A CRNA is not a medical doctor. CRNAs, or certified registered nurse anesthetists, are advanced-practice nurses who specialize in administering anesthesia. They do not attend medical school or complete a medical residency. However, as of 2025, all new CRNAs are required to hold a doctoral degree in nursing or nurse anesthesia, which can create understandable confusion about the title.
What a CRNA Actually Is
CRNAs are registered nurses who pursue additional graduate-level education specifically in anesthesia. They provide many of the same anesthesia and pain management services as physician anesthesiologists, including administering anesthesia for surgeries, managing pain during labor, and handling sedation for procedures. About 71% of patients in one AMA survey correctly identified that a nurse anesthetist is not a physician, but the remaining 29% were unsure or mistaken, which reflects how blurry the lines can seem in a clinical setting.
The distinction matters because the training paths are fundamentally different. An anesthesiologist completes four years of medical school, four years of residency, and often one to two additional years of fellowship training in a subspecialty. A CRNA program runs about 36 months and builds on a nursing foundation rather than a medical one. Both professionals may end up in the same operating room delivering anesthesia, but they arrive there through very different educational routes.
The Doctoral Degree Requirement
Here’s where things get confusing. Since January 2025, every graduate of an accredited nurse anesthesia program must earn a doctoral degree. This means new CRNAs now hold either a Doctor of Nursing Practice (DNP) or a Doctor of Nurse Anesthesia Practice (DNAP). These are legitimate doctoral degrees, but they are not medical degrees.
The DNP is a broader degree that prepares nurses for advanced practice, leadership, and healthcare policy across multiple specialties. The DNAP is more specialized, focusing exclusively on anesthesia pharmacology, the physiology of complex surgical patients, pain management, and perioperative care. Both degrees qualify someone to use the title “Doctor” in an academic sense, the same way someone with a PhD in history or a doctorate in physical therapy can be called “Doctor.”
The critical distinction is between holding a doctoral degree and being a physician. A physician (MD or DO) completes medical school and residency training. A CRNA with a DNP or DNAP has completed a doctoral nursing program. The word “doctor” applies to both in different contexts, but only one is a medical doctor.
Using the Title “Doctor” in Clinical Settings
Whether a CRNA can introduce themselves as “Doctor” in a hospital or clinic depends on state laws, and the rules vary widely. Some states restrict the use of “Doctor” in clinical environments to physicians to avoid confusing patients. Others allow any doctoral-degree holder to use the title as long as they clearly identify their role.
The State Medical Board of Ohio, for example, has taken the position that CRNAs should not use the term “anesthesiologist” in their title, noting that calling oneself a “nurse anesthesiologist” is misleading to patients who may assume that means the person is a physician. Similar debates play out in other states, and the rules are still evolving as more CRNAs graduate with doctoral degrees.
How CRNAs and Anesthesiologists Work Together
In practice, the relationship between CRNAs and anesthesiologists varies by state and by hospital. Twenty-five states and Guam have opted out of the federal requirement that CRNAs be supervised by a physician, meaning CRNAs in those states can deliver anesthesia independently. In the remaining states, CRNAs typically work under some form of physician oversight, though the degree of that supervision differs.
Research comparing patient outcomes between CRNA-led and anesthesiologist-led care has produced mixed results. Several studies have found no significant differences in mortality, readmission rates, or complication rates between the two models. Other studies have raised potential safety concerns when CRNAs practice with less physician oversight. The evidence hasn’t settled clearly in one direction, which is part of why the scope-of-practice debate remains politically charged.
Salary and Career Outlook
CRNAs are among the highest-paid nursing professionals in the country. The median annual wage was $212,650 as of May 2023, according to the Bureau of Labor Statistics. That’s a substantial salary, though anesthesiologists, as physicians, typically earn more. CRNAs with doctoral degrees can advance into roles like lead CRNA, anesthesia department director, or clinical faculty in nurse anesthesia programs.
The Bottom Line on the Title
A CRNA is not a medical doctor, but many now hold doctoral degrees. If your anesthesia provider introduces themselves as a CRNA, you’re being cared for by an advanced-practice nurse with specialized training in anesthesia, not a physician who attended medical school and completed a residency. Both are trained to deliver anesthesia safely, but their credentials, training length, and professional classifications are different. If you want to know exactly who will be managing your anesthesia and what their qualifications are, asking directly is always reasonable.