How to Become a Nurse Anesthetist (CRNA) 2026
Becoming a Certified Registered Nurse Anesthetist (CRNA) requires an RN license, at least one year of acute care nursing experience, and completion of an accredited doctoral nurse anesthesia program, either a DNP or DNAP. The full path typically takes 7 to 10 years. Graduates must then pass the National Certification Examination administered by the NBCRNA before practicing.
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CRNAs are the highest-paid nurses in the country and, in rural areas across the United States, often the only anesthesia provider available. The path to the credential is long and competitive. It starts with critical care nursing experience and moves into doctoral-level anesthesia training before candidates can sit for national certification.
On this page:
- What Does a CRNA Do?
- Steps to Become a Nurse Anesthetist
- How Long Does It Take?
- CRNA Salary and Job Outlook
- Maintaining CRNA Certification
What Does a CRNA Do?
CRNAs administer anesthesia for surgical procedures, trauma stabilization, obstetric care, and pain management. They work in hospitals, ambulatory surgical centers, military settings, dental offices, and the offices of specialty providers such as ophthalmologists. The role covers the full anesthesia care cycle: pre-anesthesia patient assessment, intraoperative monitoring, airway management, ventilation support, and post-anesthesia recovery oversight.
Practice authority varies by state. The Centers for Medicare and Medicaid Services (CMS) allows state governors to opt out of the federal physician supervision requirement, and a number of states have done so. In those states, CRNAs may practice independently. In others, they work under physician supervision as part of an anesthesia care team. The American Association of Nurse Anesthetists (AANA) represents the profession and publishes guidance on the scope of practice at aana.com.
In rural areas, CRNAs frequently serve as the primary or sole anesthesia provider. The AANA reports that more than 67,000 CRNAs practice nationwide and that CRNAs represent more than 80% of anesthesia providers in rural counties across the country.
Steps to Become a Nurse Anesthetist
Step 1: Earn a Bachelor of Science in Nursing
The path to a CRNA credential starts with a Bachelor of Science in Nursing (BSN) from a program accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN). CRNA programs require a nursing degree at the bachelor’s level as a minimum. A GPA of 3.0 is a standard threshold across most programs, though competitive applicants often exceed it.
Some programs will consider candidates who hold a non-nursing bachelor’s degree alongside specific nursing bridge coursework, but a BSN is the standard and most direct entry point. Candidates who need to earn a BSN first may want to look into accelerated BSN programs designed for second-degree students.
Step 2: Pass the NCLEX-RN and Obtain RN Licensure
After completing a BSN, candidates must pass the NCLEX-RN and hold an active registered nurse license in the state where they plan to work. See our overview of the RN licensing process for a full breakdown of the steps involved. RN licensure is a prerequisite for gaining the clinical experience CRNA programs require for admission.
Step 3: Build Acute Care Nursing Experience
CRNA programs require a minimum of one year of full-time RN experience in an acute or critical care setting. Medical-surgical, cardiovascular, and pediatric intensive care units are the typical backgrounds. Most competitive applicants have two or more years of ICU experience. Programs evaluate the complexity and acuity of that experience, not just its duration.
Admission also requires current certifications in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS). Many programs additionally require Pediatric Advanced Life Support (PALS). All certifications must be current at the time of application.
Step 4: Complete an Accredited Doctoral Nurse Anesthesia Program
As of 2025, all CRNA programs are required to graduate students with a doctoral degree. The accepted degrees are the Doctor of Nursing Practice (DNP) and the Doctor of Nurse Anesthesia Practice (DNAP). Programs are accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA), which maintains a searchable list of accredited programs at coacrna.org. As of early 2026, there are 155 accredited programs in the United States and Puerto Rico.
Program length ranges from 36 to 51 months. Coursework includes pharmacology, physiology, pathophysiology, and anesthesia principles, combined with supervised clinical rotations. The AANA reports that graduates of COA-accredited programs average more than 9,400 clinical hours before completing the degree.
Admission is competitive. Most programs require a GPA of 3.0 or higher, Graduate Record Examination (GRE) scores (typically a combined score of around 300), documented critical care experience, letters of recommendation, a curriculum vitae, and a formal interview. Selection rates at many programs are low, and the process should be treated as seriously as a medical school application.
Step 5: Pass the NBCRNA National Certification Examination
After graduating, candidates must pass the National Certification Examination (NCE) administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) before practicing as a CRNA. Eligibility requirements, exam registration, and the candidate handbook are available at nbcrna.com.
Step 6: Obtain State Licensure as an APRN
CRNAs are licensed by state boards as Advanced Practice Registered Nurses (APRNs). State-specific licensing requirements vary, including application procedures, fees, and any additional state requirements. Check with the board of nursing in the state where you plan to practice for current requirements before applying.
