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Why becoming a Certified Anesthesiology Assistant (CAA) might be your perfect career | Sally Hoang, CAA

• Ashley Love • Season 1 • Episode 33

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What began as a pre-med journey toward orthopedic surgery took an unexpected turn when Sally Hoang, CAA discovered the immediate impact and work-life balance offered by a career in anesthesia care.

With remarkable candor, Sally Hoang walks us through her typical 16-hour shift—from arriving at 6:30 AM to set up medications and equipment, to meeting patients in pre-op, to the collaborative dance of putting patients to sleep alongside attending anesthesiologists. Her descriptions paint a vivid picture of a profession that combines technical precision with human connection during patients' most vulnerable moments.

The conversation reveals surprising aspects of the CAA profession that make it uniquely appealing: the ability to work across all surgical specialties, from vascular to neurosurgery; the introvert-friendly environment where you can choose your level of social interaction; and the luxury of actually leaving work at work—something increasingly rare in healthcare. Sally shares breathtaking moments from her career, including an emergency case where her team administered an astounding 87 units of blood to save a patient's life during an abdominal aortic aneurysm repair.

For pre-health students considering their options, Sally offers thoughtful perspective on why she chose the CAA path over becoming an anesthesiologist or CRNA. The 2.5-year master's program offered a faster route to practice high-level medicine with immediate impact, without sacrificing personal interests and balanced living. Through her social media channels, she's now helping others discover this rewarding career path that combines autonomy, teamwork, and meaningful patient care.

Whether you're exploring healthcare careers or simply curious about what happens while you're under anesthesia, this episode provides rare insight into the professionals keeping watch over your vital signs and ensuring your safety when you're at your most vulnerable. Join us for this eye-opening conversation about finding fulfillment in medicine without sacrificing yourself in the process.

Follow @anesthesiasal across all social platforms and visit her YouTube page for more!

Virtual shadowing is an important tool to use when planning your medical career. At Shadow Me Next! we want to provide you with the resources you need to find your role in healthcare and secure your place in medicine.

Check out our pre-health resources. Great for pre-med, pre-PA, pre-nursing, pre-therapy students or anyone else with an upcoming interview!
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Ashley:

Hello and welcome to Shadow Me Next, a podcast where I take you into and behind the scenes of the medical world to provide you with a deeper understanding of the human side of medicine. I'm Ashley, a physician assistant, medical editor, clinical preceptor and the creator of Shadow Me Next. It is my pleasure to introduce you to incredible members of the healthcare field and uncover their unique stories, the joys and challenges they face and what drives them in their careers. It's access you want and stories you need, whether you're a pre-health student or simply curious about the healthcare field. I invite you to join me as we take a conversational and personal look into the lives and minds of leaders in medicine. I don't want you to miss a single one of these conversations, so make sure that you subscribe to this podcast, which will automatically notify you when new episodes are dropped, and follow us on Instagram and Facebook at shadow me next, where we will review highlights from this conversation and where I'll give you sneak previews of our upcoming guests. What if you could protect patients during the most vulnerable moments in their lives and then leave work completely at work? Today's guest is Sally Hong, a certified anesthesiologist assistant, whose role in the OR is equal parts precision, calm and critical thinking. From giving 87 units of blood during a trauma case to finding career satisfaction through flexibility, teamwork and autonomy, sally gives us a rare look inside the anesthesia world. We talk about her decision to pivot from pre-med to CAA, the emotional and technical highs of her job and why she created one of the only social media channels highlighting the CAA profession. Anesthesia Sal. If you've ever wondered what really happens behind the surgical curtain or what kind of healthcare career values your time and still allows you to make a massive impact, this episode is for you. Please keep in mind that the content of this podcast is intended for informational and entertainment purposes only and should not be considered as professional medical advice. The views and opinions expressed in this podcast are those of the host and guests and do not necessarily reflect the official policy or position of any other agency, organization, employer or company. This is Shadow Me Next with Sally Hong.

Ashley:

Thank you so much for joining me on Shadow Me Next today. I have been looking for an anesthesiologist assistant and here you are. I cannot wait to talk to you. Thank you for joining us today. Thank you for reaching out. So, in my head, a CAA, which is a certified anesthesiologist assistant is what we're going to be talking about. A CAA is very similar to a PA, which is a physician assistant in the realm of medicine on our own, on our own teams. So first, before we get into that, will you walk us through? Maybe growing up, did you? Did you know you always wanted to be a CAA, or is this something that you discovered later on?

