the profession by DOING RESEARCH and not simply resting on the laurels of the "good old days" when nurses didn't need no college learnin' and are smarter than these young upstarts.

[FutureOBNurse2118]

hmmm.. well, I didn't read that entire post.. I just needed to read the first line and you have by far misunderstood me... I'm not saying that 20-30 years experienced CRNA's are inferior.. I'm simply talking about the amount of education for CRNA students.. therefore, comparing entry level CRNAs... I think that the education standards have changed for the good because it will be better for recent grads, compared to recent grads from years ago... I'm not comparing recent grads to CRNAs with 30 years experience.. Come on now, thats just stupid

[Qwiigley, BSN, MSN, DNP, RN, CRNA]

I would have to vehemently disagree that 20-30 years experience makes a CRNA with inferior training equal to or better than todays BSN or MS or DNP trained nurses. If that were the case, why not just go back to the archaic way of doing things all by guilds of nursing. No, I am afraid after having 25 years of observing nurses having come from different backgrounds the following is true:

1. 2 year or diploma nurses tend to be more adept at clinical skills immediately after graduation since they frequently were effectively working as apprentices in the same hospital or system where they would be eventually employed, however within a few years their deficiencies in fundamental knowledge of pharmacology, anatomy, physiology became apparent. Advances in technology were not embraced by these nurses that preferred instead wrote nursing of repetition....doing it the way they were trained to do. The same has been true in my observations of CRNAS: those with inferior training were the last to let go of gallamine or dTC since that was what seemed to work for them in spite of the advances in neuromuscular blockade advancements. The inferiorly trained CRNAs really didn't have a working knowledge of cardiac physiology even when they were doing cardiac cases....it was routine induction/intubation/gas/wake em up mentality. They were technicians, far inferior to the currently trained nurses with BSN or earned (not grandfathered) MSNs.

2. 30 years experience frequently means blindly doing the same thing over and over again for 30 years, or until changes in technology or practice forces them to change. How many nurses with 30 years experience are frequently conducting studies to advance the field? Or going to TEE courses to enhance their knowledge about TEE even if they may not use it? Where is the thirst for knowledge when the mundane becomes an accepted way of life? Current BSN and MSN nurses (and especially doctoral nurses) will do far more for the field of nurse anesthesia than the technicians role that has been adopted by so many CRNAs, especially those with 20-30 years of experience. The AANA journal needs drastic improvement in content and original research. With over 30,000 CRNAs, why are there so few quality evidence based nursing journal article publications? Is it just not important to the older CRNAs?

I challenge the CRNAs of America to rise to the level of currently trained CRNAs and to do your duty to the profession by DOING RESEARCH and not simply resting on the laurels of the "good old days" when nurses didn't need no college learnin' and are smarter than these young upstarts.

You have quite a bit of good information and good points that are made. While I agree with what you are saying, some institutions do not support nursing research. I have worked at Childrens Hospital of LA and now at Kaiser Permanente in SoCal. Can you believe it is easier to do research projects here at Kaiser than it is at the teaching hospital (CHLA) for advanced practice RNs. My current research project is being well received so far. I do agree about the AANA magazine's articles. I skim them, but don't find much interest in the subjects on a regular basis. I do like to read Anesthesiology Today, but for a CRNA to get a subscription it costs mucho $$$. So I pretty much mooch when I can! :)

[ICU.traveler, CRNA]

Sorry about what your wife is going through. I known many nurses ( CRNA,NP,MSN) who have transitioned to become MD's here in the united states and especially here in Illinois.

First option, she could decide to go through regular path by applying to schools of medicine here in the country. Since, she already have taken a lot of science classes, and have at least a BSN, she can start the process by talking to counselor in many of these schools, to see what are her options.

The second path that many inspiring doctors with careers and families do is to contact school outside the country such as in the caribean. I know quite a few americains who became MD's using this path. You live and work here, but study outside.

Here is one particular school that I can recommand taht is worth of checking is the school of medicine at university of health sciences antigua.

Whatever your wife decide, make certain that the family can endure and afford it.

I hope this help

Hi BethhulieRN,

Thanks for posting. I'm a second year CRNA student and already thinking about going to med school. I just wanted to ask for your thoughts on the school of medicine at university of health sciences antigua. Why this school? Did you hear anything good or not so good about it? Wonder if you know anyone that went there and what residency they got in to. How hard is it to get in there?

Thanks so much.

ICU.traveler

[Kelly CRNA]

I am a CRNA and you have no idea how many times I have had doctors say that to me. General surgeons, urologists, pediatricians, PA's ect. It really is a smart career choice.

[CRNAzzle]

I would have to vehemently disagree that 20-30 years experience makes a CRNA with inferior training equal to or better than todays BSN or MS or DNP trained nurses. If that were the case, why not just go back to the archaic way of doing things all by guilds of nursing. No, I am afraid after having 25 years of observing nurses having come from different backgrounds the following is true:

1. 2 year or diploma nurses tend to be more adept at clinical skills immediately after graduation since they frequently were effectively working as apprentices in the same hospital or system where they would be eventually employed, however within a few years their deficiencies in fundamental knowledge of pharmacology, anatomy, physiology became apparent. Advances in technology were not embraced by these nurses that preferred instead wrote nursing of repetition....doing it the way they were trained to do. The same has been true in my observations of CRNAS: those with inferior training were the last to let go of gallamine or dTC since that was what seemed to work for them in spite of the advances in neuromuscular blockade advancements. The inferiorly trained CRNAs really didn't have a working knowledge of cardiac physiology even when they were doing cardiac cases....it was routine induction/intubation/gas/wake em up mentality. They were technicians, far inferior to the currently trained nurses with BSN or earned (not grandfathered) MSNs.

2. 30 years experience frequently means blindly doing the same thing over and over again for 30 years, or until changes in technology or practice forces them to change. How many nurses with 30 years experience are frequently conducting studies to advance the field? Or going to TEE courses to enhance their knowledge about TEE even if they may not use it? Where is the thirst for knowledge when the mundane becomes an accepted way of life? Current BSN and MSN nurses (and especially doctoral nurses) will do far more for the field of nurse anesthesia than the technicians role that has been adopted by so many CRNAs, especially those with 20-30 years of experience. The AANA journal needs drastic improvement in content and original research. With over 30,000 CRNAs, why are there so few quality evidence based nursing journal article publications? Is it just not important to the older CRNAs?

I challenge the CRNAs of America to rise to the level of currently trained CRNAs and to do your duty to the profession by DOING RESEARCH and not simply resting on the laurels of the "good old days" when nurses didn't need no college learnin' and are smarter than these young upstarts.

Paindoc, I thought you were a jackorifice when I read your first post. BUT now I see your point. And it is a good one. I have a BSN and graduated with a 4.0, was in the honors college at my university, was an anatomy TA, and took ALL of the required usual pre-medicine courses (including physics, organic chemistry, etc.) and obtaining A's or A+'s in all of them BEFORE I applied to CRNA this past year (and got in). I also currently work in ICU and I have to agree with you, EDUCATION is key, ESPECIALLY for nursing. I cannot stand the ADN nurses who work with me who got into their programs based on a non-competitive LOTTERY. I don't understand why these programs are not mandated by the ANA to up their standards. In summary, their critical thinking is NOT there. I have had many students who are in ADN and BSN programs and there is a HUGE disparity between the two... the BSN students are significantly more 'bright'. And by bright I mean this: no one cares if you can start an IV faster your first day on the job as an ADN than a BSN but can't think your way through why you should use fentanyl instead of morphine in an obese trauma patient. BSN and today's education teaches critical thinking, research, and application of knowledge and less focus on "tasks" without rationale. Tasks will come with practice, but critical thinking is a learned behavior that requires a strong knowledge base topped with reasoning, evaluation, and rationale.

I agree with paindoc. All advanced practice nursing ESPECIALLY something as critical as anesthesia should be at the BARE minimum a DNAP/PHD/DNP/etc. degree. This advanced education teaches one to think, to apply advanced concepts in physiology and pharmacology into practice instead of being task oriented as paindoc mentioned when saying old CRNA's MAY (not all of course) simply get into a routine of blindly following a sequence of events of intubation --> recovery. These degrees also emphasize research which is essential to any field of practice. The DNAP/DNP degrees teach a whole other type of student in general. It would be better for the public and profession if grandfathered NP's/CRNA's were REQUIRED to go back to school and earn today's degrees. We should be thirsty for more education. More knowledge, more ways to tackle the same situation in the OR, etc. It seems that old nurses are sometimes (not always, again) indeed stuck in their ways, from bedside to CRNA. The ADN programs need to go. Additionally, all online programs need to go with them. If you don't have the time to attend class face-to-face with your peers and instructors, then maybe you shouldn't be going to school (but but, I have a family! Again, maybe you should reconsider your priorites). Any online program for any healthcare profession is a joke to us and to the public and should be disbanded.

But paindoc, don't complain about our salary to that of 'other' MD's. Compare our duties to that of a plug-and-chug family practice physician managing the same old chronic diseases day in and day out. Who should get paid more? In reality, it would do hospitals, insurance companies, and today's healthcare system a huge favor to pay MDA's same as CRNA's. If the same safe and effective anesthesia is provided by both, then why is there a huge disparity in salary?

[CRNAzzle]

Hi BethhulieRN,

Thanks for posting. I'm a second year CRNA student and already thinking about going to med school. I just wanted to ask for your thoughts on the school of medicine at university of health sciences antigua. Why this school? Did you hear anything good or not so good about it? Wonder if you know anyone that went there and what residency they got in to. How hard is it to get in there?

Thanks so much.

ICU.traveler

Why are you considering medical school?

Also all of those carribean schools are a joke. Including Antigua. Another popular joke school you will hear about is Ross University. These schools have to advertise to get any applicants and anyone and everyone who applies to them has usually exhausted their US choices due to inability to get in and end up getting in to these carribean schools. Fact: carribean schools have an average MCAT school of about 14 while US schools have an average of about 26. Think about it. All of these issues will come up if you decide to apply to US residencies, especially popular ones like anesthesia.