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August 2002
Volume 66 |
Number 8
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FAER REPORT
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| The Role of
Mentorship |
Simon Gelman, M.D.
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"As it concerns science,
including science in our specialty, the role of
mentors is absolutely irreplaceable."
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Many of you probably noticed that the Foundation for Anesthesia
Education and Research (FAER) Board of Directors recently made
significant changes in the conditions for disbursing awards to
conduct research. Conceptually, the changes reflected a significant
increase in the role of mentorship. The mission of FAER is formulated
as follows:
"The mission of the Foundation for Anesthesia Education
and Research is to promote the generation of new knowledge in
anesthesiology that advances patient care and to foster career
development of anesthesiologists dedicated to research and education
in perioperative, critical care and pain medicine."
This means that the overall goal of FAER is to fund the development
of people, researchers and academic leaders in our specialty.
Through the centuries, teachers, mentors, and role models have
always been respected in all religions and cultures. Respect for
teachers and recognition of their importance in the life of a
nation is a feature of civilization. Henry Brooks Adams said it
well: "A teacher affects eternity; he can never tell where
his influence stops."
As it concerns science, including science in our specialty, the
role of mentors is absolutely irreplaceable. First of all, science
in our specialty is of an extremely wide spectrum. It includes
not only studying the mechanism of the action and development
of new general and local anesthetics, but also studying the mechanisms
of pain and developing new analgesics as well as studying the
mechanisms of stress response and inflammation and developing
new strategies in preventing or at least modifying such responses.
Research in our specialty includes studying all organs, systems
and tissues as well as using many different approaches, starting
with molecular and cellular biology and finishing with system
physiology and psychology.
During the last couple of decades, research has become not only
quite complex but also relatively distanced from the body of knowledge
directly needed for the clinical practice of anesthesiology. Therefore,
any anesthesiologist who desires to become a scientist must receive
additional education in another specialty or specialties. It takes
time and effort as well as a mentor. Who would imagine becoming
a surgeon or an anesthesiologist without specific training and
education in such a specialty? The same holds true for science:
nobody can become a scientist without hard work in a good laboratory
with a good mentor for a number of years.
On average, during the last few years, National Institutes of
Health (NIH) independent awards have been granted to 10-20 percent
of applications. We medical doctors compete for the awards with
Ph.D.s, who have great experience and training in more than one
laboratory and who devote their professional lives only to science.
In order to compete with them, it seems that we have to follow
the same route: work hard in a laboratory with a good mentor for
several years.
Present financial constraints on academic departments of anesthesiology
and overall academic medical centers do not and will not in the
future allow the funding of research by intramural funds. Therefore,
extramural funding for research is a must now and will be a must
in the future. Also, extramural funding is the only objective
measure of the quality of research. I admit that it is a very
inaccurate measure, but we do not have a better one.
During recent years, we at FAER recognized that many applications
for one or another type of grant support from FAER was suffering
from the absence of a good mentor. Therefore, the Board of Directors
has decided to modify the requirements and conditions of the awards
with much greater emphasis on the quality of a laboratory and
mentor as one of the most important criteria the ASA Committee
on Research (which functions as a study section of FAER) uses
in ranking the submitted proposals. The main reason for such a
change is to significantly increase the probability of the mentored
young investigators to be successful.
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"The main advantage of such
an approach is that an applicant would be working
in a well-funded laboratory under a knowledgeable
mentor who would be extremely interested in the
success of the project."
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There was another reason for such a change: if a mentee is working
in a well-funded laboratory under the mentorship of a mature and
well-funded principal investigator, the majority of the FAER award
would be spent to cover the time/salary of a mentee, while the
major part of the necessary supplies – particularly expensive
pieces of equipment – presumably would be available already
in the laboratory of the mentor. At least during the beginning
of laboratory training, the mentee would work on the project suggested
by the principal investigator, which would probably comprise a
part of his or her grant. The responsibility of the mentor would
be not only to provide a space in a laboratory and part of the
funding of the project but also to work on the specific aims of
the mentor, using his or her funds for research. The main advantage
of such an approach is that an applicant would be working in a
well-funded laboratory under a knowledgeable mentor who would
be extremely interested in the success of the project. Our main
expectation (and the mentors would be made aware of this) is that
an applicant would be able to compete for an NIH training grant
(K08 or K23 type) by the end of the FAER grant. After receiving
such a grant, the mentee will continue working in the same laboratory
already under his or her funding. Then a K08 or a K23 grant has
the highest probability of leading to an R01 type of independent
funding.
