What to Ask at Your First CRNA Job Interview

You spent years in the ICU. You survived CRNA school. And now you're sitting across from a department chair or anesthesia group director with a smile on your face and absolutely no idea what you should be asking to see if the job is a good fit.

That's a problem.

Most new grads walk into their first CRNA interview focused on getting the job. The smarter move is treating it like a two-way evaluation…because in the current market, it is. You're about to make a decision that affects your income, autonomy, and quality of life for the next several years. Ask the right questions now or find out the hard way later.

Here's what you need to know before you sign anything.

Do Your Homework

Ideally you had a clinical rotation at this facility which would allow you to skip most of these. If you didn’t, prepare.

Before the interview, ask around. Ideally you know someone working there already. It’s also not a bad idea to talk to people you don’t know to remove any bias. Speaking with newer employees is also great. You can even cold call the hospital.

Google the hospital or anesthesia group. Note how many times the anesthesia contract has changed ownership. Even if the anesthesia group is independent of the hospital system, that institutional churn tells you something about stability.

Site Visit

If you are serious about a job, set up a site visit. Fly in. Get the tour. Meet with management.

Stay through lunch or supper so you can meet people in other roles. Observe how surgeons treat CRNAs. Watch how the MDAs interact with the team. The vibe in that OR on a random Tuesday is more informative than anything anyone tells you in a conference room.

Schedule and Workflow i.e. The Stuff That Defines Your Day

These questions sound basic. They matter more than you think.

Cases, Equipment, and Skillset

What cases are done and will you be expected to do all cases? Do hearts and peds have their own teams?

What is the charting system? How about billing?

Do you have the drugs I like? Are they premixed? Sugammadex and Exparel? Access to pharmacy?

Ask about the videoscopes, ultrasound, fiberoptic options, and pumps? Are these the standard and easily accessible?

Who does the blocks, lines, spinals, and epidurals?

Orientation

Is there an orientation and what does it look like. No call for 3 months to get your feet wet or call every night for 3 months to build experience quickly? Any pay difference?

What does success look like 6 months in?

Morning start times

When are you expected in the OR? Are the listed case times room time or cut time? Are there staggered room start times such as 0630, 0700, and 0730?

How are you notified when you're assigned to an early room? When are you expected in pre-op and what do those responsibilities look like? Are you responsible for the preop assessment and bringing the patient back?

There are no right or wrong answers, but they may add 30+ minutes to your day.

Who runs the board?

Knowing who controls room assignments tells you a lot about how power is distributed and whether CRNAs have any real say.

Do rooms start dropping at noon or is there a second wave of cases after morning clinic? Does the board runner make alterations for efficiency or are assignments set?

How are breaks handled?

What is paid vs unpaid? How many breaks do you get? How about breaks for 10, 12, and 16-hour shifts? How often do people NOT get breaks? How is coverage communicated?

Is there a float or post call person responsible for breaking CRNAs?

Shift structure

Do you have a set shift i.e. 5x8s M-F? If so, do you leave on the hour or the half-hour? Is your 8-hour shift 0630-1500? Does your relief show up at 1445 or 1515? How often does "your shift ends at 3" actually mean 5?

Who decides who goes home when there's no formal end time? Is there a documented system for first out?

Call

Understand every detail because call can make or break a job. Get specifics in writing.

What's the call requirement? Is there a set frequency for weekday and weekend call such as 1:10? Is it paid extra or built into salary? Forced to take extra call if short? Do locums relieve the call burden?

How is call assigned or signed up for? How easy are call shifts to trade?

What do the different call tiers mean (1st, 2nd, 3rd call) and what hours do they actually cover? What is the callback window? In-house, 30 min, or 60 min? How frequently are 2nd and 3rd call working?

Is there OB call? In-hospital or from home? Does OB call also cover the OR and vice versa?

Do you get a post-call day off? Is that policy written down somewhere, or just "how it's always been"? How frequently am I working during call?

