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The use of ARNs allows greater access to anesthesia ser-vices, but also gives the anesthesiologist greater control over anesthesia services. Using ARNs may limit opportu-nities for university-trained CRNAs to practice.Most ARNs are well educated and some hold advanced degrees. However, ARNs do not necessarily receive graduate or university-based anesthesia education, are not eligible for certification, and are not licensed by the Ministry of Health and Welfare as advanced practice nurses. Anesthesia registered nurse practice is neither codified by national legislation, nor are there uniform standards for the level of training or the scope of practice. Instead, ARN training needs and scope of practice are determined by local hospitals and by the anesthesiolo-gists with whom they train and practice. In the absence of uniform national standards, the level of training and the scope of practice vary greatly from institution to institu-tion and between anesthesiologists.Although CRNA practice in South Korea developed on the American model of practice, the professional model has diverged. In the United States, anesthesia services performed by an anesthesiologist are recognized as medical practice. When the service is provided by a CRNA, it is recognized as nursing practice. The status of CRNAs as advanced practice nurses is codified and protected by State Nurse Practice Acts.10In South Korea, CRNA practice was formally rec-ognized in 1973 when the national legislature enactedMedical Law Article 56. This law was strengthened in 2003 by the Revised Medical Service Act.1,5,7 However,although a professional nurse anesthesia system exists and the practice is recognized as an advanced anesthesia practice with certification, there is no clearly established or codified scope of practice by CRNAs.12The impact of this ambiguity was later highlighted by a Korean Supreme Court decision. In 2004, a patient died while under the care of a CRNA practicing in a small surgical clinic under a surgeon’s supervision. The CRNA was charged with illegally practicing medicine, and the case eventually made its way to the Supreme Court. In 2010 the court found the CRNA guilty of practicinga The International Federation of Nurse Anesthetists (IFNA) was founded in 1989 and currently has members in 41 countries. Its purpose is to promote quality anesthesia care worldwide.