Academic Anesthesiology Career Development

Advocacy for Anesthesiologists

Advocating for anesthesiology is a professional responsibility. We need to make the public aware of the role we play in assuring their safety and comfort; and we must also ensure that payment models are fair and commensurate with the quality of our work.

Physician-Scientists: Fixing the Leaking Pipeline - A Scoping Review

Introduction

This scoping review was undertaken to assess the current status of physician-scientists, including the challenges associated with their enrollment and retention, measures of success, and determinants of their satisfaction, all of which contribute to the dwindling numbers of physician-scientists aptly referred to as a "leaking pipeline" of physician-scientists.

Methods

A total of 2555 research documents from three databases, viz. Scopus, Web of Science, and PubMed, were selected. A total of 40 documents were considered for final analysis following the 5-stage framework of Arksey and O'Malle.

Results

Medical institutions should promote and sustain enrollments by addressing various perceived parameters of success and satisfaction. The challenge of attrition due to individual, regulatory, and sociocultural considerations also needs to be addressed.

Conclusions

Medical institutions should focus on establishing well-documented career tracks with provisions for career advancement, promotion of team science, raising mentors, giving preference to students with peer-reviewed publications for post graduate (PG) admissions, and establishing a separate office for career development and guidance for physician-scientist. It is equally important to address the factors which promote retention and prevent attrition, viz. measures of success and determinants of satisfaction. Additional measures include creating a cadre of physician-scientists in government organizations, fostering collaboration of physician-scientists with incubation centers and startups, and adding additional mandatory curriculum components focused on project-based training.

A Ten-Year Analysis of Recent National Institutes of Health Funding for Anesthesiology Research in United States Medical Schools

OBJECTIVES

The characteristics of recent National Institutes of Health (NIH) grant funding to anesthesiology researchers in United States (US) medical schools have not been systematically quantified. NIH funding to cardiac anesthesiologists has also not been estimated. The author conducted an internet-based analysis of NIH awards to anesthesiology researchers from 2011-2020 to identify the types, duration of funding, and amount of grants, and the terminal degree(s), faculty rank, gender, board certification status, and type of appointment of the grant recipients including those with an interest in cardiac anesthesiology.

DESIGN

Observational study.

SETTING

Internet analysis.

PARTICIPANTS

NIH grants recipients.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

NIH grant recipients affiliated with anesthesiology departments were identified from the Blue Ridge Institute for Medical Research website. The number of grants, years of support, and total amount of funding were quantified for research project grants (R series), mentored career development awards (K series), and other grants (U and P series) using NIH Research Portfolio Online Reporting Tools. The terminal degree(s), faculty rank, gender, and type of appointment of grant recipients were identified using department web pages. American Board of Anesthesiology (ABA) certification, National Board of Echocardiography Advanced Perioperative Transesophageal Echocardiography (TEE) certification, and previous or current Foundation for Anesthesia Education and Research (FAER) awards to NIH grant recipients were obtained from each organization's website. A total of 532 researchers received 1250 grants with 3844 cumulative years of funding amounting to $1,676,482,440. R series grants accounted for three-quarters of all funding. PhDs were awarded more than one-half of NIH grants. MDs had lower median numbers of projects, R01 grants, and total R series grants than their colleagues with PhD or MD PhD degrees, but MDs received more K awards. One hundred ninety-eight MD and MD PhD NIH grant recipients were ABA diplomates. These physician-scientists received 26.0% and 53.1% of R and K series grants, respectively. Thirty physician-scientists also held TEE certification; these individuals with an interest in cardiac anesthesiology were awarded 4.8% of all NIH grants. Full Professors were awarded more than three-quarters of R grants and amassed more than $1.3 billion in funding, whereas assistant and associate professors received the majority of K series grants. Male investigators received greater median R grants but fewer median K awards than female researchers. One hundred-fifteen previous or current holders of FAER grants were identified; these individuals earned a total of 240 NIH awards totaling $357.7 million.

CONCLUSION

PhDs, Professors, and male researchers receive the majority of R01 and other R series grants to anesthesiology departments at US medical schools. Physician-scientists, including those interested in cardiac anesthesiology, are awarded a minority of R series grants. FAER continues to provide an important stimulus for subsequent NIH funding of physician-scientists in anesthesiology.

Early immersion in a dedicated one-month Anesthesiology Professional Practice rotation for Post-Graduate Year-1 interns is associated with an increase in scholarly activity during residency

STUDY OBJECTIVE

Despite the Accreditation Council for Graduate Medical Education scholarly activity requirement, incorporating education on scholarly fundamentals into residency is challenging. We designed and implemented an academic non-clinical rotation for Post Graduate Year-1 (PGY-1) interns and its association with subsequent resident scholarly productivity was determined. We hypothesized that early immersion in such a rotation would be associated with increased scholarly activity during residency.

DESIGN

Retrospective educational comparative study, of two cohorts of anesthesiology residents in the graduating classes of 2015-2020.

