Anesthesiology Career Pros and Cons: Is It Right for You?

Are you considering a career in anesthesiology? With so many specialties to choose from, it’s one of the hardest choices medical students have to make.

This guide will cover the pros and cons of becoming an anesthesiologist, from the excellent lifestyle and high compensation to the concerns about mid-level encroachment and the lack of patient continuity.

There are so many different factors to account for when choosing a specialty, including how many years you’ll spend in residency, whether or not you want to focus on procedures, the level of patient interaction you’ll have, the setting you’ll practice in, the people you’ll work with, your work-life balance, your compensation, and more.

This series delves into the career of an anesthesiologist from the perspective of Dr. Kevin Jubbal. He outlines the factors he considered and explains why he ultimately chose not to pursue anesthesiology as his specialty. That said, rest assured that this guide presents both sides of the story, outlining the pros and cons of pursuing a career in anesthesiology.

For a completely objective and unbiased look at anesthesiology, including more details into the daily life of an anesthesiologist and the exact steps to take to become one, also check out our guide to How to Become an Anesthesiologist (So You Want to Be).

What I Liked About Anesthesiology

1 | Excellent Lifestyle

Anesthesiology offers one of the best lifestyles in medicine. Many physician bloggers and content creators are either anesthesiologists or emergency medicine physicians—two specialties that provide greater flexibility and control over your schedule than most others.

While it’s not always completely relaxed, anesthesiology typically provides substantial downtime during longer cases when you’re primarily monitoring vitals and keeping patients stable. Some anesthesiologists will insist they must remain highly focused at all times, but that’s not what I consistently observed in the OR as a medical student and resident. I frequently saw attending or resident anesthesiologists reading blogs, doing puzzles, or working on personal projects during stable cases.

I would genuinely love that aspect of the job—being able to work on side projects, be productive while at work, and still get paid. That’s not a bad arrangement at all.

Even during residency, anesthesiology is comparatively laid back. When I spoke with anesthesia residents at my program, they reported working around 50-60 hours per week, which is significantly less demanding than many other specialties.

2 | Occasional Excitement

While anesthesiology is often more relaxed, you’ll occasionally encounter genuine emergencies, such as stabilizing a critical patient or leading a code blue. I’ve heard it described as a 90/10 split of calm to “shit hits the fan” moments.

You get to be chill and slower-paced most of the time with occasional adrenaline rushes. I prefer this balance over something like emergency medicine, where you have constant, hectic, frantic energy in the ED with the occasional exciting emergency mixed in.

The key difference is the baseline state. When you’re not dealing with an emergency in anesthesiology, the environment is calm and controlled. That chill nature really appealed to me.

3 | Work Doesn’t Come Home

When you’re off work, you’re completely off. No need to carry a pager, no getting called in during the middle of the night. This is because anesthesiologists don’t maintain their own primary patient panel.

There are exceptions—if you open a pain clinic, for instance—but for the most part, your work stays at work.

4 | No Clinic

There are two types of people in medicine: those who enjoy clinic and those who don’t. I’m definitely in the latter category, though I don’t hate it as much as some of my colleagues.

With most surgical specialties, you need at least some clinic time for pre-op planning and post-op management. With anesthesiology, there’s no clinic because you don’t “own” patients in the traditional sense. I loved this aspect.

5 | The Operating Room Environment

The OR is a magical place in the hospital. Each room is its own microcosm with a clearly delineated team working together for the duration of the case. While pages may come through, the focus and singular priority is what’s happening in that operating room. I love that concentrated focus.

The OR also fosters a unique level of camaraderie that I find difficult to replicate elsewhere in the hospital. It’s typically a bit more relaxed in terms of workplace culture—you can play music with profanity when patients are under, for instance.

Overall, the OR is the one place in the hospital where I felt most comfortable. Organization and cleanliness are top priorities; there’s intense focus on a single task; and the environment generally suits my personality. You’ll occasionally encounter someone who takes issue with your music choices, but that’s the exception rather than the rule.

6 | Focus on Pharmacology and Physiology

Nerding out over the pharmacology and physiology you learned in medical school and applying it to patients day in and day out is genuinely satisfying. While this wasn’t a huge factor in my decision-making, it’s a nice bonus that appeals to those who enjoy the scientific foundation of medicine.

7 | Limited Social Work and Charting

Because anesthesiologists don’t “own” patients, you’re helping other primary services rather than managing long-term care. In anesthesiology, you inform patients what will happen during surgery, provide reassurance, and after the case, you’re done.

If a particular patient annoys you, it’s no big deal—you put them to sleep, and when they wake up, they’re someone else’s responsibility. You don’t have to deal with the headache of disposition when discharging patients from the hospital because that falls to the primary service.

Your charting responsibilities are also far reduced compared to primary services, which is a significant quality-of-life improvement.

8 | Strong Compensation

Anesthesiologists are very well compensated, averaging over $523,000 per year. While not the absolute highest compensation in medicine, it’s in the upper third. That level of income, combined with the anesthesiology lifestyle, is an excellent arrangement since you’re not working yourself to the bone for that salary.

Dermatology might be the only specialty that has a better compensation-to-lifestyle ratio.

What I Didn’t Like About Anesthesiology

1 | You’re Not Doing Surgery

If you love being in the OR, you have two options as a physician: be the surgeon or be the anesthesiologist.

If you genuinely love operating, then as an anesthesiologist, you’ll be forever on the “wrong” side of the drapes, looking over and wondering “what if” while wishing you were the one performing surgery. This was a significant factor for me personally.

