How to Become a Certified Anesthesiologist Assistant and Where CAAs Train

A certified anesthesiologist assistant (CAA) is a master’s-trained anesthesia professional who works under a physician anesthesiologist. To become one, finish a bachelor’s degree with premedical courses, complete a CAAHEP-accredited master’s program of 24 to 29 months, pass the NCCAA Certification Exam and practice in a state that authorizes CAAs.

Along the way, most programs ask for the MCAT or GRE and documented anesthesia shadowing, and after graduation you obtain a state license or practice under delegated authority where the state permits it. A bachelor’s degree of about four years plus a 24 to 29 month master’s program adds up to about six to six and a half years after high school. The NCCAA counted 4,718 currently certified anesthesiologist assistants as of July 18, 2026, so the profession is still small enough that program choice and state law shape your career from the start.

The details matter because programs differ in their entrance exams, prerequisite courses, shadowing rules and length, while CAAs can practice only in certain jurisdictions. This route is much shorter than the physician pathway described in our guide to how to become an anesthesiologist, but it leads to a different role, one that always works under a physician anesthesiologist’s supervision. If you are still deciding between the three anesthesia careers, our side-by-side comparison of CRNA vs anesthesiologist vs CAA training, scope and pay lays out how the roles differ before you commit to one path.

The CAA Path at a Glance

• CAA preparation requires a bachelor’s degree with premedical coursework followed by a CAAHEP-accredited master’s program, which takes 24 to 29 months depending on the program.
• CAAHEP listed 25 accredited program locations at 15 institutions in 11 states and Washington DC on September 20, 2026. Each campus is listed separately.
• Most programs accept the MCAT or GRE and most require at least eight documented hours of anesthesia shadowing, but several programs set different rules.
• After passing the NCCAA Certification Exam, CAAs maintain certification through 50 CME hours every two years and the Continued Demonstration of Qualifications exam in years 4 and 10 of certification, then every ten years. Where they may practice depends on state law.
• The American Academy of Anesthesiologist Assistants counts 22 states, Washington DC and Guam where CAAs can practice, and its January 2026 fact sheet puts the average CAA starting salary at $200,000.

What Is a Certified Anesthesiologist Assistant and What Does a CAA Do?

A certified anesthesiologist assistant is a graduate-level anesthesia professional who helps plan and deliver anesthesia care under the supervision of a physician anesthesiologist. The American Academy of Anesthesiologist Assistants (AAAA) places CAAs within the Anesthesia Care Team, while the American Society of Anesthesiologists describes them as graduate-level nonphysician anesthesia care professionals.

CAA responsibilities can span the perioperative period. The AAAA says they may take a health history, perform a pre-anesthesia physical examination, establish intravenous access and monitoring and interpret advanced monitoring. They also participate in induction, maintenance and emergence from anesthesia, manage airways, record patients’ physiological and pharmacological status and continue care into the postoperative period.

Physician anesthesiologists often lead teams that can also include nurse anesthetists, CAAs and anesthesiology residents. Our anesthesiologist vs CRNA comparison provides more context on the other anesthesia professionals you may encounter. The CAA profession originated in the early 1960s when physician anesthesiologists proposed adding a new professional role to the team in response to a staffing shortage.

A CAA is not a physician assistant. CAA education focuses specifically on anesthesia, certification comes from the National Commission for Certification of Anesthesiologist Assistants and practice is tied to the Anesthesia Care Team. U.S. Department of Labor data nevertheless group CAA wages with physician assistant wages, which matters when you read salary claims, as the pay section below explains.

How Do You Become an Anesthesiologist Assistant?

You become an anesthesiologist assistant by completing the required undergraduate preparation, entering an accredited master’s program, passing the national certification examination and meeting the practice requirements of an eligible jurisdiction. The American Academy of Anesthesiologist Assistants’ overview of CAAs explains that CAAs complete premedical education, earn a master’s degree from an accredited anesthesia program and deliver care under anesthesiologist supervision.

The steps in the table above run in that order. Plan your bachelor’s coursework around the prerequisites of the programs you may apply to, complete the required entrance exam and shadowing before their deadlines and apply through CASAA. After the master’s program, certification and state authorization are separate steps. Certification does not by itself mean you may practice in every state.

The schooling adds up to about six to six and a half years after high school. That is arithmetic: a bachelor’s degree, which the National Center for Education Statistics defines as usually requiring at least four years of full-time study, plus 24 to 29 months in the master’s program. It grows if you need extra time for prerequisites, the entrance exam or a second application cycle.

