Doctoral training becomes the new norm for CRNAs starting in 2025

Editor's Note

All newly certified registered nurse anesthetists (CRNAs) in the US will be required to hold a doctoral degree, marking a significant shift in training standards for the profession, according to a May 3 post by James Allen, MD, on his page, “Hospital Medical Director,” also covered by Becker's ASC Review May 27. This change stems from a 2009 decision by the Council on Accreditation of Nurse Anesthesia Educational Programs to transition all CRNA programs from master’s to doctoral-level education, with full implementation required by 2025.

As detailed in the post, prospective CRNAs must now complete a 3-year doctoral program after earning a bachelor’s degree—typically a BSN—and gaining 1 to 2 years of critical care nursing experience. Accepted doctoral pathways include clinical degrees like the Doctor of Nursing Practice (DNP) or Doctor of Nurse Anesthesia Practice (DNAP), as well as academic or administrative doctorates such as the PhD, EdD, DNS, or DMPNA. Most students are likely to pursue the DNP or DNAP, both of which provide graduates equivalent clinical preparation, Dr Allen says. While the DNP is offered by nursing schools and often includes multiple specialty tracks, the DNAP is tailored to nurse anesthetists and offered through anesthesia-focused programs. The DNP may be more widely recognized for academic tenure-track positions.

Following graduation, all CRNAs must pass the National Certification Exam (NCE) and obtain state licensure. Ongoing recertification every 4 years includes 100 continuing education hours and core modules in key clinical areas. Licensure and scope of practice vary by state. These expanded training requirements mean future CRNAs will receive 50% more anesthesia-specific instruction than their predecessors, potentially equipping them for more autonomous roles in hospitals. Hospitals may begin using CRNAs more extensively for starting cases at night, providing endoscopy sedation, or handling emergency airway management—roles traditionally overseen by physician anesthesiologists.

However, the shift could strain an already tight labor market. A whitepaper cited in the post warns of a projected nursing shortfall of 450,000 by 2025, with delays in CRNA entry into the workforce possibly exacerbating shortages. Despite this, CRNAs—who already administer over 50 million anesthetics annually and comprise more than 80% of rural anesthesia providers—are likely to see expanded responsibilities as cost-effective physician extenders in perioperative care.