So you want to be a CRNA?
Nurse anesthesia practice is one of the most independent, challenging, revered, and rewarding areas of nursing. Surveys show that job satisfaction among CRNAs is almost 100%. Like most things in life, however, nothing good comes for free. Becoming a CRNA requires hard work, a rigorous educational program, and a commitment to lifelong learning. The two years you will spend with us will be one of the most challenging endeavors of your life. However, the rewards of becoming a CRNA with the respect and reputation of being a Wake Forest Baptist Health graduate will repay your efforts many times over.
As for generic recommendations, the points below address some common concerns and questions regarding preparation for entering the CRNA program at WFBH.
Once your basic questions are answered, use our interactive self-evaluation tool to assess how your particular qualifications stack up.
What does the typical accepted student look like?
For the class of 2015, the average undergraduate GPA of accepted students is 3.6, and they have an average of 3 years of nursing experience, with 2.6 years in the ICU. The average GRE is 304 for combined verbal and quantitative scores. We look at the cumulative GPA and in particular at performance in science and nursing courses. Many applicants complete some graduate coursework before or while applying. Performance in relevant graduate coursework is weighed in our assessment, as well.
Why are school positions so competitive?
As stated above, nurse anesthesia is a very rewarding career. Our program is the oldest in North Carolina, and has an excellent reputation for quality education since 1942. We are situated in a world-class medical center, and we enjoy many educational resources such as a patient simulation lab, wireless networking, Blackboard on-line educational platform, medical school library, etc. We are ranked among the top 10 programs nationally.
As a result, many people would like to attend our program. We even have people applying here from other countries. In our 2012 interview season, 16 different states were represented among applicants, and approximately 60% of accepted students are from states outside of North Carolina. We receive far more applications than the number of potential positions, but we aim to interview up to 75 applicants for 24 positions. Since most programs admit students only once a year, it is advisable to apply to more than one program to give yourself the best chance of keeping your plan rolling, if you do not get accepted to your first choice. We will keep applications on file for one year to facilitate reapplication by those who are not initially selected.
You must hold a Bachelor’s degree in nursing prior to starting the program. If you are an experienced nurse, you may be granted an interview if you are in your last semester of your BSN program.
Your undergraduate study should include completion of chemistry and statistics courses, and a basic course in health assessment. The chemistry course prerequisite is a basic chemistry. We do not require specific content, as long as it is a college-level class. There is, of course, much chemistry in anesthesia practice, and in particular, many of our common drugs are carbon-based with various functional groups. Therefore, students with an understanding of organic chemistry find that they have an easier time learning the chemistry concepts here. The statistics course must include inferential statistics.
We prefer to evaluate candidates based on performance on the Graduate Record Examination. We will also evaluate performance on the Miller Analogies Test. We expect applicants to have a GRE score over 300 for the combined quantitative and verbal score. However, individual area scores should exceed approximately the 50th percentile (150 for verbal, and 150 for quantitative). A MAT score over 400 is expected. As these measures are meant to predict your ability in graduate study, consideration of significant graduate-level work completed may outweigh the impact of your standardized scores. Foreign applicants or those with very low GRE verbal scores will be required to demonstrate a TOEFL score of at least 600.
We evaluate your performance in undergraduate education, expecting a GPA of at least 3.0. However, a GPA less than 3.5 without good academic indicators otherwise may be considered less competitive. A high GPA based upon a large number of transfer credits or non-nursing courses may not be considered adequate. Your earned GPA on nursing and science courses will be considered in determining suitability. Performance in graduate level courses will also be considered as attesting to your academic ability. Students in the program are required to maintain at least a 3.0 GPA for continued progression. We do not graduate any “average” nurse anesthetists. Therefore, indications of strong academic ability in applicants are a necessity for admissions consideration.
We require at least one year of recent experience as an R.N. in an intensive care unit, prior to your interview. This must be one year as an independent nurse (does not include time in preceptorship or orientation). For people working part-time, the equivalence would be 2080 hours of work within the past 2 years.