How Long Does It Take to Become a CRNA?
The total path typically takes between 7 and 10 years. The major stages are:
- BSN program: 4 years
- Critical care RN experience: 1 to 3 years
- Doctoral nurse anesthesia program: 3 to 4 years
Candidates who need to complete an RN-to-BSN bridge after an ADN, or who spend additional time building ICU experience before a competitive application, will fall toward the longer end. Program length also varies by institution, and some candidates enter with prior graduate coursework that may shorten the doctoral portion.
CRNA Salary and Job Outlook
According to the Bureau of Labor Statistics, nurse anesthetists earned a median annual salary of $236,590 as of May 2025. That figure is the highest median of any nursing occupation tracked by the BLS. The national mean annual salary was $248,320. Salaries vary considerably by state and practice setting.
| Area | Median Annual Salary |
|---|---|
| National | $236,590 |
| Alaska | $341,210 |
| New York | $321,030 |
| Massachusetts | $295,550 |
| California | $292,410 |
| New Jersey | $291,350 |
Job growth for nurse anesthetists is projected at 8.9% between 2022 and 2032, according to Projections Central, with an average of 2,500 job openings per year. Demand in rural and underserved areas continues to drive hiring, as does the ongoing need for anesthesia services across surgical specialties.
Maintaining CRNA Certification
As of August 2025, the NBCRNA’s Maintaining Anesthesia Certification (MAC) Program replaced the former Continued Professional Certification (CPC) Program as the sole pathway for CRNA recertification. All practicing CRNAs are now enrolled in MAC. The program runs on a four-year cycle with three components: MAC Check (a quarterly longitudinal knowledge assessment), MAC Ed (continuing education credits), and MAC Dev (professional development activities).
Recertification requirements have changed from the prior CPC structure, and specific credit requirements are set by the NBCRNA. Check nbcrna.com for current MAC Program requirements, your personal recertification timeline, and any transition details that apply to your credential cycle.
State licensure renewal runs on a separate schedule from NBCRNA recertification. Requirements vary by state. Contact the board of nursing in your state for current renewal deadlines, continuing education requirements, and any additional documentation needed for APRN license renewal.
Find nursing licensure requirements by state for RNs, LPNs, LVNs, and advanced practice nurses.
Frequently Asked Questions
What is the difference between a CRNA and an anesthesiologist?
CRNAs and anesthesiologists both administer anesthesia, but they follow different educational paths. Anesthesiologists complete medical school and a residency, while CRNAs complete a nursing education path through a doctoral nurse anesthesia program. CRNAs may practice independently in states that have opted out of the federal physician supervision requirement. In other states, they work as part of an anesthesia care team alongside physicians.
Do all CRNA programs now require a doctoral degree?
Yes. As of 2025, all COA-accredited CRNA programs are required to award a doctoral degree, either a DNP or DNAP. The transition from master’s-level programs is complete. Candidates entering any accredited program today will graduate with a doctoral degree.
Do CRNA programs require the GRE?
Many programs require the GRE, with most looking for a combined score of approximately 300. Some programs have moved away from the GRE requirement in recent years. Requirements vary by institution, so review the specific admissions criteria for each program you are considering.
Can CRNAs specialize after certification?
Yes. CRNAs can develop focused expertise in areas such as obstetric anesthesia, pediatric anesthesia, cardiovascular anesthesia, regional anesthesia, and pain management. Specialization typically develops through clinical experience, fellowship training, or additional coursework after completing the CRNA credential.
Key Takeaways
- Doctoral degree required as of 2025 — All accredited CRNA programs now graduate students with a DNP or DNAP. No master’s-level entry is available for new students.
- Critical care experience is a hard requirement — Programs require at least one year of acute care RN experience. Most competitive applicants have two or more years in an ICU before applying.
- The path takes 7 to 10 years — BSN, RN licensure, ICU experience, and a 3- to 4-year doctoral program come before the NBCRNA certification exam.
- Salary is the highest in nursing — BLS data shows a national median of $236,590 for CRNAs as of May 2025, with top states exceeding $300,000.
- Recertification is required every four years — The NBCRNA’s MAC Program replaced the former CPC Program in August 2025. Check nbcrna.com for current requirements for your credential cycle.
The foundation of a CRNA career is a strong BSN and nursing program. Find accredited nursing programs in your area to start building the credentials this path requires.
2025 US Bureau of Labor Statistics salary data and Projections Central 2022-2032 job growth forecasts for Licensed Practical & Vocational Nurses, Registered Nurses, and Advanced Practice Nurses across roles, reflect state and national data, not school-specific information. Conditions in your area may vary. Data accessed June 2026.