CAAs in Florida: 20 years of supporting physician-led
perioperative care
By Frank Rosemeier, MD, FASA, Ashley Tilton, MHSc, CAA, and Charles Chase, DO, FASA
Today, more than 1,000 Certified Anesthesiologist Assistants (CAAs) are employed by over 65 healthcare systems across Florida. They practice in academic medical centers, community hospitals, ambulatory surgery centers, and other settings; however, the CAA profession may be less familiar to physicians outside anesthesiology.
Florida law structures CAA practice under the direct supervision of a licensed anesthesiologist. This framework preserves physician accountability and ensures that care remains medically directed. CAAs are an integral part of the anesthesia care team. They conduct preoperative evaluations and participate in anesthetic planning, induction, maintenance, and emergence. In contemporary clinical practice, CAAs work alongside and with a similar scope of practice as certified registered nurse anesthetists.
Florida has assumed a national leadership role in developing this workforce. CAA licensure was implemented in 2004, and the state now hosts four accredited CAA programs at Nova Southeastern University and two at South University. Collectively, these programs graduate approximately 200 CAAs annually, strengthening Florida’s in-state anesthesia workforce pipeline. Admission is highly selective and competitive: Applicants complete rigorous, science-based undergraduate coursework comparable to premedical requirements, including advanced biology, organic chemistry, physics, and physiology. Many programs also require competitive Medical College Admission Test (MCAT) scores like those of accepted applicants at U.S. medical schools. Acceptance rates are approximately 5%.
CAA-focused graduate education spans 24 to 28 months and includes high-fidelity anesthesia simulation. Students complete more than 2,000 hours of supervised clinical training and log at least 650 anesthetic cases across surgical specialties. Graduates are certified by the National Commission for Certification of Anesthesiologist Assistants, licensed by the Florida Board of Medicine and Board of Osteopathic Medicine, and recognized by the Centers for Medicare & Medicaid Services as “qualified anesthesia personnel.”
For surgeons and proceduralists who depend on consistent anesthesia coverage to support block time, accommodate add-on cases, and reduce cancellations, integrating CAAs into the anesthesia team offers practical benefits. It enables anesthesiologists to extend physician-directed coverage while keeping appropriate supervision and continuity of care.
In Florida, CAAs are not a future proposal – they are highly skilled, physician-supervised anesthesia practitioners who help address the long-standing shortage of anesthesia professionals across the state.
Frank Rosemeier, MD, FASA, MRCP (UK), is Assistant Professor for the Anesthesiology Assistant Program at the NSU Dr. Kiran C. Patel College of Allopathic Medicine in Orlando. Ashley Tilton, MHSc, CAA, is Program Director and Assistant Professor. FMA Vice President Charles Chase, DO, FASA, LHRM, is Medical Director.