Sally:

Oh yeah, I didn't figure out about the anesthesia like anesthesiologist assistant profession until probably my junior year of college when I started undergrad at the University of Georgia. I majored in exercise sports science because I wanted to become an orthopedic surgeon and that was kind of my pre-med route. So I took all of the pre-medical courses, got involved with the medical organizations, I volunteered at St Mary's Hospital for a little bit and then worked as a scribe at Mercy Health Center in Athens. But then later on I became a medical assistant for an orthopedic surgeon and that kind of gave me the firsthand day-to-day reality of what it would be like. And then over that year I followed the patients through their entire course of care, so from injury to surgery, to castings afterwards and then physical therapy after that. They would always come back for check-ins so I would see them and talk to them and see how they progressed.

Sally:

Even though I found that process valuable, the long timeline and delayed feedback of the patient care wasn't really the type of impact I wanted to have. And that's when I learned like, oh, this might not be the right choice for me, but he had his own anesthesiologist on his team and that's where I met the anesthesiologist and I would watch him come to work, do his thing and then, once the case was over, he was done for the day. There was no clinical backlog or extensive post-op care, it was just acute hands-on medicine. And then the instant feedback of knowing like, okay, I did my job, I did it right, and then you go home. And that kind of resonated with me and I was like, oh, this is what I want to do.

Ashley:

I love the way that you just described that, because it is so clear, it is so well articulated the differences in scope, really, between what a medical doctor, what an NP perhaps, might be doing and then what an anesthesiologist is doing and what a CAA is doing. I do love the fact that at the end of the day, you really do leave work at work, and I don't know how many people in medicine can say that. Probably not many, probably not many, in my experience at least. So, sally, tell us about, tell us about a CAA. Describe it for me. You know, what does the schooling look like? What is your scope of practice as a CAA generally? And then we'll dive into a day in your life, because that is what I'm really excited about.

Sally:

Okay, so a CAA. It's very similar to a physician assistant as far as the schooling to get there. It's a two and a half year master's program. You do all of your clinicals within that two and a half year program and then you graduate and then you immediately start working that two and a half year program and then you graduate and then you immediately start working. Another similarity with the physician assistant role is that you work under an MD, a medical doctor In this case it would be an anesthesiologist. It's a very team-based kind of medicine For schooling.

Ashley:

For PA school it is one year of basically book work. We call it didactic study, books and lectures. Nobody uses books anymore. But I year of basically book work. We call it didactic study, books and lectures. Nobody uses books anymore, but I still call it book work. And then it's another year of clinical rotations. So is it the same for CAA school or is it kind of intermixed?

Sally:

throughout the whole two and a half. As soon as you start the program, there are didactics, and it's a little bit heavier the first year, but clinicals are two days a week right off the bat. Wow, gradually throughout the program it becomes increasingly more so it's like three days a week and then as a second year it's every single day and flips to where you only have didactics maybe once a month for, like, just testing and review. So it's kind of like a inverse.

Ashley:

Yeah, I like that. That's a really cool way to learn. What kind of classes would you take while you were doing like your didactic work? What would be some of the things that like the course schedule or the course names?

Sally:

Just like your standard anatomy and physiology, basic physics. And then we got into kind of the more anesthesia heavy subjects. So anesthesia, cardiac peds, pharmacology, a lot of pharmacology and then just basic machines and instrumentation because we deal a lot with monitoring in the OR. So it was all anesthesia, Anything. Anesthesia was a class.

Ashley:

PAs, we can work in just about any medical specialty as long as we have a supervising physician who's willing to oversee us right. So literally anything. I could be in a hospital. I could be in an OR and in hospital. I could be in clinic. I could be in rural medicine working at a very small urgent clinic. As a CAA, are you guys always in a hospital operating room or does your place of work look a little bit different?

Sally:

The majority of us work in a hospital setting, but we can work in outpatient settings and clinics as well and then kind of offside position that we can be in is teaching.

Ashley:

So all of the AA programs you can work there too here, for I'm so excited you wake up and you realize that it is your job to protect these patients while they are getting surgery. Tell me what a day in your life looks like as a CAA.

