In many ways, certified registered nurse anesthetists and anesthesiology assistants perform the same functions: administering
anesthesia and monitoring patients. However, there are several areas that make these two career paths very different, including licensing and practice environments.

Each practice area offers two education programs in Georgia. The Medical College of Georgia in Augusta trains nurse anesthetists. Emory University's School of Medicine offers the anesthesiology assistant degree through its physician assistant department. South University in Savannah has partnered with the Mercer University School of Medicine for anesthesiology
assistant training; Mercer also graduates nurse anesthetists.

Both career tracks require four-year degrees for admission. At least one year of critical care experience is a prerequisite for admission to an NA program, and the applicant must be a licensed registered nurse. There is no such prerequisite for admission to become an AA.

"We have applicants from a variety of backgrounds," said Richard Brouillard, AA, Ph.D., academic program director for the anesthesiology assistants program at Emory, which was founded in 1969. "They may have been working as respiratory therapists, pharmacists or surgical assistants when they apply. They must have completed premed prerequisites."

Both tracks begin with intensive classroom sessions, augmented with clinical work. As students progress, training moves toward practical experience. Typically, programs take 24 to 36 months, depending on the institution, with at least 15 months of clinical focus.

"We want the students to have strong clinical experience when they enter the operating room," said Shannon Powell, MN,
CNRA, assistant director of the nursing anesthesiology program at Medical College of Georgia."We do all the didactic work up front."

Once candidates graduate, they must be licensed to practice, and this is one of the differences between the two careers. Nurse anesthetists are licensed through the Georgia Board of Nursing; anesthesiology assistants are licensed through the state medical board.

Other differences begin after graduation.

"Nurse anesthetists can work in any practice, medical or dental, because they can be supervised by any physician," Brouillard said. "Anesthetist assistants can only work under the supervision of an anesthesiologist, and so they're more likely to work in
a hospital or pain-management setting."

NAs have more flexibility in the practice arena, as long as they are supervised by physicians.

"We have collegial relationships with physicians, working side by side with them," Powell said. "Also, we can bill directly for our services. AAs have more restrictive supervisory and logistical issues for where they can practice."

Because AAs must practice with anesthesiologists, they are more likely to work in more populated areas, where there are more anesthesiologists. According to the American Association of Nurse Anesthetists, NAs administer about 65 percent of the 26 million anesthetics given to patients each year in the United States.

Salaries for AAs and NAs are comparable, especially in larger metropolitan areas.

"Statistically, in rural hospitals there are fewer anesthesiologists available, so there tend to be more NAs in these areas," Brouillard said. "However, we all function virtually the same - as safe, competent practitioners."