Specialty Profile

Anesthesiology /Anesthesia
GENERAL INFORMATION
(Sources: Perspectives on Health Occupations, the Canadian Medical Residency Guide and Pathway
Evaluation Program, RCPSC)

Anesthesiology (anesthesia) is a diversified specialty requiring physicians to draw upon

their knowledge of pharmacy and physiology and to utilize their technical skills in the
provision of perioperative care, critical care, emergency care and pain management.
Anesthesiology is a relatively flexible, mobile specialty and is involved in the following
settings:
for surgery, anesthesiologists evaluate the patients overall health, plan
techniques, choose agents, administer anesthesia, and monitor the effects of
anesthesia and surgery on the patients vital functions
in the ICU, they care for critically ill patients by providing airway management,
cardiac and pulmonary resuscitation, advanced life support and pain control
on the maternity ward, attend to the management of pain relief during childbirth
in pain clinics, anesthesiologists provide acute and chronic pain relief to a variety
of patients.
Certain strengths may be needed to pursue this specialty such as the ability to perform
under pressure, to think quickly in stressful situations, to use your hands and to work in a
team environment. The opportunity to establish continuing, long-term physician/patient
relationships is limited in this specialty.
Upon completion of medical school, to become certified in anesthesiology requires an
additional 5 years of RCPSC-approved residency training. This training includes:
1 year of basic clinical training; and
4 years of RCPSC-approved training that must include: 30 months of RCPSCapproved resident training in anesthesiology; 1 year of RCPSC-approved
resident training in internal medicine (to be undertaken preferably after a year of
clinical training in anesthesiology); 6 months of training that may include further
training in an approved anesthesiology program or research experience in a
clinical or basic science department approved by the Royal College; and 6
months training in clinical pharmacology undertaken in an accredited program
during the final residency year.
For more detailed training requirements go to:
http://rcpsc.medical.org/residency/certification/training/anesthesiology_e.html#special
There are currently 2,698 anesthesiologists practicing in Canada. Of these, 6% are
under the age of 35, 59% are 35-54 and 34% are 55 and older. Nearly three-quarters of
practicing anesthesiologists are male (74%) and 26% are female. (Source: 2008 CMA
Masterfile).

DETAILED INFORMATION

The remainder of the data contained in this specialty profile has been extracted from the
2007 National Physician Survey (NPS), unless otherwise stated. All percentages are for
respondents only. A total of 946 anesthesiologists responded (for a response rate of
34%). Complete data tables for anesthesiology from the 2007 NPS are available at:
http://www.nationalphysiciansurvey.ca/nps/2007_Survey/Results/physician3.1_sp-e.asp
For an index to all specialties, go to:
http://www.nationalphysiciansurvey.ca/nps/2007_Survey/2007results-e.asp

Choosing anesthesiology (2004 NPS Data)

In 2004, a total of 35% of anesthesiologists decided on this specialty as a career choice
during their clerkship year (i.e., the last year of medical school), while 25% decided after
a period of time in practice and 19% decided during their residency.
Most anesthesiologists (83%) chose this specialty for the intellectual
stimulation/challenge it provides. Also cited as factors cited were workload flexibility
(60%), the influence of a mentor (40%) and the quality of the doctor-patient relationship
(40%). From these factors, intellectual stimulation/challenge of the specialty was cited as
the single most important career decision-making factor (46%).

Practice Setting
For half (50%)f anesthesiologists their main work setting is an academic health sciences
centre, while 49% work mainly in a community hospital, 21% work in a private
office/clinic and 21% are in a university/faculty of medicine. Anesthesiologists see
patients in a variety of settings, with the academic health sciences centre being the main
patient care setting for almost half (45%), followed by the community hospital (40%).
Liking the location was the major influence (58%) on an anesthesiologists selection of
their current practice location, 58% liked the location, but the availability of a practice
opportunity (51%), family reasons (39%), the availability of a medical support
system/resources (37%) and the opportunity for affiliation with a university (36%) were
also cited as important influences.

Practice Profile
More than half of anesthesiologists (54%) work in a group practice, where on-call duties,
equipment, office space and/or staff are shared amongst the physicians, while 23% are
in an interprofessional practice setting, where physicians and other health professionals
have their own caseloads and 22% work in a solo practice setting.

In their main patient care setting, 85% of anesthesiologists share patient care with other
types of health care providers, including:
nurses (69%)
pharmacists (46%)
family physicians (39%)
Nearly all anesthesiologists (92%) feel that this collaboration improves the care that their
patients receive and enhances the care that they can deliver.
During a typical week, anesthesiologists see an average of 36 patients. The majority of
anesthesiologists (65%) serve mainly an urban/suburban population.
Anesthesiologists work an average of 55 hours per week on professional activities
(excluding on-call). The majority of this time (42 hours per week) is devoted to direct
patient care, with or without a teaching component. An additional 2 hours per week is
spent on indirect patient care, such as making appointments with specialists, charting,
meeting a patients family, etc. The remainder of the time is spent on research,
CME/CPD, administration and/or teaching.
Most anesthesiologists (85%) make themselves available to their patients (i.e., on-call)
outside of their regularly scheduled hours. Because of the nature and primary location of
their practice, nearly all (98%) provide on-call for hospital in-patients, but a fair number
(38%) also provide obstetrical on-call, while 16% do emergency room on-call and 9%
are on-call for non-hospitalized patients (are available by telephone and see patients as
required). Of those who do on-call, the majority (79%) spend up to 120 hour per month
on-call, 12% put in between 121 and 180 hours per month and 7% spend more than 180
hours per month on-call. On average, anesthesiologists spend 94 hours per month oncall. During the time an anesthesiologist is on-call each month, they spend an average of
36 hours on direct patient care and see an average of 36 patients.

Income
The majority of anesthesiologists (57%) receive 90+% of their income from fee-forservice and more than a quarter (27%) receive 90+% or more through a blended source
(i.e., made up of a combination of 2 or more payment methods like fee-for-service,
salary, capitation, sessional, contract, benefits/pensions, on-call remuneration or some
other form). When asked their preferred method of remuneration, 58% of
anesthesiologists would prefer some form of blended remuneration, while 25% would
prefer fee-for-service only.
According to the Canadian Institute for Health Informations Average Gross Fee-forService Payment Report 2005-2006, the average gross fee-for-service payment per
anesthesiologist in 2005-06 was $273,486. Note that this is gross billings and does not
take into account deductions for overhead expenses, taxes, etc.
To protect their income, physicians take out medical liability coverage in the event that a
patient is harmed in a medical misadventure. According to The Canadian Medical

Protective Associations Fee Schedule for 2009, the annual cost for insurance for an
anesthesiologist is:
Quebec
$ 3,793

Ontario
$ 3,840

Rest of Canada
$ 1,680

Satisfaction
Three-quarters of anesthesiologists (75%) report that they are very or somewhat
satisfied with their current professional life.
Most anesthesiologists (85%) are very or somewhat satisfied with their relationship with
their patients and with their relationship with other specialist physicians (80%). They are
much less satisfied with their relationship with family physicians (only 43% are very or
somewhat satisfied).
They also report being less satisfied with finding a balance between personal and
professional commitments (55%), with their net revenue per hour compared to other
anesthesiologists (50%) and with their net revenue per hour compared with other
specialties (40%).

ADDITIONAL INFORMATION
Additional information on this specialty can be found from the:
Canadian Anesthesiologists Society: http://www.cas.ca/