The FAER Board of Directors hopes that the change in the process
and the criteria of the determination of the disbursement of the
funds would help the mission of FAER and would develop outstanding
scientists and leaders in our specialty in the future.
Announcement of Recent Research Winners, Part II
| This article represents the final installment of FAER's
award recipients. Previous winners, Amr E. Abouleish,
M.D.,* Martin S. Angst, M.D., Christopher J. Jankowski,
M.D., Rashmi N. Mueller, M.B.B.S.,* and David T. Raphael,
M.D., Ph.D., were featured in the July NEWSLETTER. |
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Research Training Grants ($175,000 for two years)
Simon C. Body, M.B., Ch.B., Brigham and Women's Hospital,
Boston, Massachusetts: "Genotypic Influences on Adverse Bleeding
and Thrombotic Outcomes After Coronary Artery Bypass Surgery."
Mentor: Carlo Brugnara, M.D. Co-sponsor: Society of Cardiovascular
Anesthesiologists.
Cardiopulmonary bypass (CPB) and coronary artery bypass graft
(CABG) surgery induce profound activation of the coagulation,
fibrinolytic and inflammatory pathways directly resulting in adverse
clinical outcomes. However, little is known of the role of coagulation
and inflammation-genetic polymorphisms in determining the frequency
of adverse hematological outcomes such as post-CPB bleeding or
thrombotic outcomes such as graft thrombosis, recurrence of anginal
symptomatology, myocardial infarction and cardiac death after
CABG surgery. The aim of this research proposal is to investigate
whether specific coagulation and inflammation genotypes and phenotypes
(serum levels) related to thrombin and its receptors and other
coagulation genes are associated with an increased incidence of
specific adverse perioperative bleeding and postoperative thrombotic
clinical outcomes after CPB and CABG surgery. Data to be obtained
from this study will hopefully provide insight into genetic and
molecular mechanisms that predispose individuals to perioperative
morbidity following cardiac surgery. Additionally, this data also
may be used to improve patient risk stratification, target specific
therapies to appropriate patients and possibly identify drug development
targets.
Chuanyao Tong, M.D., Wake Forest University, Winston-Salem,
North Carolina: "Visceral Pain of Uterine Cervical Distention:
Role of COX." Mentor: James C. Eisenach, M.D. Co-sponsor:
Society for Obstetric Anesthesia and Perinatology-Obstetric Anesthesia
and Perinatoloty Endowment Fund
Labor pain is difficult to treat with simple methods, and
we understand very little about the nerves that carry the pain
of labor and how this information passes to the brain. We will
test how dilation of the cervix, which causes labor pain, stimulates
spinal cord cells and changes the enzymes that they make. Nonpregnant
and pregnant rats will be anesthetized and the uterine cervix
dilated using small metal rods, which causes a contraction of
the stomach muscles. We will examine whether aspirin-like medicines,
given in the back near the spinal cord, block this reflex. We
will remove the spinal cord from the animals and look at cells
excited by this dilation during pregnancy and stain the tissue
for certain enzymes that are related to aspirin-like medicines.
These studies will help us better understand the process of labor
pain and may lead to better, simpler ways of treating it.
| *Corrections: Dr. Abouleish is located at the University
of Texas Medical Branch in Galveston (not Houston),
Texas. Dr. Meuller's project is titled "The Effect
of Zinc Chelation on Neurobehavioral Outcome After Transient
Global Cerebral Ischemia in Rabbits." |
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Simon
Gelman, M.D., Ph.D., is Chair, Department of Anesthesiology,
Perioperative and Pain Medicine, Brigham and Women's Hospital,
Boston, Massachusetts. |
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