SETTING

Large anesthesiology residency program at a U.S. academic medical center.

INTERVENTION

A one-month academic rotation titled Anesthesia Professional Practice for PGY-1 interns has been implemented since 2014. The rotation curriculum broadly covers important topics for scholarly projects and provides introductions to academic faculty and institutional resources.

MEASUREMENTS

The scholarly products (abstracts, publications, book chapters, research protocols, and grant applications) were quantified using Scholarly Activity Points, a previously described metric that accounts for significance and the resident's contribution. Total Scholarly Activity Points for each resident and number of publications prior to residency were determined for both cohorts. Segmented regression was employed with Scholarly Activity Points as the outcome; participation in the early immersion rotation and prior publications were used as input variables.

MAIN RESULTS

Resident participation in the early immersion rotation was significantly associated with higher Scholarly Activity Points. The confounding variable of pre-residency publication count was not significantly correlated to this increase.

CONCLUSIONS

Immersion in a one-month academic program during PGY-1 internship may contribute to increased scholarly productivity during residency.

Impact of Mentorship, by Gender, on Career Trajectory in an Academic Anesthesiology Department: A Survey Study

INTRODUCTION

Mentorship has been identified as a key component of success in business and in academic medicine.

METHODS

After institutional review board approval of the study, an email survey was sent to anesthesiologists in one anesthesiology department to assess mentorship status. A survey link was sent to nonrespondents at 2 weeks and 4 weeks. All participants were deidentified. The identification of a mentor was compared by gender, academic rank, and years of practice.

RESULTS

Among 233 anesthesiologists, 103 (44.2%) responded to the survey. More than 90% of survey respondents agreed or strongly agreed that having a mentor is important to career success. Of the 103 respondents, 31 (30%) indicated they had a mentor. Overall, 84% of the identified mentors were men; however, this percentage differed significantly between men and women respondents (95% versus 60%; P = .03). Characteristics associated with having a mentor included younger age (P = .007), fewer years since finishing training (P = .004), and working full time (P = .02). For respondent age and years since finishing training, there was some evidence that the association was dependent on the gender of the respondent (age-by-gender interaction, P = .08; experience-by-gender interaction, P = .08).

DISCUSSION

Anesthesiologists in this department believed that mentorship led to more academic success. Few women mentors were reported, and women were unlikely to identify a mentor once advanced past an assistant professor rank. Most respondents believed that mentorship was important for overall career success, but only approximately one-third identified a mentor at the time of the survey.

Pediatric anesthesia training to early career stage: Opportunities for firm foundations

Attaining professional contentment can be challenging for many. Academic success, psychosocial support, and the confidence to provide excellent clinical care at the workplace are key pillars that can help build a sense of meaning in a career. The role of mentorship in facilitating these key pillars at different stages of pediatric anesthesia training and new independent practice is instrumental. For mentees aspiring for a career in pediatric anesthesia, there are several points of focus. Mentees should seek out mentors early in training, build on these relationships, and explore opportunities for peer mentorship as they advance in their career. For mentors, introducing mentees to the clinical and academic aspects of pediatric anesthesia and setting the foundation for the mentee to advance in their career can be both gratifying and stimulating. In this article, we explore the development and progression of a mentor-mentee relationship through training to the early career stage and its role in developing a meaningful career in pediatric anesthesia.

The world needs our science: broadening the research pipeline in anesthesiology

Anesthesiologists are innovative and adaptable problem solvers. Despite these talents, our field is still working to consistently develop and support the translation of innovation and creativity into productive scientists. This article is focused on opening the discussion on identifying the gaps and move toward developing a sustainable and diverse research pipeline.

Food for Thought: Opportunities to Improve Diversity, Inclusion, Representation, and Participation in Epidemiology

DeVilbiss et al. (Am J Epidemiol. 2020;189(10):998-1010) have taken on the noble and worthy cause of improving diversity, inclusion, representation, and participation across the Society for Epidemiologic Research (SER) membership-a reflection/microcosm of society. The objective of this commentary is to underscore the importance of diversity and to offer initiative ideas, which should be centered around inequity stemming from the widespread historical and contemporary maldistribution of power (e.g., decision-making) and resources (e.g., funding) within institutions and organizations. Nonexhaustive strategies could include SER becoming an opportunity and information hub that helps to fill resource gaps. It is also recommended that SER leadership learn from existing associations and scientific initiatives to improve the culture of science in general by equitably incorporating policy, systems, and environmental interventions throughout the career spectrum. Examples include the provision of tools and incentives to address explicit or implicit biases, enhance mentoring skills, and remove predictable barriers (e.g., financial). Explicitly labeling diversity/inclusion efforts should be avoided, and the initiative should be evaluated based on impact rather than intent. Our fates are interconnected, and we can all help increase diversity, inclusion, representation, and participation to improve our science in hopes of equitably improving public health.