About exposure. The problem with APRNs is that their educational requirements are inadequate for independent practice right out of school, especially NPs. CRNA training is much better and more preparatory than what NPs get but still nowhere near what an anesthesiologist is exposed to. The medicine route is more rigorous academically, but more importantly, clinically.

I truly believe that over time competence can level out, even up. I currently work with and have previously worked with some highly competent CRNAs who Id trust with my or my kids lives. Ive worked with anesthesiologists who I wouldnt allow anywhere near me or my family. The big issue I see is in the NP and even CRNA programs themselves. The training simply needs to get better.