Anesthesiologists are the physicians responsible for administering anesthesia, allowing surgeons and other physicians to complete medical procedures with little to no patient discomfort. Anesthesiologists also closely monitor a patient’s vital signs and critical life functions before, during and after surgery – making rapid decisions on limited data when required. To say that the profession is stressful is an understatement.

More than 150 years ago, ether – the first anesthetic – was hailed the "greatest gift ever made to suffering humanity." Today the drugs are different, but any woman who has experienced the excruciating pain of contractions followed by the amazing relief of an epidural will tell you that anesthesia remains one of the greatest gifts to humanity.

Anesthesia is often portrayed as going to sleep, but J.P. Abenstein, an associate professor of anesthesiology at the Mayo Clinic, explains that general anesthesia is more akin to a powerful drug-induced coma. Anesthesiologists typically administer a combination of intravenous drugs and inhaled gasses to render a patient unconscious and pain-free. For operations on the head, chest or abdomen, anesthesiologists also have to support a patient’s breathing with a breathing tube. So it’s no wonder that Abenstein describes the job like this: "An anesthesiologist keeps a patient alive during an invasive procedure that would otherwise kill them."

Anesthesiologists may also administer sedatives intravenously to calm the patient. With regional anesthesia, as opposed to general, anesthesiologists inject medications near a knot of nerves to prevent pain signals from traveling to the brain – in other words, numb a particular part of the body. Patients who are given regional anesthesia are awake, although they may also be sedated intravenously, which helps them relax, feel drowsy or even sleep, depending on the level of sedation.

Abenstein says the breadth of the profession has dramatically expanded in the last several years. Anesthesiologists still work in hospital operating rooms, but their expertise is increasingly needed in other departments, including invasive radiology, gastrointestinal endoscopy and electrophysiology. The Bureau of Labor Statistics projects 2.6% employment growth for anesthesiologists between 2022 and 2032. In that period, an estimated 1,000 jobs should open up.

The journey to becoming an anesthesiologist is a long one. Here are the steps to take:

1. Get a bachelor’s degree. You’ll need a college degree to apply to medical school. Prerequisites include courses in subjects like biochemistry and physics.
2. Take the Medical College Admission Test. Taking the MCAT – and earning a high score – is required for entrance to medical school. Topics covered on the exam include biology, chemistry and critical analysis.
3. Attend medical school. Medical school is typically completed in four years. The curriculum includes clinical rotations in addition to traditional coursework.
4. Pass a licensure exam. Graduates wanting to practice medicine in the U.S. must first pass a licensing exam. MD degree holders take the United States Medical Licensing Examination, and those with a DO take the Comprehensive Osteopathic Medical Licensing Examination.
5. Undergo residency. After completing medical school, you’ll undergo a four-year residency program, during which you’ll focus on anesthesiology.
6. Obtain state licensure. All anesthesiologists have to meet state-specific licensure requirements, which vary.

After going through medical school, residency and a fellowship, an anesthesiologist will have completed anywhere from 12,000 to 16,000 hours of clinical training, according to the American Society of Anesthesiologists.

Many anesthesiology residents complete a one- to two-year fellowship program to learn a subspecialty, such as critical care or obstetric anesthesia. Anesthesiologists may also receive board certification through the American Board of Anesthesiology. Though not required, it demonstrates advanced skill and knowledge. Becoming certified may also help you receive more professional opportunities or earn a higher salary.