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Anesthesiologist

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Manage patients' painThey may work in different areas of specializationThey are often expected to put in long hoursAt least 11 years of training goes into becoming fully qualified

A total of about 40 million anesthetics are used every year, says the American Society of Anesthesiologists. As a result, anesthesiologists are in demand -- and it seems that demand for their services will rise.

Advances in technology, new diseases and the increasing number of senior citizens are all increasing the need for these physicians. For those going into the field, the outlook is great.

Anesthesiologists are doctors who specialize in monitoring and controlling pain.

It's the anesthesiologist's job to give anesthesia to a patient undergoing surgery, monitor the patient's life-support needs during surgery and manage the patient's pain after the surgery is complete.

"Most large hospitals embrace the anesthesia care concept, which means anesthesiologists evaluate the patients pre-op [before the operation], are present during the critical periods of the 'takeoff and landing' of the anesthetic, and are immediately available at any point in the case to render assistance or consultation. They also care for the patient in post-op or later with acute pain management," says New York anesthesiologist Dr. Steven Shoum.

There's more to the anesthesiologist's job than simply "knocking people out." The administration of anesthesia is a complex and exact science.

"The anesthesiologist uses reversible poisons that selectively inhibit normal body functions, without any permanent damage," says Shoum. "At the end of the operation, the anesthesiologist would wake up the patient by letting the drugs naturally wear off, or would administer an antidote that would reverse the drugs' effects."

Applying poisons in the name of health is a heavy responsibility. Too much anesthesia and the patient may never wake up; too little and the patient may wake up too early.

Anesthesiologists do quite a bit of work away from the operating table. They use their vast knowledge of pain and drugs to make life easier for patients who have acute (short-term and intense) or chronic (all the time) pain.

"We have some really sophisticated techniques for pain management," says Dr. Theresa Walker, an anesthesiologist.

"We can provide patients in acute pain with opiates that are hooked up in such a way that they block pain at the spinal cord level. We also have patient-controlled analgesia [pain relief] that the patient can control by pushing a button on a tiny computer-chip-operated portable pump. So they control their own painkillers according to how they feel."

Although all are qualified to handle any major anesthesia procedures, anesthesiologists may work in different areas of specialization. Some specialize in providing care for patients undergoing surgery for specific problems.

Vascular specialists (dealing with blood vessels), cardiac specialists (heart surgery), thoracic specialists (surgery for the lungs) and neurosurgery specialists (brain and spinal cord) are all anesthesiologists who have taken extra training to focus on a specific area of medicine.

Other areas of specialization for anesthesiologists include pediatric (children), obstetric (pregnant women), trauma (accident victims) and chronic pain.

Regardless of their area of specialization, all anesthesiologists must be experts in what Shoum calls the "three As" -- affability (easy to get along with), ability and availability. Walker agrees.

"We must be totally under control when complications occur, but keep alert during six-hour procedures [ability]. And on many occasions, we have to be available to work all night [availability]. Anesthesiologists also have to be good team players, because we work so closely with the surgeon and other members of the surgical team [affability]," says Walker.

Anesthesiologists are often expected to put in long hours. In most hospitals, operating rooms are busy from 8 a.m. to 3:30 p.m., and they have to be present long before and after surgical hours.

"I arrive at 7 in order to ensure the [operating room] is set up and all the equipment I need is functioning properly," says anesthesiologist Dr. Ian Zunder. "At the end of the day, I spend about an hour with administrative responsibilities and reviewing the charts of the patients scheduled for the following day. I usually leave by 5 p.m."

Anesthesiologists often work on call once a week, which might mean being available to work from 6 p.m. to 8 the next morning.

Most anesthesiologists in America work in hospitals. However, some opportunities exist for anesthesiologists in private or free-standing clinics.

In the U.S., nurse anesthetists can also give patients anesthesia. However, these nurses work under the supervision of a doctor. Anesthesiologists are doctors and anesthetists are nurses.

Physicians held about 577,000 jobs in 1998, says the Occupational Outlook Handbook (OOH). Anesthesiologists made up about 4.4 percent of this number. About seven out of 10 doctors were in office-based practices, and two out of 10 doctors were employed by hospitals, the OOH adds.

"There [were] about 26,000 anesthesiologists practicing in the U.S. in 1999," says Karin Bierstein. She is the practice management coordinator for the American Society of Anesthesiologists.

The OOH reports that employment for physicians will grow faster than average through 2008. The growth is due to an expansion in health care because of a growing and aging population, adds the OOH.

Bierstein agrees that the growing population plays a key role in the need for more anesthesiologists. But "there are more surgeries done now where anesthesia is not required." So the market for anesthesiologists fluctuates all the time, she adds.

According to the OOH, physicians have among the highest earnings of any occupation. Earnings increase with the number of years in practice. The median salary for anesthesiologists was $220,000 per year in 1997, says the American Medical Association (as quoted in the OOH).

Bierstein says the average salary range for anesthesiologists in 1999 was about $230,000 to $250,000. "The salary may actually be a tiny bit higher than that," she says.

RegionAverage Annual EarningsAverage Hourly EarningsU.S. National$265,990$127.88RegionOutlook2017 Workforce2017 to 2026 Growth RateU.S. NationalAverage30,5905.3%

Becoming an anesthesiologist is no small feat. At least 11 years of training goes into becoming a fully qualified doctor of anesthesia. Here's how it works.

Students spend two to four years in an undergraduate program, four years getting their medical degree, four years receiving postgraduate training in an approved residency program for anesthesiologists, and one post-doctoral year of fellowship in which they specialize in one of the subsections of anesthesiology.

After all this, the doctor can take a written and oral examination to become a diplomat of the American Board of Anesthesiology -- meaning they become a certified anesthesiologist.

Since this career requires such a long training period, experienced anesthesiologists recommend getting all the exposure you can to this profession before jumping in.

"Spend time in the operating room doing anesthesia while a medical student," recommends anesthesiologist Dr. Theresa Walker. "It's not for everyone, and you need to find that out! There is not much exposure to anesthesia in many medical schools and it is a very different area of medicine, so exposure is the answer."

"If you go through medical school and are thinking about anesthesia, it is often advisable to spend some of your elective clinical training in anesthesia," says Dr. Ian Zunder. "This is the only way that you will be able to determine whether this field is for you."

While trying the career on for size may be the only way to be sure if anesthesiology is right for you, there are other ways to test the waters. Volunteering at a hospital or extended care unit is a good way to test your aptitude for this career. It has the added benefit of looking great on a medical school application.

Here is a comprehensive list of medical schools:

Medical Schools in the U.S. and Canada
Internet : http://www.aamc.org/members/listings/msalphaae.htm

Here is a sample of related training:

University of Kentucky
College of Medicine
Chandler Medical Center
Lexington , KY 40506
USA
Internet : http://www.mc.uky.edu/medicine/

Drew University of Medicine and Science
1621 East 120th St.
Los Angeles , CA 90059
USA
Internet : http://www.cdrewu.edu/

Associations

American Society of Anesthesiologists
Internet : http://www.asahq.org/

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Anesthesiologist

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