2 | Second in Command

This perspective may ruffle some feathers, but it reflects my experience and observations—and we’ve already established that my opinion is questionable at best.

The OR is the surgeon’s domain, and the anesthesiologist is second in command. The patients are “theirs,” and surgeons lead the team in the operating room. Yes, the anesthesiologist is mission-critical and the surgery can’t proceed without them, but everything is done in service of the surgical procedure, with the surgeon at the center.

I’ve lost count of how many times I witnessed surgeons being disrespectful to anesthesiologists—complaining about patient movement during a case, intubation speed, wake-up time, or countless other issues. I was consistently impressed by how calmly anesthesiologists handled these situations without responding in kind.

I suspect if I were an anesthesiologist, there would be instances where I’d reach my limit and put the surgeon back in their place for being unreasonable.

3 | Limited Procedural Variety

People sometimes overstate the procedural nature of anesthesiology. While it’s more procedural than many clinical specialties, the procedures themselves are relatively limited in scope and complexity.

This was a slight con for me. Examples include intubation, oral or nasal gastric tube placement, arterial lines, epidurals, and mask ventilation. Overall, not the most exciting procedural work, especially compared to surgical specialties.

4 | No Patient Continuity

I’m not entirely sure whether this is a pro or con for me. It might be neutral or a slight con, since I generally enjoyed building relationships with certain patients.

You see patients pre-operatively, intra-operatively, and post-operatively, and then you’re typically done unless you go into subspecialties like chronic pain management. That said, I could never do chronic pain. While I never worked in a chronic pain clinic personally, I’ve heard from colleagues that the patient population is, on average, more challenging to work with.

5 | Moderate Burnout Risk

I would have expected anesthesiologists to have low burnout rates given the lifestyle, but the data tells a different story. Anesthesiologists are usually middle of the pack in terms of burnout.

The Medscape 2025 burnout report ranked anesthesiology at 50%, placing it in the top 7 specialties most likely to experience burnout. Specialties with higher burnout rates include emergency medicine, ranked number 1 at 63%, followed by family medicine, pediatrics, and OB/GYN.

6 | Lack of Recognition

Anesthesiologists are unsung heroes, meaning they rarely receive the recognition they deserve. Patients typically thank the surgeon, while the anesthesiologist’s crucial role goes largely unacknowledged.

Anesthesiology is ideal for those without large egos who don’t need external validation. However, I’ll admit that I’m sensitive enough to appreciate some recognition for my work.

7 | Mid-Level Encroachment

Mid-level encroachment is a significant issue across several medical specialties, and anesthesiology faces a particularly high risk.

It concerns me that some CRNAs (Certified Registered Nurse Anesthetists) believe they’re equally qualified as anesthesiologists when, objectively, based on training levels, they simply aren’t. This is the Dunning-Kruger effect in full force. Some are even lobbying to change their title from “nurse anesthetist” to “nurse anesthesiologist” to blur the lines further, confuse patients, and appear more qualified than their training warrants.

I want to be clear: I have no blanket animosity toward CRNAs. Those who understand their role and work within their scope are valuable team members. The problem arises with CRNAs who overestimate their capabilities and push for independent practice.

CRNAs can handle approximately 80% of routine cases similarly to anesthesiologists. Still, when complications arise in the OR—and they inevitably do—I want an anesthesiologist managing my care, not a CRNA.

Anesthesiologists have an order of magnitude more training and are far better equipped to handle emergencies. CRNAs are excellent when working under an anesthesiologist’s supervision, but independent practice is problematic in my opinion.

This situation also decreases employment opportunities. Hospitals now need fewer anesthesiologists, as one anesthesiologist can oversee multiple CRNAs, saving costs but potentially compromising patient safety.

The current trajectory is concerning. I believe we’re approaching a critical threshold where enough serious complications from underqualified providers will force hospitals to reconsider their cost-cutting measures and restrict mid-level scope. Unfortunately, by that point, preventable harm will have already occurred.

If You’re Considering Anesthesiology

Should you become an anesthesiologist?

Ultimately, it comes down to this: If you love the OR and want to make surgery the focus of your life, become a surgeon. But if you appreciate the OR environment and don’t need to be the one wielding the scalpel, anesthesiology is an excellent choice.

Consider whether you value lifestyle and work-life balance over procedural complexity and patient relationships. Can you find satisfaction in being the crucial but often unrecognized member of the surgical team? Does the idea of working behind the scenes to ensure patient safety provide enough fulfillment?

If you thrive in controlled environments with occasional high-stakes moments, appreciate the scientific aspects of pharmacology and physiology, want excellent compensation without sacrificing personal life, and can accept not being in the spotlight, anesthesiology could be an outstanding fit.

However, you must accept that you won’t be performing surgery. You’ll operate in a support role to surgeons, patient continuity will be minimal, and mid-level encroachment presents ongoing professional challenges.

Anesthesiology attracts physicians who value stability, appreciate the OR environment without needing to be the primary operator, and prioritize lifestyle alongside meaningful work. If you’re considering anesthesiology, make sure you spend time observing not just the exciting emergency cases, but also the routine procedures that will comprise the majority of your career.

Anesthesiology is an excellent specialty for those who enjoy applied pharmacology and physiology, can find satisfaction in behind-the-scenes critical work, and prioritize work-life balance. The field offers one of medicine’s best ratios of lifestyle to compensation while still providing occasional adrenaline-filled moments.

If you want to learn more about anesthesiology, check out So You Want to Be an Anesthesiologist.