A day as an Anesthesiologist
Your day starts before the surgeon's and usually ends after it. As an anesthesiologist you're the physician responsible for keeping a patient alive and comfortable while someone else operates on them. This page follows a weekday in a busy hospital operating room, where you're supervising several rooms at once rather than sitting in one.
One weekday in a hospital OR
Pre-op bay, before anyone is asleep
You walk the pre-op area and meet every patient in your rooms. You read the chart, ask about loose teeth and past reactions to anesthesia, look in their mouth, and listen to their heart and lungs. Then you get consent and explain the plan in words a scared person can follow. The patient who ate a full breakfast gets found here, not in the OR, and their case slides to the afternoon.
First starts across three rooms
In a care team model you're medically directing CRNAs or residents in several rooms. You're present for each induction and each emergence, so the first hour is a sprint between doors. You push drugs, place a breathing tube when the airway looks hard, and sign the anesthesia record in Epic before the incision is made.
The case that stops following the plan
A routine hip replacement drops its blood pressure hard and fast. You get paged back, open up the fluids, start a pressor, send a blood gas, and talk to the surgeon about what they're seeing in the field. For a few long minutes the whole room watches the monitor. Meanwhile your other two rooms still need you for their emergences, so you're doing triage in your head the whole time.
Blocks, labor floor, and the board
Between turnovers you might place an ultrasound-guided nerve block for a shoulder case or answer a call to put in a labor epidural. You also check in with the anesthesia coordinator at the OR board, who is juggling add-on cases, a room that's running late, and a surgeon who wants to start early. Those negotiations are part of the job whether you like them or not.
PACU rounds and handing off call
You check your patients in PACU for pain, nausea, and breathing, and sign them out when they're ready to leave recovery. If you're on call you stay for trauma and emergency surgery overnight. If you're not, you give the incoming attending a clean handoff on every open room and every sick patient still in recovery.
Why the call schedule shapes your life
Ask any anesthesiologist what they'd change and many will name call, not the cases. Hospitals need anesthesia coverage around the clock for trauma, obstetrics, and emergency surgery. So you'll take nights, weekends, and holidays in rotation, and a busy call night can wipe out the next day too.
The practice type decides how heavy that load is. A private group that covers a big trauma center will ask more of you than a group that only staffs outpatient surgery centers. Academic departments trade some pay for teaching residents and a lighter clinical load. Before you sign with anyone, ask to see the real call calendar for the past few months, not the one in the recruiting packet.
There's also a quieter strain. The job asks you to stay alert through long, uneventful cases, and a lapse in attention can hurt someone. People who do well in it build habits: checklists at induction, a set scan of the monitor, and a clear rule for when they call for help.
Where anesthesiologists end up after residency
General operating room practice
Most new graduates join a private group, a hospital-employed department, or a large national practice and cover everything from appendectomies to spine surgery. You'll supervise CRNAs or anesthesiologist assistants in a lot of these jobs, so learning to run several rooms well matters as much as your hands.
Fellowship and a subspecialty
A fellowship year after residency lets you focus on cardiac, pediatric, obstetric, regional, critical care, or pain medicine. Pain medicine and critical care move you partly out of the OR and into clinics or the ICU. Cardiac and pediatric fellowships are the ones that open doors at big academic and children's hospitals.
Academic department
Teaching hospitals hire anesthesiologists who like working with residents, doing research, or running quality projects. You'll have protected non-clinical time in some jobs, and you'll be judged partly on teaching reviews and papers. The ladder runs toward residency program director, division chief, or department chair.
What Anesthesiologist postings ask for
Hiring the most
- AAC Pacific Northwest28
- prismahealth.wd5/PrismaHealthProviders23
- Essential Anesthesia Management22
- AAC Midwest20
- Ochsner Health (Ochsner)15
Remote
0% of openings are fully remote.
Posted pay
$431,512 – $550,001
Typical range in the 8 of the newest 60 postings that list pay.
Questions people ask
How long does it take to become an anesthesiologist?
It's a long road. You finish a bachelor's degree, then medical school, then an anesthesiology residency that includes a first year of broad clinical training. An optional fellowship adds more time. You spend most of your young adult life in training before you practice on your own, and that's worth planning around before you commit.
What license and certification does an anesthesiologist need?
You need an MD or DO, a passing record on the USMLE or COMLEX licensing exams, and a full medical license from the state where you practice. You also need a DEA registration and usually a state controlled substance registration to order the drugs you use every day. Board certification comes from the American Board of Anesthesiology through its written and oral exams. Hospitals nearly always expect it, and rules for licensing differ by state, so check with the state medical board where you plan to work.
What's the difference between an anesthesiologist and a nurse anesthetist?
An anesthesiologist is a physician who trained through medical school and residency. A nurse anesthetist is an advanced practice nurse with a doctoral anesthesia degree. In many hospitals they work side by side, with the anesthesiologist medically directing several rooms and stepping in for the hardest patients and moments. How much independence a CRNA has depends on state law and hospital rules.
299 Anesthesiologist jobs are open today
HeroApply applies to them for you, so you can keep doing the job you have.