Who calls you in? House supervisor or the surgeon? Is there a calling tree?

Verbal promises about call are worth nothing. If it's not in the contract or in formal policy, assume it can change.

Anesthesia Model and Scope of Practice

This is the one that can quietly erode your professional identity.

What is the anesthesia model and does it run as it should?

Medical Direction Questions

Is the medical direction model fraudulent in any way? Is the MDA actually present when required? Are charts being signed appropriately? Are the number of rooms running appropriate for the MDA coverage? Does the model change after hours?

Are the MDAs open to collaboration or is there an authoritarian regime? Is the MDA present for induction and extubation? Do they push induction medications? Does the MDA expect a call for every deviation from the plan? Who performs blocks, lines, etc.?

Do not join a practice involved in fraudulent billing. Your name is on the chart even if you aren’t the one failing to adhere to the guidelines.

If your scope of practice in this role is narrower than what you trained for, ask why. Factor it into your decision.

Money, Benefits, and the Contract

Don't be shy here. This is your livelihood. Everything is negotiable.

Sign-on bonuses are rarely as clean as they look. Before you get excited about a number, ask:

What's the repayment term? Claw back or in its entirety? Do you owe the gross amount or the net (after taxes)? What happens if you're fired before the term ends? With cause vs without cause? Can it be structured as a completion bonus instead?

In most cases, sign-ons just lock you in. Negotiate base pay instead.

Retirement

What's the plan? What's the match? 401(k) matches are fixed, so no negotiating there. How long until you're vested? A lower offer with a strong match and fast vesting can easily outperform a higher base with a stingy or delayed match.

CME Allowance

How much and how is it reimbursed? What does it cover i.e. conferences, licensing fees, AANA dues? Or do dues come out of that same pool, leaving you with less than you think?

PTO

How soon can you take it after starting? Do you have to earn it before using it? Is there a blackout period before termination? How to schedule PTO? Can my scheduled PTO be taken away for any reason?

Can I cash out PTO? Does PTO carry over?

At bigger places, there is a tier system in the fall to schedule for the following year. If you sign in January, all of the weeks will be spoken for.

Experience-Based Incentives

Many large centers base pay on years of service. I’m not a fan of this method, but you should understand how the steps work. How frequently have there been changes to the system? Do all steps receive an annual percentage increase? Are there any other experience-based incentives such as PTO or call favorability?

Unpopular Opinion: As a new grad, make the argument, same cases, same reimbursement, same call, means same pay. I’m a fan of retention bonuses. This earned me an extra $110,000 over 3 years.

And from experience, just because you are a 20 or 30-year CRNA doesn’t mean you are more skilled than a 5-year CRNA.

Culture and Retention

Massively, massively important.

High turnover is a red flag. Low turnover at a miserable place is also a red flag. You want to understand why people stay or go.

How many CRNAs and MDAs have left in the last two years? Why?

Are new CRNAs expected to take the worst cases, earliest starts, and off-site assignments? For how long?

Who makes daily assignments, and how? Can I expect a rough room every day because of XYZ? Are you told ahead of time? When you give notice, do the assignment-makers suddenly give you every terrible room until you leave?

Some of these sound bad, but they are important to know.

Miscellaneous

If you work with SRNAs, what are the expectations? Who's their clinical lead on site?

What is the paternity/maternity leave policy?

Is there a non-compete? What is the effect, radius, duration, and negotiability of this piece? Does your state uphold non-competes? Avoid signing if possible.

In Closing

Your first job out of school sets a baseline. Ideally you know what you are signing up for. A bad fit in your first year is recoverable. But signing a contract you didn't fully understand, or taking a role that underutilizes you or burns you out, costs you time and leverage you won't get back.

Ask every question on this list AND MORE. Write down the answers. Compare them across offers. The job that feels the most comfortable in the interview isn't always the one that holds up six months in.

I’ll put together a document for new grads and perm positions. I’ll make another one for locums because it’s that different.

You earned the credential. Now make them earn you.