What Bachelor’s Degree, Prerequisites and Entrance Exam Do CAA Programs Require?

You need a bachelor’s degree and the science and mathematics prerequisites each program lists, not a particular major. Ohio Dominican and South University both say most of their students arrive with a degree in a science or health care field, but that it is not required. What matters is whether your transcript contains the required premedical courses and meets each program’s academic rules.

For example, Saint Louis University requires two semesters each of biology, general chemistry, organic chemistry and physics with labs, anatomy and physiology and one semester of calculus. Kansas City University includes biology, general and organic chemistry, biochemistry or a second organic chemistry course, anatomy, physiology, physics, calculus, statistics and English composition. These examples overlap, but they are not a universal curriculum. Compare requirements before choosing or dropping undergraduate courses.

What Should You Major In to Become an Anesthesiologist Assistant?

Major in the subject you can do well in while still fitting every prerequisite course on your list. Because CAA programs set course requirements rather than a required major, biology, chemistry, biochemistry, health science, kinesiology and physics majors all work, and so does a humanities major with the science sequence added. The practical test is whether your transcript shows every course the programs on your list name, such as the two-semester biology, general chemistry, organic chemistry and physics sequences with labs that Saint Louis University requires, or the statistics and English composition courses on Kansas City University’s list.

A science-heavy major has one advantage: the coursework overlaps with the MCAT and with the pharmacology and physiology you will study in the master’s program. If you are choosing among majors, our guide to the best classes to take before the MCAT shows which courses do double duty for the entrance exam and for CAA prerequisites.

Do Anesthesiologist Assistant Programs Require the MCAT or GRE?

Most CAA programs accept either the MCAT or GRE, but there are important exceptions. The University of Colorado requires the MCAT and does not accept the GRE. UTHealth Houston prefers the MCAT but also considers the GRE. Kansas City University accepts the MCAT, GRE or DAT, while Bluefield University at VCOM does not require an entrance exam.

Published MCAT expectations vary considerably. Northeast Ohio Medical University (NEOMED) requires a score above 490, while the Medical College of Wisconsin describes 490 as competitive. The University of Missouri-Kansas City (UMKC) recommends 494, UTHealth Houston requires at least 498 and Indiana University does not accept a score below 499. Nova Southeastern describes scores of 500 and above as competitive, Case Western Reserve recommends 500 or higher, Saint Louis University considers 501 competitive and Emory asks for 502. If you are working from practice tests, our MCAT score calculator turns the number of questions you answered correctly into an estimated scaled score that you can set beside these marks.

A target or minimum is not the same as a matriculant average. Case Western Reserve reported a 506 average for its 2025-2026 matriculants, while UTHealth Houston reported a mean of 508 among MCAT takers in its 2025 and 2026 cohorts. Programs also limit the age of scores, commonly to three or five years, so confirm that your planned test date fits the application cycle.

How Much Anesthesia Shadowing Do CAA Programs Require?

Most anesthesiologist assistant programs require at least eight documented hours of anesthesia shadowing, but you must follow the rule of each program. The University of Colorado, Indiana University, Emory, the Medical College of Wisconsin, NEOMED, Nova Southeastern, Ohio Dominican, South University, the University of New Mexico and UTHealth Houston all publish eight-hour minimums.

Other programs use different thresholds. Saint Louis University requires 16 hours documented by an anesthesiologist or CAA. Case Western Reserve strongly recommends 16 or more hours with a CAA in an operating room. UMKC requires four hours but does not count shadowing completed as part of employment, an internship or a class. Bluefield University at VCOM encourages clinical shadowing without making it an admission requirement.

Documentation matters as much as the number of hours. Some programs require their own form or a signature from the anesthesia professional you observed. Before arranging an experience, check which professionals qualify, whether observation must be in person and what record the program expects.

Our CRNA and anesthesiologist assistant internships abroad place you with anesthesia teams at partner teaching hospitals in Kenya and Peru, where you learn under supervision in the operating room and help the team run community medical clinics. That experience does not automatically satisfy a CAA program’s shadowing requirement, so obtain the program’s guidance on which professionals and settings count before relying on it for documented hours.

Shadowing hours sit alongside your broader clinical background. The shadowing log proves you have seen anesthesia care up close, and wider time in hospitals helps you answer the interview question every program asks in some form: why anesthesia, and why this role on the team. Our guide to shadowing vs clinical experience explains how admissions committees read the two kinds of hours differently.

Which Anesthesiologist Assistant Programs Are Accredited?