Sally:

It's probably four to five days a week and cases start at 7.30 at most hospitals. So you arrive at the hospital at probably 6.30, depending on how much you have to set up, but you're assigned your case and you're attending the night before, so you know what you're getting into. Oh, that's nice. You can either be the general anesthetist in any specialty as far as surgery goes, you can do vascular one day, the next day you can do neurosurgery or plastics, like it's random. So every day is different, which kind of changes things up and makes it a little more exciting. You meet different people every single day and you work with different attendings. Also, every day you go to the hospital, change into your scrubs and you go get your drugs and these are your narcotics and just any other special medications that you might need for the surgery. You go to your OR room and then you set up for the case. You do a machine check, you pull up your drugs, you do an airway setup, kind of get everything ready for the surgery, and once your room is done you walk to pre-op and that's where your patient is going to be, and you meet them. You say hey, my name is Sally, I'm with the anesthesia team. I have to get an IV started on you.

Sally:

So you do the IV. Hopefully they brought their veins Some people. It's just a little bit more difficult. You have to pull out the ultrasound to get an IV. So not only is your case different and your team is different, but then your patients are also. You don't know who you're going to meet.

Sally:

So after that the IV is done, everybody else kind of meets the patient and does their interview and then, once that is it, it's probably going to be like 7.20 AM right now and you take the patient back to the operating room. You're pushing the structure it's your job to do that and at 7.30, you hook up the patient to all the monitors and then you call your attending, say hey, we're ready to go to sleep, and then the attending comes on in and then you guys both work together to get the patient off to sleep. Usually the anesthetist is the one intubating the patient If the procedure calls for general anesthesia, and the anesthesiologist will be the one kind of giving the medications. But sometimes they want to change it up and then be like, hey, can I intubate today? So we'll like swap roles.

Sally:

It's very I don't know very chill, very relaxed, very team-based. So whatever you want to do, you can kind of pitch it to your attending and you know it's a collaborative effort. But once that case is done and that also, it varies you can have a one-hour surgery or you can have a 15-hour surgery.

Ashley:

What happens if you have to go to the bathroom?

Sally:

Yeah, so in anesthesia one of the greatest perks is that you get breaks all the time. You have so many breaks there's morning break, afternoon break, lunch break, dinner break and there's like kind of a running joke where everybody else is still in the operating room. You know they're scrubbed in. They can't break on our fifth break. So when we're in their closing we kind of start to titrate the anesthesia off and once the surgery is done we call our attending hey, patient's waking up. Sometimes they come into the room, sometimes they don't. It kind of depends on the acuity of the patient and how difficult they were. But we'll extubate when the patient is ready and then take them to the recovery area, give report and then if you have another case scheduled in your room, then you kind of rinse and repeat and do the same thing.

Ashley:

I really love how you are so involved in every single step, from the pre-op room all the way through. That's very cool and, honestly, I would imagine, quite comfortable for the patient too to know that from the minute they arrive, you know the first person to really start poking at them is you, and they know you're going to be with them throughout most of the start, except for your breaks.

Sally:

That's got to be comforting.

Sally:

Yeah, so my schedule. I work long hours so I'll do 16 hour shifts from 6am to 11pm. Honestly, the patient, whoever I take care of, I'm there from beginning to end for the most part. Some cases go to like 2am which I won't be there for. Yes, I do see most of my patients throughout the whole case, but then some anesthetists they leave at three o'clock and that's the end of their day. So everybody has different schedules and I think that's like a great part of being an anesthetist. There's so many schedules out there that can work with your life outside of work.

Ashley:

There does seem to be a lot of flexibility, a lot more flexibility than I was expecting, so that's definitely a pleasant surprise. Well, the coolest sounding day for sure. I love the fact that you're on a bunch of different cases. I think it's probably quite interesting that you get to see a lot of different medicine while you're there. If you're working with a vascular surgeon one day, maybe a gynecologic surgeon the next day and everyone in between, and I would imagine you're also communicating with the attending, ie the surgeon, during the surgery when necessary, right? You're not just sectioned off behind the curtain, right.

Sally:

Um, so I'm a very introverted person. There are some days that I just don't want to talk to anybody. So you have the option of kind of just being in your corner at the top of the head just monitoring the patient doing the anesthesia and speaking when necessary to your team, but otherwise you can kind of just sit in a corner. That was also one of the things about anesthesia that I love. Some days I'm super social and I just want to talk to everybody and you can, because you meet so many different people every single day. But then you can also, if you're tired, you're socially drained, then you can just kind of retreat back and nobody you know nobody kind of worries about it, because they know some people are talkative and some people are focused.

