How to become a CRNA

Path confirmed against the American Association of Nurse Anesthesiology and the Council on Accreditation.

A certified registered nurse anesthetist is an APRN who administers and manages anesthesia. Day to day, a CRNA performs the pre-anesthesia assessment, develops the anesthetic plan, and delivers general, regional or neuraxial (spinal and epidural), and monitored-anesthesia-care sedation. Through the case they manage the patient intraoperatively, controlling the airway and hemodynamics, and they oversee recovery in the post-anesthesia period. CRNAs also provide acute and chronic pain management services.

You will find CRNAs in operating rooms, obstetric suites (labor epidurals), and office settings such as dental, podiatry, ophthalmology, plastic-surgery, and pain clinics. In many rural and critical-access hospitals, a CRNA is frequently the sole anesthesia provider.

CRNAs practice with a high degree of autonomy, but whether physician supervision is required is set by state law and facility policy. States can "opt out" of the federal Medicare physician-supervision requirement for CRNAs, and many have, so there is no single national rule. See APRN licensing and scope by state, and confirm the rules with your state board of nursing and your facility.

The COA requires a minimum of one year of full-time RN experience (or its part-time equivalent) in a critical care setting. That is the eligibility floor, not a typical number: many programs prefer more, and competitive admissions often favor two or more years. A qualifying setting is one where you routinely manage invasive hemodynamic monitors, mechanical ventilation, and vasoactive infusions. Surgical, cardiothoracic, coronary, medical, pediatric, and neonatal ICUs commonly qualify. Emergency-department time is frequently not sufficient on its own, so confirm with each program.

Your program must be accredited by the COA (Council on Accreditation of Nurse Anesthesia Educational Programs); graduating from a COA-accredited program is the prerequisite to sit the exam. After graduation you take the National Certification Examination (NCE), administered by the NBCRNA. Passing the NCE confers the CRNA credential and is required to use the title. You then keep your certification current through the NBCRNA's continued-certification program, which is itself transitioning to a renamed cycle around 2026, so check the NBCRNA for the current requirements.

The component figures are authoritative; the summed total is an estimate, not a number any single body publishes. Actual time depends on how long you spend in the ICU before applying and your program's length.

Nurse anesthetists are the highest-paid of the advanced-practice nursing roles the BLS tracks. The U.S. Bureau of Labor Statistics reported a median annual wage of $236,590 for nurse anesthetists (May 2025), well above nurse practitioners ($132,300) and nurse midwives ($134,040). That figure is the nurse-anesthetist-specific median, not the $132,050 combined median you will sometimes see for the three roles together. Pay varies by region, setting, and experience.

How long does it take to become a CRNA?

Typically about 7 to 8 years from the start of nursing school: roughly 4 years for a BSN, at least 1 year of critical-care experience (often more before a competitive application), and a 36-to-51-month doctoral nurse anesthesia program. The total varies with how long you spend in the ICU before applying.

Do CRNAs work independently or under supervision?

It depends on the state and the facility. CRNAs practice with a high degree of autonomy and are often the sole anesthesia provider in rural and critical-access hospitals, but whether physician supervision is required is set by state law and facility policy, not by a single national rule. States can opt out of the federal Medicare physician-supervision requirement for CRNAs, and many have. Confirm the current rules with your state board of nursing and the facility where you work.

How much critical-care experience do I need?

The COA requires a minimum of one year of full-time RN experience (or part-time equivalent) in a critical care setting. That is the eligibility floor. Many programs prefer more, and competitive admissions often favor it, but one year is the mandated minimum. Qualifying units are those where you routinely manage invasive monitoring, ventilators, and vasoactive infusions.

Do I need a doctorate to become a CRNA?

Yes, for new students. Since January 1, 2022, all students matriculating into a COA-accredited program must enroll in a doctoral program (a DNP or a DNAP). As of 2025, entry-into-practice graduates are doctorally prepared. Practicing CRNAs certified under the older master's standard keep their credential.

What exam makes you a CRNA?

After graduating from a COA-accredited program you must pass the National Certification Examination (NCE), administered by the NBCRNA. Passing the NCE confers the CRNA credential. You then maintain certification through the NBCRNA's ongoing continued-certification program.

How much do CRNAs make?

The U.S. Bureau of Labor Statistics put the median annual wage for nurse anesthetists at $236,590 (May 2025), the highest of the three advanced-practice roles BLS groups together (ahead of nurse practitioners and nurse midwives). Pay varies by region, setting, and experience.