CAAHEP is the only nationally recognized accreditor for anesthesiologist assistant education, with accreditation services provided through ARC-AA. On September 20, 2026, the CAAHEP Find an Accredited Program directory contained 25 accredited listings at 15 institutions in 11 states and Washington DC. Each campus is listed separately and every listing awards a master’s degree.

The programs in the table above are listed alphabetically, not ranked. Florida has six listings, more than any other state. Emory University and Case Western Reserve University’s Cleveland program have the earliest accreditation dates in the directory, both in 1988. Kansas City University in Joplin and Bluefield University at VCOM in Spartanburg received initial accreditation in 2025, as did Saint Louis University, UTHealth Houston and Nova Southeastern University’s Orlando campus.

How Should You Compare CAA Programs?

Start with location and where you may eventually want to practice. A program’s location does not remove the need to qualify under the law of the jurisdiction where you seek employment. Then compare the entrance exam, prerequisite courses, shadowing documentation and score-age limits against the preparation you already have.

Program length ranges from 24 months at Case Western Reserve to 29 consecutive months at UMKC. That difference may affect living expenses and the amount of time before graduation, but length alone does not show that one program offers better training.

Clinical structure deserves a close look. CAAHEP standards set minimums of 600 anesthesia cases and 2,000 clinical anesthesia hours. Some programs publish higher totals: Emory states that students complete at least 2,500 clinical rotation hours, while UTHealth Houston lists at least 650 cases and 2,500 clinical hours. CAAHEP’s standards also require every program to be supported by an accredited school of medicine.

Finally, consider published outcomes in their proper context. ARC-AA’s 2024 data for the 17 programs that had graduates that year showed average retention of 91.7 percent, average job placement of 99.6 percent and an average NCCAA examination pass rate of 99.6 percent. These are program-level averages, not a promise of an individual student’s outcome.

What Are the Best Anesthesiologist Assistant Programs?

No official ranking of anesthesiologist assistant programs exists, so the best program is the accredited one that fits your preparation, budget and practice plans. CAAHEP accreditation is the baseline every program in the table above meets. Beyond it, the most useful comparisons are the outcomes each program reports: first-attempt NCCAA pass rates, attrition and job placement for recent graduating classes.

Read those outcome pages with class size in mind. A program that graduates a dozen students can swing several points from one year to the next because of one or two results, while a multi-campus program reports each campus separately. Ask each program for its most recent three years of outcomes, where its students rotate and how many cases a typical graduate logs, then compare the answers against the CAAHEP minimums of 600 cases and 2,000 clinical hours.

What Is the NCCAA Certification Exam?

The NCCAA Certification Exam is the national examination used to award the CAA credential after accredited education. Graduates of an accredited anesthesiologist assistant program may apply, and so may enrolled students whose program director verifies that they are progressing on pace toward graduation. The NCCAA sets the exam content and passing score and contracts with Pearson to deliver the test at centers across the United States.

According to the NCCAA Certification Exam information, the test contains 180 multiple-choice items divided into two blocks of 90. Candidates receive 110 minutes for each block, 235 minutes of exam time in all, with an optional break of up to 15 minutes between the blocks. Thirty questions are unscored pretest items spread through the exam. The exam assesses entry-level cognitive and deductive skills.

Eligibility also includes an approved educational background and a documented clinical experience record meeting NCCAA standards. Students self-report their clinical hours and experiences to the NCCAA through a mobile application, and that logging is mandatory for students who matriculated into an anesthesiologist assistant program on or after January 1, 2025. The initial eligibility period lasts no more than two years from graduation or the first attempt, whichever comes first, and candidates have a maximum of six opportunities to take the exam.

The exam is offered three times a year. The NCCAA’s calendar lists administrations in February, June and October 2027, with registration for the February 9 to 13 window open from November 9, 2026 to February 6, 2027. In August 2026, the NCCAA invalidated the results of the June 2026 Certification Exam and offered affected candidates a retest at no cost, so check your NCCAA profile for your own status if you tested that month.

The NCCAA’s By the Numbers page counted 4,718 currently certified CAAs as of July 18, 2026, and 4,872 people certified since the commission began. It reported 485 newly certified CAAs in 2025 and 381 in 2024, with 1,585 students enrolled in programs. The NCCAA publishes pass rates by administration on its exam results page, and those national figures are measured differently from the program-level pass rates reported to ARC-AA, so do not read one against the other.

What States Can Anesthesiologist Assistants Work In?

CAAs can work only in jurisdictions that authorize their practice, and the published association totals differ. The American Academy of Anesthesiologist Assistants currently counts 22 states, Washington DC and Guam.

