Residents Make Their MARC

The 2003 Midwest Anesthesiology Residents’ Conference (MARC) will be hosted this year by the University of Illinois at Chicago College of Medicine on March 14-16, 2003, at the Marriott Hotel in downtown Chicago, Illinois. One of the purposes of the conference is to give anesthesiology residents an opportunity to present basic and clinical research in a forum that encourages in-depth discussion and debate among their peers and mentors. Many of the residents who attend will be eligible for Foundation for Anesthesia Education and Research (FAER) grants, so we are pleased to have the opportunity to participate in this year’s program.

FAER Director John P. Kampine, M.D., Ph.D., Professor and Chair, Department of Anesthesiology at the Medical College of Wisconsin, will be one of the guest speakers at the Saturday breakfast. In addition, previous award recipients will represent FAER at a booth and will have application materials and information available. We hope to arrange a FAER presence at the Western Anesthesia Residents’ Conference (WARC) on April 4-6, 2003, in Stanford, California, and the Gulf Atlantic Anesthesia Residents’ Research Conference (GAARC) on March 14-16, 2003, in New Orleans, Louisiana.

Effects of Diminished Recruitment: In the early 1990s, fears of managed care, diminishing reimbursement and possible oversupply of anesthesiologists were followed by a reduction in recruitment. The number of residents in the critical CA-1 year fell from a high of 1,904 in 1992 to a low of 1,073 in 1996. More striking, the number of American medical graduates (AMGs) in these CA-1 years fell from 1,609 to 496. Although interest in the specialty has now resumed, the period of diminished recruitment has left us with critical shortages, particularly in academic departments.

The Role of Research: Anesthesiology-based research has been responsible for many critical advances such as blood gas analysis (Severinghaus); neonatal assessment (Apgar); anesthetic potency (Eger); labor analgesia (Bonica, Schnider); neuromuscular blockade (Miller, Savarese); pulse oximetry (New); and anesthetic toxicity (Cohen). Furthermore, anesthesiology education is an essential component of the acquisition of knowledge and the perpetuation and advancement of the specialty. Current demands for clinical productivity, combined with faculty shortages and diminishing clinical revenue, are compromising the generation and dissemination of new knowledge, which, in turn, imperils the future of the specialty. An ongoing basis of education, innovation and scientific inquiry is an essential foundation on which to build the future — it clearly underlies the progress we have enjoyed to date.

Distribution of NIH Grants: The distribution of National Institutes of Health (NIH) grant awards probably reflects current application rates. Recently 242 grants were awarded to anesthesiology, compared to radiology (581), neurology (753), surgery (948), pediatrics (1,346), pathology (1,397), psychiatry (1,777) and medicine (5,641). In 2001, only 45 of the 132 (34 percent) Accreditation Council for Graduate Medical Education-approved anesthesiology programs received any NIH awards.

Maintaining Research: Many critical questions uniquely suit investigation by scientist/anesthesiologists, including improvements in pain therapy, monitoring and protection of specific organs, advances in palliative care, discovering the mechanisms of anesthesia, perfecting agents for regional and general anesthesia and optimizing postsurgical prognosis. These endeavors require time, space and resources to promote mentoring and research by faculty and residents. The enthusiastic return of AMGs to anesthesiology provides both opportunity and motive. These residents must be greeted with facilities and support to develop careers based on excellent research and sound scientific enquiry.

FAER’s Role: FAER must continue to be a leader and motivator in processes involving research and education. FAER enjoys a reputation for impartiality and integrity in awarding grants and is currently budgeting $1.4 million annually. On average, an individual receiving a FAER award goes on to receive 11 times that amount in future competitive grants. These figures emphasize the seminal role played by FAER in encouraging research early in people’s careers.

Three FAER research awards: The one-year Fellowship Grant ($50,000) is offered to anesthesiology trainees taking the clinical scientist track during their clinical residency. The two-year Starter Grant ($35,000 first year, $50,000 second year) is available to Instructors/Assistant Professors spending 40 percent of their time on the research project. The two-year Training Grant ($75,000 first year, $100,000 second year) is awarded to Assistant Professors spending 80 percent of their time involved on their research project. FAER is now placing increased emphasis on mentoring as a requirement for the award.

Start making your mark — check eligibility and plan to submit before one of our application deadlines of August 15 or February 15 each year.

For further information, visit <www.marc2003.com>, <warc.stanford.edu> and the GAARC Web site <www.cme.tulane.edu>.

We wish to attribute some of the content of this report to Myer H. Rosenthal, M.D., and Alan W. Grogono, M.D.

Granting Researchers a Chance to Shine, Part 2

The Foundation for Anesthesia Education and Research (FAER) Board of Directors is pleased to announce the award recipients from the August 2002 submissions. FAER is grateful to ASA, its individual members, component societies, subspecialty societies and corporations for the generous contributions that allow funding of these awards. The descriptions of the projects were provided by the investigators. Previous winners appeared in this column in the January 2003 NEWSLETTER.

Research Starter Grant

Randall P. Brewer, M.D., Duke University, Durham, North Carolina: “Intravenous Magnesium Sulfate in Subarachnoid Hemorrhage: Analysis of the Effects of Hypermagnesia Upon Cerebrospinal Fluid Magnesium Concentration.” Mentor: David S. Warner, M.D.

Every year, more than 20,000 people in the United States suffer from subarachnoid hemorrhage due to a ruptured intracerebral aneurysm. Neurosurgical and endovascular techniques have improved our ability to prevent further bleeding. When an aneurysm ruptures, brain injury occurs. In many of these patients, cerebral vasospasm develops, limiting blood flow to the injured brain. Vasospasm is a major cause of disability in survivors because it results in additional brain injury. Our research is designed to define the role of magnesium sulfate, a vasodilator and neuroprotective agent, in the treatment and prevention of brain injury from vasospasm. The current study will determine the extent to which magnesium actually enters the brain when given to patients with subarachnoid hemorrhage. Because many drugs are limited in their ability to reach brain tissue, the results from this study will determine the need for further research evaluating the effect of magnesium on neurologic outcome after subarachnoid hemorrhage.