Dream Job

Anesthesiology’s allure: High pay, flexibility, intellectual stimulation

DO anesthesiologists describe their field as fast-paced and demanding, yet amenable to family life and personal time.


Anesthesiologists like to joke, “We put people to sleep.” But in fact, the specialty is anything but dull. DOs who specialize in anesthesia describe their field as fast-paced and intellectually demanding, yet amenable to family life, with intense high-pressure workdays offset by ample personal time.

One of the top-paying medical specialties, anesthesiology attracts far more applicants than available graduate medical education positions. To be competitive for residencies, osteopathic medical students need stellar scores on the Comprehensive Osteopathic Medical Licensing Examination—USA (COMLEX-USA) or the United States Medical Licensing Examination (USMLE).

Many DO students who are interested in anesthesiology take the USMLE because it carries more weight with ACGME-accredited residency programs, which outnumber AOA-approved programs in the specialty 10-to-1. However, students need to select their residency route with an eye to the future because certain administrative positions within osteopathic medical education are closed to those who are not AOA board certified.

Normally, osteopathic medical students have limited formal exposure to anesthesiology until the fourth year of med school, when it is offered as an elective rotation. But students contemplating an anesthesiology career need to lay a strong foundation in Year 1 by mastering the basic sciences. Such students should also find opportunities to learn more about and demonstrate interest in the science and technology of anesthesia.

Long career, balanced life

Experienced hospital-based anesthesiologists often make more than $350,000 a year. Compared with other medical specialties, the pay for anesthesiologists is in the top 5%, says Dennis E. Kane, DO, the president of the American Osteopathic College of Anesthesiologists.

Although attending anesthesiologists frequently work 12-hour days and are on in-house call for 24-hour shifts, they typically receive several weeks of paid vacation time per year and they aren’t expected to be accessible on their days off.

“One of the things that was appealing to me about anesthesia was that when I was at the hospital I was at work and when I was on call, I was on call. But when I was not at work or on call, they weren’t calling me,” says Barbara D. Dougherty, DO, a Sewell, N.J., anesthesiologist who raised three children and has been in practice for 32 years. “It was my time when I was at home.”

A former chair of a hospital anesthesia department, Dr. Dougherty is winding down her career by practicing at an outpatient surgical center, which means shorter, more consistent hours.

Today, anesthesiologists have many practice options, with varying hours and flexibility, notes Allan R. Escher, DO, the vice chairman of the American Osteopathic Board of Anesthesiology. “By practicing at a surgery center or with a group administering office-based anesthesia, or by practicing pain management in an office setting, it is possible to have a career in anesthesiology in which you have set hours or work part time,” he says.

Given this flexibility, it is not usual for anesthesiologists to practice well into their 70s, and more and more women are entering the specialty, Dr. Escher points out. Although anesthesiologists sometimes experience career burnout because of daily pressures, it less likely than in emergency medicine and surgical specialties, he says.

Nevertheless, due in part to their easy access to narcotics, anesthesiologists have a higher rate of opiate abuse than do most other medical specialists, warns Dr. Escher, who serves on the Florida Board of Osteopathic Medicine.

What it takes

Despite the adaptability of an anesthesiology career, the requirements to enter the field are strict. Only those with specific interests, aptitudes and personality traits should consider the specialty, anesthesiologists say.

“As anesthesiologists, we essentially are doing applied clinical pharmacology,” observes Mike Green, DO, the director of the anesthesiology residency program at the Drexel University College of Medicine in Philadelphia. “We’re giving patients medications and watching the changes in realtime as they are occurring in the operating room. That’s what makes it exciting.”

The specialty, thus, draws medical students who excel in the basic sciences and pharmacology, Dr. Green says. And it appeals to results-driven individuals, who like to see the fruits of their labors immediately. With patients’ lives hanging in the balance, anesthesiologists must be extremely observant and able to think and act very fast. They must detail-minded and always well-prepared should something go awry.

“Anesthesiology is also a specialty for people who want to work with their hands,” Dr. Green says. “Whether it be vascular access or airway management, we are doing procedures to some degree on every patient we see.”

Hospital-based anesthesiologists constitute a major component of critical care medicine, so individuals considering anesthesiology need to have an aptitude, as well as passion, for caring for patients with life-threatening conditions, Dr. Green notes. “We assess people when they enter the hospital. We assess them preoperatively and develop and anesthetic plan. We take care of them in the operating room. And we take care of them during the postoperative period,” he says.