The American Society of Anesthesiologists’ list, last updated in September 2025, names 24 jurisdictions: Alabama, Colorado, District of Columbia, Florida, Georgia, Kansas, Kentucky, Indiana, Michigan, Missouri, Nevada, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington and Wisconsin. It marks Kansas, Michigan, Pennsylvania and Texas with the note “delegatory authority”, so ask the medical board in those states how a CAA is authorized to practice there.

The map continues to change. The ASA reports that Tennessee and Virginia enacted CAA licensure laws in 2025, following Washington in 2024 and Nevada in 2023. Before choosing a program or accepting a position, confirm the current requirements directly with the medical board in the jurisdiction where you intend to practice.

How Do CAAs Maintain Their Certification?

CAAs maintain certification by registering continuing medical education every two years and passing the Continued Demonstration of Qualifications exam on the NCCAA schedule. The NCCAA CME requirements call for 50 hours every two years, including 40 hours of CAA Category I anesthesia CME. The other 10 hours can be Category II, and extra Category I hours can stand in for Category II but not the reverse. Each CAA follows an odd-year or even-year cycle based on the year of first certification.

The NCCAA certification cycle runs on ten years: CME every two years, the Continued Demonstration of Qualifications (CDQ) exam in year 4 and year 10, and then the CDQ every ten years after that, in years 20, 30 and so on. CME registration and any audit are due in years 2, 4, 6, 8 and 10 of each cycle.

The CDQ examination contains 135 multiple-choice items divided into two blocks of 68 and 67 questions, 20 of them unscored pretest items. Candidates have 165 minutes in total, 83 for the first block and 82 for the second, with an optional break of up to 15 minutes between them. The CDQ is offered in February and June, and eligibility covers three consecutive offerings beginning in the calendar year the exam is due.

How Does a CAA Compare With a CRNA and Physician Anesthesiologist?

CAAs, CRNAs and physician anesthesiologists can all participate in anesthesia care, but they reach practice through different educational, licensing and certification systems. As the American Academy of Anesthesiologist Assistants describes the path, a CAA completes premedical preparation and an accredited anesthesia master’s program, then practices under physician anesthesiologist supervision. A reader considering the nursing route should review how to become a nurse anesthetist: CRNA preparation requires nursing education, an RN or APRN license, at least one year of full-time critical care nursing experience and a doctoral nurse anesthesia program. Under Council on Accreditation standards, students accepted into an entry-level program on or after January 1, 2022 must graduate with a doctoral degree, so every new CRNA now enters practice with a DNP or DNAP.

This section covers the comparison only as far as it affects a CAA applicant. For the full side-by-side, including the difference between an anesthetist and an anesthesiologist, supervision rules and pay for all three roles, read our guide to anesthesiologist vs CRNA vs anesthesiologist assistant careers.

A physician anesthesiologist completes a bachelor’s degree, four years of medical school and a four-year anesthesiology residency. That physician route leads to an MD or DO and a broader medical role in anesthesia care, pain management and critical care medicine.

The comparison below includes national wage context from the Bureau of Labor Statistics Occupational Outlook Handbook for May 2025. The BLS reported a $236,590 median annual wage for nurse anesthetists; our CRNA salary guide examines that figure in more detail.

The table above comes down to the starting point. If you are a premedical student, the CAA route builds on the courses you are already taking. The CRNA route starts with a nursing license and critical care experience, and the physician route adds medical school and residency.

How Much Do Anesthesiologist Assistants Make?

There is no separate federal median wage for anesthesiologist assistants. The U.S. Department of Labor groups their wage reporting with physician assistants, so a precise national CAA median cannot be stated from federal data.

O*NET OnLine’s anesthesiologist assistant page displays a 2025 median annual wage of $135,880, but it explicitly labels that amount as physician assistant wage data. It is not a CAA-only median and should not be presented as one.

The American Academy of Anesthesiologist Assistants’ Become a CAA fact sheet (January 2026) puts the average CAA starting salary at $200,000 and counts more than 4,500 active CAAs. That is the profession’s association figure rather than a government wage statistic. For scale, BLS May 2025 medians were $236,590 for nurse anesthetists and $391,490 for anesthesiologists, but those figures describe different professions with different education and practice structures.

Pay for anesthesiologist assistants depends heavily on location because the jobs exist only in the jurisdictions that authorize CAA practice. Program locations follow the same map: Florida has six accredited listings, and Missouri, Ohio and Texas have three each, all in states that authorize CAA practice. If you need to stay in a state that does not authorize CAAs, the salary figures above will not apply to you, which is one more reason to check state law before you apply.

