What does board certification mean in Anesthesiology?
Board certification indicates that an Anesthesiologist has completed specified postgraduate training and met an independent certifying board’s examination and ongoing requirements. It is distinct from the medical license required to practice medicine.
A board-certified Anesthesiologist is a physician who has completed a rigorous, multi-step specialty certification process during and after Anesthesiology training. The process is overseen by the American Board of Anesthesiology (ABA), a member board of the American Board of Medical Specialties, and is designed to determine whether a physician has met the standards expected of a consultant in Anesthesiology.
Quick Summary
- Anesthesiology residency lasts at least four years and may be followed by one or more subspecialty fellowships.
- Residents complete annual In-Training Examinations as part of progression through specialty training.
- Initial ABA certification requires successful completion of the BASIC, ADVANCED, and APPLIED examinations.
- The APPLIED examination includes both an oral examination and an Objective Structured Clinical Examination, testing how physicians reason, communicate, and respond to complex clinical situations.
- After initial certification, Anesthesiologists must continue to meet ongoing education, licensure, knowledge-assessment, and quality-improvement requirements to maintain certification.
The process begins during residency
Anesthesiology residency lasts at least four years. During residency, physicians take an annual In-Training Examination developed through the American Society of Anesthesiologists and the American Board of Anesthesiology. The examination is used by residency programs as one measure of a physician’s progress through training.
Some Anesthesiologists then complete one or more additional one-year fellowships in subspecialty areas after residency.
The BASIC examination
The first major ABA certification examination is the BASIC exam, taken during residency after the physician has completed the initial portion of specialty training. It is a high-stakes, 200-question multiple-choice examination focused on the scientific and clinical foundations of Anesthesiology.
The BASIC examination must be passed before the physician can move forward through the remaining stages of the ABA initial-certification process.
The ADVANCED examination
After completing the four-year Anesthesiology residency, the physician becomes eligible for the ADVANCED examination. This is another high-stakes written examination consisting of 200 single-best-answer questions that test advanced clinical Anesthesiology knowledge and decision-making.
The ADVANCED examination must be passed before the physician can proceed to the final stage of initial board certification.
The APPLIED examination
The APPLIED examination is the final major stage of the initial ABA certification process. Unlike the BASIC and ADVANCED examinations, it is designed to assess how a physician applies medical knowledge in real-time clinical situations.
Standard Oral Examination
The oral portion is an intensive, in-person examination in which Anesthesiologists must work through complex clinical scenarios with ABA examiners. It is designed to test higher-level competencies expected of a consultant in Anesthesiology, including:
- Judgment: sound decision-making and safe management of anesthetic, surgical, and medical complications.
- Adaptability: the ability to modify plans appropriately when unexpected clinical changes occur.
- Organization: the ability to structure medical information and treatment pathways logically.
- Presentation: clear and effective communication of clinical reasoning and recommendations.
Objective Structured Clinical Examination
The Objective Structured Clinical Examination, or OSCE, uses a series of structured stations to evaluate practical clinical and communication skills. These may include interpretation of ultrasound or echocardiographic information, recognition and management of simulated clinical emergencies, communication under stress, discussion of risks and benefits, and analysis of ethical issues in patient care.
Together, the oral and OSCE components are intended to assess not only what an Anesthesiologist knows, but how that physician thinks, communicates, and responds when circumstances change.
When does an Anesthesiologist become board certified?
After successfully completing the required ABA examinations and meeting the board’s professional and licensure requirements, the physician becomes a Diplomate of the American Board of Anesthesiology—commonly described as a board-certified Anesthesiologist.
Board certification continues throughout a physician’s career
Initial certification is not the end of the process. ABA diplomates enter an ongoing maintenance-of-certification program organized in recurring cycles. Continuing requirements include:
- maintaining an active medical license and good standing with the applicable state medical board;
- continuing medical education, including patient-safety activities;
- participation in longitudinal knowledge assessment through the ABA’s MOCA Minute program;
- quality-improvement activities intended to improve clinical practice and patient care.
MOCA Minute uses repeated online knowledge assessments throughout the year rather than relying only on a single large recertification examination. Continued participation in these requirements is necessary to maintain ABA board certification.
Subspecialty board certification
Some Anesthesiologists complete additional fellowship training and then pursue separate board certification in Anesthesiology subspecialties. Examples include pain medicine, pediatric Anesthesiology, critical care medicine, and adult cardiac Anesthesiology.
These subspecialty credentials require additional examinations and continuing-certification requirements. Some areas of practice also use additional procedural certifications, such as perioperative transesophageal echocardiography, to demonstrate expertise in highly specialized clinical skills.
As a result, some Anesthesiologists maintain certification in Anesthesiology as well as one or more additional subspecialties.
Is physician board certification the same as CRNA certification?
No. The word certification is used in both professions, but the underlying education and certification pathways are different.
For Anesthesiologists, ABA certification follows medical school and a minimum four-year physician residency and includes multiple staged examinations: the BASIC, ADVANCED, and APPLIED examinations, including oral and structured clinical performance testing.
For CRNAs, initial certification is obtained after completion of nurse-anesthesia education through a single computerized adaptive national certification examination administered by the National Board of Certification and Recertification for Nurse Anesthetists. The examination ranges from 100 to 170 questions. CRNAs then participate in their profession’s continuing-certification process through continuing education and ongoing knowledge assessments.
Because the professions follow different educational, licensure, and certification systems, the two credentials should not be considered equivalent simply because both use the term “board certification.”
Questions patients can ask
- Is my Anesthesiologist board certified by the American Board of Anesthesiology?
- Has my Anesthesiologist completed fellowship training relevant to my condition or procedure?
- Does my Anesthesiologist hold any additional subspecialty board certifications?
- Who on my anesthesia care team is a physician?
- Who is medically responsible if my condition changes or a complication occurs?
Outside resources
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Reviewed By
- Physician reviewer:
- Russell McAllister, MD, FASA Verify certification and MOCA status (opens in a new tab)
- Board certification:
- Anesthesiology — American Board of Anesthesiology (ABA)
- Last reviewed: