USA – Anaesthesiologist Assistant v Nurse Anaesthesiologist Programs

Although both are considered by the Centers for Medicare & Medicaid Services (CMS) to be mid-level anesthesia providers, and both may serve as physician extenders in the delivery of anesthesia, AAs and NAs are very different with regard to their educational background. According to the Council on Accreditation of Nurse Anesthesia Educational Programs, a typical applicant to an NA program must have attained a bachelor’s degree in either nursing or another appropriate area. Until recently, nurses with only an associate’s degree in nursing also were accepted. Additionally, the applicant must be licensed to practice as a registered nurse and take either the Graduate Record Exam (GRE) or the Miller Analogies Test (MAT) prior to matriculation. Finally, one year of nursing experience is required in an “acute care setting.”

In order to be admitted to an AA program, the applicant must have achieved a bachelor’s degree with prescribed prerequisites, these being premedical course work in general and organic chemistry, advanced college math, general and advanced biology, and physics. Applicants must then take either the (MCAT) or the (GRE). Although many applicants are from allied health backgrounds such as respiratory therapy and emergency medical technology, and have many years of clinical experience, a clinical background is not an absolute requirement if academic background is of sufficient course content and quality. Nurses who have met the prerequisites may be admitted to AA programs.

NA training programs must include a minimum of 24 months in a Master’s level program accredited by the COA. The training programs may be based at any college or university offering a Master’s level degree. Many nurse anesthetists do not possess a Master’s degree as this was not required until 1998. Nurse anesthetist programs do not require involvement of a medical school or academic physician faculty. Community hospitals may serve as main clinical sites. A minimum of 450 hours of classroom/laboratory education, 800 hours of clinical anesthesia education, and administration of 450 anesthetics, including all types of surgery, must be achieved for the student to successfully complete the training program.

AA training programs must include a minimum of 24 months in a Master’s level program accredited by the Commission for the Accreditation of Allied Health Educational Programs (CAAHEP). The programs must be based at, or in collaboration with, a university that has a medical school and academic anesthesiologist physician faculty. Main clinical sites must be academic medical centers. An average of 600 hours of classroom/laboratory education, 2600 hours of clinical anesthesia education, and more than 600 anesthetics administered, including all types of surgery, are required to successfully complete AA training.

Upon completion of an accredited nurse anesthetist program, a student may become certified by passing the Council for Certification of Nurse Anesthetists certification exam. This examination is an adaptive computer examination consisting of 90-160 questions. Forty hours of approved Continuing Education Units (CEU) are required every two years in order to recertify. To be recertified, nurse anesthetists do not take an additional exam.

Upon completion of an accredited AA program, a student may become certified by passing the NCCAA examination, which is co-validated by the National Board of Medical Examiners. This six-hour examination is administered in a classroom and consists of 200 questions. In order to re-certify, an AA must complete 40 hours of CME every two years. Additionally, AAs must take the Continuing Demonstration of Qualification Exam every six years. This exam follows the same format as the initial certification exam.

~ From the ASA website

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