Ashley:

Yeah, I'm so glad you brought that up because it is really important for our more introverted people to realize that there are elements of medicine where you don't have to talk all day, every day and be on your a game literally every minute of every day. That's, that's nice. Thank you for bringing that up. I appreciate that. Let's pivot a little bit. We have a segment on the show called quality questions. It's where, if you have either been asked a weird interview question or a good interview question, or you ask questions, this is basically a way for our pre-health students to develop a cache of interview questions that they might hear, like either you know, before school, before they get their first job, before we hear what Sally's quality question is. Keep in mind that there's more interview prep, such as mock interviews and personal statement review over on shadowmenextcom. There you'll find amazing resources to help you as you prepare to answer your own quality questions.

Sally:

There is a program who asks more technical questions, like just really right off the bat very textbook questions that, like a undergraduate student probably won't know the answer to. And that's on purpose, because they're just trying to stump you to see how you kind of process the stress and see how you react.

Ashley:

Sally, you are so impressive. You work these 16 hour shifts I don't know how you do it and you have this fabulous social media online presence. So you have a YouTube and an Instagram channel. Tell us a little bit about these two things. Is it? Is it just an enjoyable outlet for you?

Sally:

Yes, so I'm. I'm a very creative person, so I love modeling and music and kind of just being able to create. And when I was applying to AA school like there was none of this social media TikTok day in the life reels that you could watch an anesthetist go through to see if that's what you wanted to do I was literally just like at night Googling AA. Reading Reddit forums from four years ago through the threads is like this crazy rabbit hole. So I don't know, I just figured I had this kind of ability to share because this profession has honestly changed my life. But it was also super fun to like, do and have this content that nobody else really had access to. So I started doing my YouTube channel, I started the Instagram and I I'm a new mom now so I just don't have time to edit my YouTube videos Like I would back then. So there, I haven't posted in probably a year and a half, but that's probably the most fun for me.

Ashley:

It's such a great way for students to get more information, but it doesn't replace getting to actually see people doing things in live time. It's why shadowing is so important and there are so many options now for shadowing. I would imagine it's probably quite difficult to get shadow in-person shadows where you're at I mean, I think, hospital systems it can be hard to tap into.

Sally:

Um yeah.

Ashley:

So the only way to do it really is to chat with you face-to-face, to listen to you interview, like we're doing today, and then to jump on your Instagram, which I'll tag in the show notes below, and your YouTube and get a great idea of what a day in your life looks like and the challenges that you're kind of working through and maybe some of the wins that you've experienced. It's a great option for pre-health students. So thank you for doing that. Thank you for putting all of your time into this. I know it's a lot of work.

Sally:

There's some people that will message me and I'll just answer their questions and later on there'll be like oh my gosh, I'm an AA student, now I'm about to graduate because of you. So it feels good having impacted all of these people and I know they're going to have a great life because this job has been so good to me.

Ashley:

Yeah, it just sounds like the coolest job ever. And you're absolutely right. Getting to not only do what our job is I mean, this is what we are paid to do is work as a CAA, is work as a PA but then getting to share that with other people, it just makes the job that much sweeter. Plus getting to see how excited certain students get when they either see what you're doing or you have the comment on something that you do and they'll say that's so cool. And I'm like, oh, you know what that is so cool, I forgot.

Sally:

I know it's refreshing to get the new students in and that energy back, because you know you work in a hospital for eight, 10 years. It kind of you get kind of drained a little bit and becomes just a job. So having the students it's just like a reminder of oh yeah, this is what I. It's pretty cool.

Ashley:

Absolutely, Absolutely. I tell my shadows all the time. You guys are giving me more life than I'm giving you right now. I can guarantee it. Your job as a CAA is. It is so technical and the things that you're doing. You mentioned pharmacology, you mentioned dealing with machines, things like that, but when it comes to patients and when it comes to making memories in your job, is there anything that really stands out to you? That just blew you away?

Sally:

So far I've been lucky to not have a code or lost a patient on the table. I think those are from what you see in the movies. That's the big thing that happens in the operating room. But one case that I'll never forget was early on when I started working maybe two years in I was doing a open AAA. It's like a abdominal aortic aneurysm repair. It's a vascular case and it was an emergency add-on. The patient was flown in by helicopter at like 9 pm and it turned out into this whole like massive all hands on deck situation because the patient was bleeding. We ended up giving 87 units of blood and that's a lot. Normally the average case it's like maybe six units you know, 10 units, but this is 87 units.

