Clinical rotations are where student nurse anesthetists give anesthesia to real patients under supervision. Students who start in 2026 or later must log at least 700 cases and 2,000 clinical hours before they can graduate.
Most students log far more than the minimum. This guide covers the requirements, how rotations are organized, and what to ask programs about call and travel.
The COA minimums
The Council on Accreditation (COA) sets the minimum clinical experience every student must complete. These numbers apply to students who matriculate on or after January 1, 2026.
| Requirement | Minimum | COA preferred |
|---|---|---|
| Total cases | 700 | 750 |
| Clinical hours | 2,000 | |
| ASA physical status III to VI | 200 | 300 |
| General anesthesia | 400 | |
| Tracheal intubation | 250 | |
| Emergence from anesthesia | 300 | |
| Geriatric (65 and older) | 100 | 200 |
| Pediatric, 2 to 12 years | 30 | 75 |
| Pediatric, under 2 years | 10 | 25 |
| Trauma or emergency | 30 | 50 |
| Obstetric management | 30 | 40 |
| Intra-abdominal | 75 | |
| Intrathoracic | 15 | 40 |
| Open heart | 5 | 10 |
| Intracranial | 5 | 20 |
| Regional techniques, actual administration | 35 | |
| Spinal, epidural and peripheral blocks | 10 each | 50 each |
| Moderate or deep sedation | 25 | 50 |
Clinical hours include anesthesia time plus other time in the clinical area. Examples are in-house call, pre- and post-anesthesia assessments, room setup and clinical rounds.
Simulation is part of every program. Some categories, such as endoscopic airway techniques, can be partly met with simulation, but no clinical experience can be met by simulation alone.
How many cases students actually log
National data shows students log well beyond the minimums. For students who graduated in 2025, the NBCRNA reported:
| Measure | Median | Mean |
|---|---|---|
| Total cases | 893 | 913 |
| Total clinical hours | 2,692 | 2,718 |
| Anesthesia hours | 1,716 | 1,784 |
Those 2025 graduates started before the new standard, when the case minimum was 600. Program-reported averages are similar. In Everything CRNA's School Finder data (October 2026), the median program reports about 828 cases per student.
How rotations are organized
When clinicals start
It depends on the program format. In a front-loaded program, you finish most classroom work before full-time clinicals begin. In an integrated program, classes and clinical days run side by side.
In our data, 105 programs are front-loaded and 47 are integrated. See front-loaded CRNA programs and integrated CRNA programs.
Clinical sites
Programs place students at hospitals, surgery centers and specialty sites. In our data, the median program uses 16 clinical sites, with a range of 3 to 64.
Different sites offer different case types. Ask which sites provide the specialty cases you need, such as cardiac, obstetric, pediatric and regional anesthesia.
Supervision
The COA limits supervision to no more than 2 students per CRNA, or 2 students per anesthesiologist when no CRNA is involved. Only CRNAs and anesthesiologists can supervise your anesthesia care.
Case logs
You must keep accurate clinical logs, and faculty review them regularly. Your program submits your final record to the NBCRNA to prove you met every minimum before you can sit the NCE.
Call shifts
Programs must offer clinical experience outside regular hours. The COA defines call as planned time outside normal operating hours, such as after 5 PM, before 7 AM and on weekends.
Call gives you emergency cases you rarely see on a day shift. You may be assigned a 24-hour call, but the COA bars more than 16 continuous hours of direct patient care.
Travel and relocation
With a median of 16 sites per program, rotations often mean commuting to several hospitals. Some programs also send students farther away for specialty cases.
The Army program, for example, sends students on four to six out-rotations a year for obstetric, cardiac, pediatric and neuro cases. Before you accept a seat, ask each program:
- How far are the clinical sites from campus?
- Will I need to relocate or keep two homes for any rotation?
- Does the program provide or help with housing?
- How are sites assigned, and can I request one?
- How many call shifts a month should I expect?
Check whether travel and housing are included in the program's cost estimate. Add them to your budget with the CRNA school cost calculator.
Tips for clinical success
- Review the next day's cases and plan your anesthetic the night before.
- Ask your preceptor how they want to be updated during the case.
- Log cases the same day so nothing is missed.
- Track your counts against each minimum early, so gaps show up while you still have time.
For a full picture of student life, read what is an SRNA. For the exams that bookend clinicals, see the SEE exam and the NCE exam.
FAQ
How many clinical hours are required for CRNA school?
The COA requires at least 2,000. Graduates in 2025 logged a median of 2,692.
How many cases do CRNA students need?
At least 700 for students starting in 2026 or later, with set minimums in each category.
How long can a clinical shift be?
You may be assigned 24-hour call, but the COA limits direct patient care to 16 continuous hours.
Can I choose my clinical sites?
It depends on the program. Ask how sites are assigned before you accept a seat.
Sources
- COA Standards for Accreditation of Nurse Anesthesia Programs, Practice Doctorate (revised May 2025, effective January 2026)
- NBCRNA Annual NCE and SEE Report, Calendar Year 2025
- NBCRNA: National Certification Examination Handbook
- Health.mil: USAGPAN / Certified Registered Nurse Anesthetist Residency
- Everything CRNA School Finder data (October 2026), compiled from program websites and admissions-office correspondence