Your Next Step Toward the CAA Path

Begin by identifying accredited programs that fit where you are willing to study and practice. Compare their prerequisite courses with your transcript, then note the entrance exam, score-age rule and shadowing documentation each one expects.

If you are still choosing among anesthesia careers, focus first on the training model and professional role rather than the title or a single salary figure. The right next step is the one that lets you test your interest in anesthesia care while keeping your coursework and application timeline aligned with the programs you may pursue.

A simple timeline helps. Two years before you apply, map each target program’s prerequisites against your transcript and schedule the MCAT or GRE. One year out, complete and document your anesthesia shadowing, line up recommendation letters and confirm the score-age rules. In the application year, apply through CASAA or the program’s own portal, prepare for interviews and keep your state practice plans in mind as offers arrive.

Frequently Asked Questions

What Is a Certified Anesthesiologist Assistant?

A certified anesthesiologist assistant is a master’s-trained anesthesia professional who helps plan and deliver anesthesia care within the Anesthesia Care Team under a physician anesthesiologist’s supervision. CAAs may assess patients, establish monitoring and intravenous access, participate in anesthesia administration, manage airways and continue care into the postoperative period.

How Long Does It Take to Become an Anesthesiologist Assistant?

It takes about six to six and a half years after high school based on approximately four years for a bachelor’s degree plus 24 months (Case Western Reserve) to 29 months (UMKC) in an accredited master’s program. That total is arithmetic and may be longer if you need additional time for prerequisites, testing or the application cycle.

Do Anesthesiologist Assistants Take the MCAT?

It depends on the program. Most accept either the MCAT or the GRE, the University of Colorado requires the MCAT and does not accept the GRE, UTHealth Houston prefers the MCAT, Kansas City University also accepts the DAT and Bluefield University at VCOM does not require a standardized entrance exam.

How Many Anesthesiologist Assistant Programs Are There?

CAAHEP’s directory listed 25 accredited program locations at 15 institutions as of September 20, 2026. The directory counts each accredited campus separately, so the number of listings is larger than the number of institutions.

What States Can Anesthesiologist Assistants Work In?

CAAs may work only in jurisdictions that authorize their practice. The American Academy of Anesthesiologist Assistants (AAAA) counts 22 states, Washington DC and Guam, while the American Society of Anesthesiologists’ list, last updated in September 2025, names 24 jurisdictions, among them Florida, Georgia, Ohio, Texas, Colorado, Missouri and Wisconsin. Because laws change, confirm the current rules with the relevant state medical board before choosing a school or job.

What Is the Difference Between a CAA and a CRNA?

The principal difference is the education and professional pathway. A CAA enters through premedical undergraduate coursework and an accredited anesthesia master’s program, then works under physician anesthesiologist supervision. A CRNA enters through nursing, holds an RN or APRN license, completes critical care nursing experience and graduates from a doctoral nurse anesthesia program.

How Much Do Anesthesiologist Assistants Make?

No separate federal median wage is available for CAAs. The U.S. Department of Labor’s O*NET displays $135,880 for 2025 but identifies it as physician assistant data, not a CAA-only wage. The AAAA’s January 2026 fact sheet puts the average CAA starting salary at $200,000, which is the professional association’s figure rather than a federal statistic.

Is an Anesthesiologist Assistant the Same as a Physician Assistant?

No. A CAA completes an accredited graduate anesthesia program, earns certification through the NCCAA and practices within an Anesthesia Care Team under physician anesthesiologist supervision. Federal wage reporting groups anesthesiologist assistants with physician assistants, but that statistical grouping does not make the professions the same.

What Should I Major In to Become an Anesthesiologist Assistant?

Any major works if your transcript includes every prerequisite course the programs you want require. Most entering students hold a science or health care degree, but CAA programs set course requirements, such as biology, general and organic chemistry, physics, anatomy, physiology and calculus or statistics, rather than a required major.

How Many Certified Anesthesiologist Assistants Are There?

The NCCAA counted 4,718 currently certified anesthesiologist assistants as of July 18, 2026. It certified 485 new CAAs in 2025 and 381 in 2024, and it reported 1,585 students enrolled in anesthesiologist assistant programs.

What Is the Difference Between a CAA and an Anesthesiologist?

An anesthesiologist is a physician who completes medical school and a four-year anesthesiology residency, then practices medicine and often leads the Anesthesia Care Team. A CAA completes a 24 to 29 month master’s program after a bachelor’s degree and always works under an anesthesiologist’s supervision. The BLS May 2025 median wage for anesthesiologists was $391,490.