Sally:

I'll never forget that number. It was so much. And there's two anesthetists in the room. My attending was in a room the whole time and we're just like verifying the blood, pushing the blood, managing the blood pressure, charting, trying to keep the patient stable for the surgeon to finish up what he was doing, and we probably didn't finish till five in the morning, but the patient made it to ICU.

Ashley:

Wow, wow. I imagine, like with every single bag of blood that was passed over to you, you're probably thinking like this is the last one.

Sally:

It was like I was giving the blood and then you look at the field and the blow is coming out. Oh my, I remember at the end of the case, when the patient was gone, we looked at the room and it was a bloody mess. The floor was just puddles of blood. It was crazy.

Ashley:

And they get onto your table and the surgeon's just like, all right, I'm going to get to work. And he looks at you guys and he's like keep this patient alive. It's unreal to me. It is so cool.

Sally:

What you do is just, it blows my mind, yeah, but I don't want to scare everybody and have them think you know this is every day. You can work at a trauma hospital and maybe you're going to do these cases more often, but there are also standard elective cases that are a breeze and you just you know, goes everything the way you plan the patient's healthy so you can have easy days as well.

Ashley:

You need them, otherwise, could you imagine doing that all the time you would? You would. Your body would actually break down, I think. I think you would just melt into a puddle of blood yourself.

Sally:

That one was a big one, yeah, but outside of kind of the high trauma cases, there are a lot of other surgeries that kind of stick with me for different reasons. Like earlier this week I had an eye trauma case. The patient had like a foreign body got hit into his eye. And that's just a reminder to wear eye protection when you're cutting metal or wood. You know just like come on, guys, wear eye protection when you're cutting metal or wood. You know just like, come on, guys, wear eye protection.

Ashley:

You see so much in medicine like that, those cautionary tales.

Sally:

I'm on the neuro team, so I do a lot of brain surgery and aneurysms, brain tumor resections, and then those cases kind of make me realize, you know, cancer doesn't discriminate. It can happen to anybody, if you're like 20, if you're 60, and it can happen fast, out of nowhere too. So it's just a good wake up call about how short life can be and how crazy life can be. Same thing with cancer cases. We do a lot of those too. It reminds me not to take my health for granted and not take my family for granted too, because they're healthy right now.

Ashley:

No, you're absolutely right, sally. I just so appreciate you spending time with us today. Before we wrap up, I do have one last question, if there is someone listening that is torn between becoming a CAA and then maybe going to PA school or CRNA school which we didn't even talk about the difference there but PA school, crna school, medical school, things like that what questions do?

Sally:

you think they should ask themselves when they're trying to figure all this out. So it's different for everybody, depending on when they're making that decision. Like if they're early on high school, you know they can go any route. But then if they're making a second profession, like career change, that time becomes like an issue for a lot of people too. I can just speak on what happened to me and then maybe they'll kind of like gather I don't know, make a decision or learn from that.

Sally:

But so I figured out about the AA program my kind of early junior year, so the only kind of. I know for sure that I wanted to be in the anesthesia field and because I found out so late about it in undergrad, the two paths were either become an anesthesiologist or an anesthesiologist assistant. Pursuing the CRNA route didn't make sense because then I would have to start all over and get my BSN. But then for me to decide between AA route versus the MD route, the two and a half year program structure kind of just like won me over because I was weighing that against the fact of four years of medical school, three years of residency and then maybe a fellowship year after that.

Sally:

But the AA route, you know I still get to practice high level medicine, hands-on procedures, and would be in the OR immediately after two and a half years and start working. So that to me was like kind of a deciding factor. In addition to that, there's also the risk of not matching residency. I just didn't want to deal with all that stress. I'm like life is short, I'm going to go work after two and a half years and I have a lot of other hobbies and interests that I'm into. Time was more valuable to me to do other things while still being able to practice medicine.

Ashley:

Sally, thank you so much for joining us today. You are amazing. The information you've provided is just absolute gold. Thank you so much, anesthesia. Sal, sally, you're the bomb, thank you, thank you. Thank you for having me. Thank you so very much for listening to this episode of shadow me next. If you liked this episode or if you think it could be useful for a friend, please subscribe and invite them to join us next Monday, as always. If you have any questions, let me know on Facebook or Instagram access. You want, stories you need. You're always invited to shadow me next.

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Ashley Love

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