We appreciate the great demands of those areas and the great experience of nurses who have worked there. However, anesthesia practice most closely reflects the types of skills and knowledge you use as an ICU nurse. Statistics demonstrate that graduates who came from a non-ICU background (as some programs allow) have a higher rate of failure to pass their board exam, which is required for certification. An ideal applicant, therefore, would have a broad base of experience, so a few years in PACU or ED followed by a year in ICU would reflect well on an applicant’s diversity of experience.
What types of ICU experience are applicable and which type is best?
Experience as an R.N. in surgical, medical, trauma, neonatal, cardiovascular, neuro, burn, or pediatric ICU is acceptable, as is coronary care unit experience. Each of these practice areas brings its own advantages in terms of preparation of the nurse. As a CRNA student you will care for patients who are neonatal to 100 years old, and you will have to be equally comfortable with drug dosing, age-related factors, etc. for all of them. A NICU nurse will find great comfort adapting to pediatric anesthesia, while the former CCU nurse will have a breeze in evaluating ECG and stress test results prior to cardiac surgery. The program will help all students bridge the gaps between their past experience and this broader set of responsibilities.
No one area is perfect in terms of previous experience, although a surgical ICU will give you familiarity with many aspects of anesthesia care, anesthetic medications, postoperative complications, etc. For people who are considering a job change to better prepare for CRNA school, you might consider changing areas as well, to give yourself a broader experience base. For example, if you are in a small MICU and you are going to move to a larger ICU to get better experience, consider going to SICU to increase both your breadth and depth of experience.
Why is the ICU experience component so important?
A nurse anesthesia program involves 24 months of very intensive study. There is much to be learned in a short period of time, and the commitment of time and energy is almost always described as one of the most difficult and challenging things the students have ever taken on. Considering that, the level of preparation of a student when they begin the program has a great impact on how easily they fare during the program. In the selection process, the quality of ICU experience as well as the duration weighs heavily on the admission decisions.
Unfortunately, we do not have time to teach someone all the information between basic nursing knowledge and beginning student anesthetist levels of knowledge. Therefore, we rely on students to come in with a good, current, and comfortable competence with advanced ICU skills. Experience in a large ICU which includes vasoactive infusions, ventilator management, balloon pumps, blood gas interpretation, PA catheters, etc. even for 1-2 years, is probably better than 10 years of experience in a small ICU where you have limited experience with those type of things.
What else can I do to make myself more competitive as an applicant?
Some things people do as they look forward to applying to anesthesia programs include completing some graduate coursework in pharmacology, physiology, or chemistry. This helps prepare you for graduate education and may lighten your course-load if you do enter the CRNA program formally.
Some other suggestions would be to shadow some CRNAs in your own OR to get a better idea of what the job entails or what things are important to learn; take a review course and try to get your best possible score on the GRE; provide inservices on your own unit on something "anesthesia-related", like muscle relaxants; or check out our H3A course (see under Lifespan Development Programs). These are all things which can help you solidify your resolve to pursue a career as a CRNA, and also convince the selection committee of that resolve.
Academics are a challenging component of a nurse anesthesia program. Whether or not you have been out of school for some time, a good benefit would be work on academic skills. Graduate work involves much self-direction. Successfully managing this involves an understanding of your own learning style and knowledge of effective study techniques. We cover some of this in our anesthesia preparatory course offered during the summer.
How important is the personal interview in gaining admission to the program?
Very. Experience shows that people fail to successfully complete programs of nurse anesthesia for various reasons. There are no “givens” that a student with a certain GPA or so many years of experience will automatically be able to successfully pass through the rigorous curriculum. The interview is an extremely important opportunity for us to assess the less-quantifiable attributes that may predict an applicant’s success here. Based on the interview, sometimes applicants with relatively short ICU experience are admitted and some with more experience are declined. The same applies to GPA, test scores, and other measures. Our most important goal, for our benefit and that of our students, is to admit those who give us the best indication that they will be able to withstand the rigors of the program and to become the high quality graduates for which we are known.
What if I am not accepted at first?
Because we have limited spaces for students, many people who apply will not be accepted at first. We will keep your application on file for one year after you interview to facilitate your re-application, if you choose to re-apply. If not accepted initially, you may consider ways to increase the competitiveness of your application. This page describes some areas of concentration by candidates to make their application more competitive. Additional academic work (particularly in sciences) or expanding your ICU experience may help bolster your application.