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There are many opinions but these are the facts: Anesthesiologists (physicians) must complete a 4 year pre-med college curriculum making stellar grades, take the extremely difficult MCAT test to get into medical school, and complete 4 years of medical school. During medical school, they learn all aspects of medicine and do hands-on rotations during medical school in every medical specialty including surgery, ob-gyn, pediatrics, internal medicine, and critical care just to name a few. They earn a professional M.D. degree after this time. Then they complete a 4 year residency in anesthesiology, including a 1 year internship in medicine, surgery, or a combination of both. Some even do an additional 1-2 year fellowship in anesthesiology sub-specialties, such as cardiothoracic, pediatric, regional, pain, or critical care to further specialize their training in the specialty. Total years of education to become an anesthesiologist= 12-14 years Approximately 50% of CRNAs (nurse anesthetists) do NOT have a 4 yr bachelor degree, but rather a 2 yr RN degree. They then go on to complete 2 yrs of nurse anesthesia school (master’s level degree). Many states do not even require that a CRNA have the master’s degree, and in the states that do require it, there are clauses that 'grandfather' in the older CRNAs with only the 2 yr RN and 2 yr nurse anesthesia school. These particular states also vary with the cutoff date, with some states even grandfathering in these CRNAs back to 2003. Additionally, SRNA’s (student nurse anesthetists) rely heavily on Anesthesiologists (physicians) to teach them during the clinical portions of their 2 year nurse anesthesia school education. Total years of education to become a nurse anesthetist= 4-6 years To become a CRNA (nurse anesthetist) there are only 2 board exams to pass. Upon completion of nursing school, the applicants sits for the NCLEX board exam and must pass it to receive the 'RN' or 'BSN' (bachelor’s level degree). This board exam is only 75 multiple choice questions with FIVE hours to complete it. The applicant can fail and retake this exam an infinite number of times. NCE (National Certification Examination) is the second and final exam to take upon completion of nurse anesthesia school. This test is only 100 multiple choice questions with 3 hours to complete. After this test, a CRNA says that they are “board certified.” Total number of board questions to become a CRNA= 175 multiple choice questions. To become an Anesthesiologist (M.D., physician) there are 6 board exams to pass. To first become a licenced Medical Doctor, you must sit for and pass a series of exams called the United States Medical Licensing Exams (3 exams or 'Steps'). Step 1: taken upon completion of year 2 in medical school. 8 hour exam, 350 questions. Step 2 CK (clinical knowledge): taken upon completion of year 3 in medical school. 9 hour exam, 370 questions. Step 2 CS (clinical skills): also taken upon completion of year 3 in medical school. 8 hours, 12 live patient encounters. Step 3, 2 days: taken during Internship (first year of residency). Day one, 8 hours 336 questions. Day two, 4 hours 144 questions. In most cases, failure to pass Step 1 or Step 2 results in the medical student getting dismissed from the medical school and that person never becoming a physician in any specialty. If the applicant fails to pass all 3 Steps in a 7 yr period, he or she will not become a licensed physician. The American Board of Anesthesiology (2 exams) Part 1: Written Boards: taken upon completion of 4 years of Anesthesia Residency, 4 hours, 250 questions. Part 2: Oral Boards: taken upon successfully passing the written boards, Two 35 minute oral exams. Total number of board questions to become a board certified anesthesiologist= 1450, in addition to over 9 hours of demonstrating clinical skills and answering oral board questions and case scenarios. Recertification. The recertification process is completely different. CRNAs do NOT have to take another board exam for the rest of their life. All they have to do is 'recertify' every 2 years. By 'recertify', all they have to do is prove to the AANA that they have completed 40 hours of CME (continuing medical education) in a 2 year period. Only 20 hrs/year of continuing education that can easily be accomplished during a weekend course or with a couple of online powerpoint presentations. On the other hand, Anesthesiologists have to average approximately 50 CME hours every year, complete case evaluations, complete a hands-on simulation course which demonstrates valuable crisis management techniques, and take another written board exam (4 hours 200 questions) every 7-10 years to be able to continue practicing as a “board certified” Anesthesiologist.