What training do anesthesiologists have? 
Where do anesthesiologists work?
What are the challenges of being an anesthesiologist?
What is the Anesthesia Care Model? 

Despite what you may have heard, or seen on movies and TV, anesthesiologists do much more than “put you to sleep” for surgery. These critical care physicians specialize in managing pain and performing life-saving intervention for patients when needed. From the moment your surgery begins, they closely monitor your vital signs and work to keep you safe and comfortable throughout your procedure and recovery.


An anesthesiologist taking care of a patient in the OR

Before you have an operation, your anesthesiologist will ask numerous questions about your health and lifestyle. This information helps them to identify any factors that could increase risks with your anesthesia and surgery. They’ll also advise you on steps you can take to reduce your likelihood of complications, and if you require any special tests in advance, they will order them and review the results prior to your procedure.

On the day of your surgery, your anesthesiologist will review your medical history and discuss your anesthetic options with you. Once they’ve obtained your consent, they’ll develop an anesthetic plan tailored to you and your surgical procedure.

During your surgery, your anesthesiologist carefully monitors your heart, breathing, blood pressure, and other vital signs. They adjust the anesthesia as needed to keep you safe and pain-free throughout the procedure. In other words, it’s your anesthesiologist’s job to safeguard your wellbeing during your surgery. Any number of complications can arise during the operation, and if any intervention is required, your anesthesiologist—not your surgeon—is the lead physician that stabilizes or resuscitates you.

At the end of the procedure, your anesthesiologist will reverse the anesthetic and transfer you to the post anesthesia care unit (PACU), where your vital signs, pain levels, and any potential side effects are managed under their direction.

What training do anesthesiologists have?

In Canada, becoming an anesthesiologist typically takes 13–15 years. Requirements include an undergraduate university degree with mandatory science courses, four years of medical school, and a five-year anesthesiology residency training program. Anesthesiologists also need to pass the Royal College of Physicians and Surgeons of Canada’s (RCPSC) qualification exam, and some provinces have additional certification requirements. Some anesthesiologists go on to specialize in areas like childbirth (obstetric anesthesia), children’s care (pediatric anesthesia), or heart surgery (cardiac anesthesia). All practicing anesthesiologists need to meet annual continuing medical education (CME) requirements set by the RCPSC each year to keep their licence active.

In some Canadian community hospitals—particularly rural ones—Family Practice Anesthetists (FPAs) provide anesthesia and obstetrical pain relief services, and fill various other roles as needed. An FPA receives one year of anesthesia training upon completion of medical school and their family medicine training.

Where do anesthesiologists work?

Anesthesiologists work in hospitals, specialized clinics, pain treatment centres, universities, and more. Since complex surgeries can take eight hours or more, many who practice in hospitals spend most of their time in the operating room monitoring patients’ vital signs, keeping them anesthetized, and resuscitating them if needed. They also look after patients requiring urgent care in other parts of the hospital, including the emergency room, birthing centre, and intensive care unit.

Anesthesiologists based in pain treatment centres work with patients who suffer from chronic pain issues and often collaborate with other pain management professionals, such as physiotherapists and osteopaths. Many anesthesiologists also work in research related to the specialty, such as studying drugs, equipment, or techniques to potentially improve anesthesia care for patients. Medical students, interns, and residents are taught by anesthesiologists in universities and affiliated hospitals.


A surgical team, including an anesthesiologist, caring for a patient in the OR

What are the challenges of being an anesthesiologist?

Anesthesiologists have an essential role in nearly every area of acute care. In addition to anesthetics for surgery, they provide care for obstetrical patients (pain relief and anesthesia for cesarian sections), as well as pain management services for patients after surgery and chronic pain patients. They are also often first responders for patients who arrive at the hospital in critical condition, such as accident or disaster victims.

An ongoing anesthesiologist shortage has created significant challenges for Canada's healthcare system—and resulted in many of these doctors regularly working over 60 hours per week. Pressure on anesthesiologists was especially high during the COVID-19 pandemic. Their specialized airway management skills were crucial to enabling patients to breathe, and they continued to care for those undergoing emergency surgeries, giving birth, or in critical condition.

Today, the need for anesthesiologists throughout the hospital remains high. However, in many parts of the country, not enough training positions are opening each year to keep pace with the demand. Rural areas are particularly impacted by the shortages—which can result in patients traveling long distances to receive care or having their surgeries delayed.

That’s why CAS engages government and healthcare leaders with this issue year-round. We advocate to increase the number of doctors who specialize in anesthesia and train more certified clinical anesthesia assistants—to reduce surgical wait times and improve access to quality anesthesia care for patients throughout Canada.

Learn more by reading CAS’ position statement on health human resource issues in anesthesia.

What is the Anesthesia Care Team (ACT) model?

This model of care involves an anesthesiologist being aided by one or more certified clinical anesthesia assistants (CCAA) before, during, and immediately after surgery. The CCAA acts as a second set of qualified hands and helps with various tasks, including preparing anesthesia machines and drugs prior to the start of surgery and monitoring the patient during their procedure. In some cases, they can provide light sedation under the direction of an anesthesiologist, and they can also help transfer and observe a patient post-surgery. 

CCAAs are healthcare professionals—typically registered respiratory therapists or nurses—who undergo specialized training. They are supervised by the anesthesiologist, who oversees the implementation of the patient’s anesthesia plan. With CCCAs’ valuable support and dedication, the ACT model enables anesthesia departments to operate more efficiently, cover more areas of the hospital, and decrease surgical wait times—while providing patients with safe, physician-led care.