“The most desirable trait for an anesthesiologist is reliability, followed by honesty, functionality under stress, punctuality and discipline,” says Dr. Escher, who is an attending anesthesiologist at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Fla. “The patients are very dependent on you, and the surgeries don’t happen without your presence. This is the kind of field where if you are having a bad day, you still have to perform at your best.”


  1. robert migliorino,d.o.

    However,if you are solo or a small group,enjoy those 3 am hours in OB or Trauma if you are located in a high volume area

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  3. Unisom

    So, you’re telling me that Anesthesiologists make money and have great hours, when not being replaced by a CRNA for half the price? I think we knew about all that, but the author needed the pub for his CV I guess. This is irrelevant to most of us osteopaths because there are very few DO Anesthesiology Residencies for us anyways and no MD program will take us seriously after how much mud we’ve slung at the AMA/ACGME. A DO to CRNA program may be the best compromise at this point.

    1. Gasman

      I and 15 other of my osteopathic classmates matched into an acgme anesthesiology program this year. We were all strong applicants but I tell everyone, “If I can do it, you can do it”, and I honestly believe it.

      1. Long Call Hours

        I agree. If you want an ACGME residency it can be done. Lay the foundation by doing rotations in a hospital that has an anesthesia residency and connect with the people there like a great Osteopathic physicians that we are. I was the FIRST DO to graduate from my ACGME program (1998) and then more DOs followed after my success in the program. Granted I had a really cool chairman.

        However, most Anesthesia positions are not glamorous and hours are not fixed as the cases have no set times to end in private practice. And our rates are being killed by CRNA and HMO. My practice has not seen an increase in pay for the last 15 years.

        Also, I often worked 36 hours many a times as you take 24 hours OB call and if you are short you will be asked to take the shortest room which will add another 6 to 8 hours.

    2. R. O'Connor, DO

      My experience has not been at all like you have described. I attended an osteopathic internship and then an allopathic residency and found the qualities I obtained in in my osteopathic training fit extremely well with Anesthesiology. My attendings and follow residents never had an issue with my background, in fact they often took opportunity to learn from it. I was one of 2 DO’s in a class of 10. The class before me had 3 DO’s out of 10. We did as well as medical graduates from Mayo Clinic, UVA, UNC, etc.

      There are major issues in Anesthesiology though. CRNAs have a powerful lobby that fights every minute for independent practice rights. Private practice pays well (for now) and when you are off, you are off. When you are on, the hours are long and demanding. Overall…I am happy with my chosen profession.

      1. The Anesthesia Way D.O.

        There is a lot of flexibility in all of this.
        I was invited for anesthesia residency interview to 3 MD Medical Centers in the 90s in California. Two of the three spoke to me very nicely, one of them was so rude, and they did not even complete the scheduled program with me. I had flown in from NY to the West Coast during my internship year. The other two were elite centers in Los Angeles and they spoke to me very nicely. After all these years, one of our family friends has become the recruiter for this one center that did not finish my interview. Now, she flat out reveals that they do not hire DOs as attending as their policy. Ironically, this MD school and Medical Center ranks the lowest among the MD schools in California.
        I was accepted at one of the places I interviewed.

      2. The Anesthesia Way D.O.

        The hospital that has the policy of not hiring the DOs, they hire FMG MDs, MBBSs, and MBCHBs etc. Basically, they are willing to hire and give away jobs (supported by the USA tax payer’s money) to non-American trained FMGs, but, not DOs. They have made up their mind in concrete that FMG MBBSs coming from the Common Wealth countries are better than the USA DOs, hence, they can choose to overlook the American DOs looking for jobs and hire FMGs. This is just so malignant. Our tax money goes to support these hospitals, yet they hire FMGs over DOs.

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  5. Pikachu

    court, you still got a long way, highschool courses hacve litteraly no effect on me school or becoming an anesthesiologist, Get a good ACT and get accepted into a good Pre-Med, do good on your pre med and MCATs go to med school or DO and then you look for residency prgorams

  6. Nuclear Weapons

    This random comment has nothing to do with the article.

    BTW, thanks for the helpful information for my career class!!!!!!!!!!!!

  7. Lee Everett

    Thnx for the info Pikachu, I am also in high school and I was looking around to see what profession I might want to strive towards in the future!

  8. Muhammad sadiq

    My name is M sadiq. i learning anesthesia from Bashir para medical institute islamabad pakistan.I like anesthesia than other field of Medical because it is one of the best field in Medical line through anesthesia we can also help the many peoples.Allah hafiz

  9. Pingback: Anesthesiologist Residency - Anesthesiology Resident Work Hours - Brigham And Women'S ...

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