Expert: Ronald Levy, M.D. - 3/21/2007

Question
QUESTION: Hi Dr. Levy,

I have been interested in a career as an MDA for many a years now but am a bit concerned about the CRNA surge.  What are your thoughts on this?  I know the healthcare system has changed so much with regards to infrastructure and it seems as though business is more and more driving the entire healthcare sector.  I'd had to put in that many years of school to become an MDA just to have to worry or feel threatned about job security because a CRNA would be just a qualified to perform my significant duties.  I know that an MDA has much more extensive training from a medical perspective which will always be an essential difference between the two roles, but I know that the salary gap has been closing between the 2 professions and am concerned about the future of an anesthesiologist with the CRNA surge.  Any thoughts, comments, advice, etc. would be GREATLY appreciated!  Thanks in advance for your time and consideration Dr. Levy!

Kindest regards,


ANSWER: As with the MD vs nurse practictioner debate, there will always be a need for MDAs. I think that while the salary difference is lessening, I still think that CRNAs will reach a ceiling while MDA can keep pushing the top. While income is an important consideration, if it is a primary reason for going into medicine, there are many other jobs that pay better and have less risk. I still think you will be better off as an MDA because you are more likely to have independent control of your destiny.

Hope this helps,

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston

---------- FOLLOW-UP ----------

QUESTION: Hi Dr. Levy,

Thanks so much for your prompt reply!  Income is not my primary reason for wanting to go into medicine but as you said it is an important consideration and I am just curious with the CRNA surge since the salary gap between the 2 professions is closing quite markedly in recent years.  I was just a little threatened in thinking that perhaps the MDA's role would be replaced to an extent by a CRNA in managing anesthesia.  I've heard that the MDA's role will be more focused with academia and research because CRNA's are doing more and more of the actual anesthesia monitoring and pre/post-op of surgical cases, diagnostic tests, etc.  My passion lies with staying with the patient through the entire procedure, not "behind" the doors doing research or looking over others necessary.  As a result, I just want to make the best decision for myself since the MDA career entails such a big committment in so many aspects in life from the candidate.  Any thoughts on this?

Also, I know that medical school is very competitive and was wondering if you could offer any advice regarding strengthening my application?  I have a sub 3.0 GPA and know that I will need to boost that GPA up and score very well on the MCAT.  I graduated nearly 4 years ago with a BS in biochemistry/cell biology and have "matured" if you will and have learned so much from working in the pharmaceutical/biotech field for the past 4 years.  I know I have a different perspective on school/education and am extremely motivated to do what it takes to secure a career in anesthesia.  Is that entire maturation process a significant factor in the application process and do I even stand a fighting chance of acceptance into a medical school in your personal opinion?

I know these are difficult questions but any help/advice would be greatly appreciated!!

Best wishes and many thanks,


Answer
I don't think that CRNAs will replace MDAs in the OR. While they may be a major force in some of the smaller markets or rural groups, I thinks MDAs will still be the dominant one. As for getting into medical school, obviously your GPA is a major issue. Clearly you need to do very well on the MCATs but I might also recommend taking a few college courses (particularly the premed courses like organic, etc) and showing that now you can get the grades. Be prepared to address the reasons for your GPA in your essay and hope the admissions office is kind that week. You might also consider foreign medical schools as an alternative.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston