The 39,000-plus members of ASA are engaged in a variety of diverse clinical and educational activities that reflect our expanded focus on perioperative medicine. As a result of these new activities, there has been a dramatic increase in the formation of specialty-specific societies aimed at addressing the educational and clinical needs of their subspecialty constituencies. These subspecialty societies enrich the educational and academic fabric of our specialty.

The ASA Committee on Anesthesia Subspecialties was created to ensure that these organizations remain closely aligned with our parent organization and to foster communication between ASA and its subspecialty societies. Clearly both ASA and our specialty organizations are strengthened by this relationship. Subspecialty societies have always had an important historical relationship with ASA, which was highlighted in a recent article by Editor Douglas R. Bacon, M.D., in the April 2004 ASA NEWSLETTER.

Composition
The composition of the committee is defined in section 1.721 of the ASA Bylaws. To be a member of the committee, the subspecialty must have a delegate in the House of Delegates. The president and president-elect of each subspecialty serve on the committee. Eligible parent (i.e., subspecialty) organizations are defined as representing a subspecialty of anesthesiology that has scientific validity for which there is recognized subspecialty training defined by the Residency Review Committee and recognized by the Accreditation Council for Graduate Medical Education and is active in the field of medicine. The committee is convened each year at the ASA Annual Meeting and provides the opportunity for members to report on the Society’s activities during the past year and to discuss future educational endeavors.

Consistent with these bylaws, the present composition of the Committee on Anesthesia Subspecialties include representation from the following organizations:

Society for Ambulatory Anesthesia (SAMBA): Frances Chung, M.D., Lydia A. Conlay, M.D., Ph.D.

Society of Cardiovascular Anesthesiologists (SCA): Glenn P. Gravlee, M.D., Roger A. Moore, M.D.

American Society of Critical Care Anesthesiologists (ASCCA): Michael J. Breslow, M.D., Clifford S. Deutschman, M.D.

Society of Neurosurgical Anesthesia and Critical Care (SNACC): Piyush M. Patel, M.D., Tod B. Sloan, M.D.

American Society of Regional Anesthesia and Pain Medicine (ASRA-PM): Terese T. Horlocker, M.D., James C. Eisenach, M.D.

Society for Obstetrical Anesthesia and Perinatology (SOAP): Joy L. Hawkins, M.D., Richard N. Wissler, M.D.

Society for Pediatric Anesthesia: Anne M. Lynn, M.D., Francis X. McGowan, M.D.

Enhancing subspecialty education opportunities at the ASA Annual Meetings: Subspecialty tracks
One of the principal functions of the Committee on Anesthesia Subspecialties is to ensure that the educational interests of subspecialty societies are represented at the ASA Annual Meeting and other ASA educational activities. The incorporation of specialty-specific educational tracks at the Annual Meeting exemplifies the educational expertise provided by our specialty societies. These specialty-specific tracks provide an opportunity for members who attend the Annual Meeting to concentrate their education in selected subspecialty areas. This new approach provides a venue for our members to engage in a variety of focused subspecialty educational opportunities.

The educational content of these tracks will be developed by a task force composed of representatives from specific subspecialty societies and ASA. This new format will strengthen the collaborative relationship between ASA and the subspecialties. The subspecialty representative will be appointed from the various subspecialty societies, with the ASA Committee on Anesthesia Subspecialties assisting in the recruitment of additional representatives. At the 2003 Annual Meeting, the incorporation of an “unofficial” pain track was met with resounding success. As a result, the 2004 Annual Meeting will be the first to “officially” incorporate educational subspecialty tracks. This year’s meeting will introduce two new educational tracks, critical care medicine and obstetric anesthesia. For the 2005 Annual Meeting, educations tracks will be expanded to include cardiovascular anesthesiology and neuroanesthesia.

Fostering communication
The committee also serves to provide a liaison between ASA and its subspecialty societies. One of the charges of the committee is to improve communication between ASA and its subspecialty societies. Over the past several years, the opportunity to share ideas and concerns with the ASA leadership has proven extremely valuable. Discussion between ASA leadership and ASCCA resulted in the creation of a task force by ASA President Roger W. Litwiller, M.D., to examine the role of critical care within anesthesiology and to provide suggestions as to how critical care might become a more integral part of the practice of anesthesia.

Innovations in patient care: Optimizing our subspecialty society expertise
One such example is a recent project sponsored by the Society of Neurosurgical Anesthesia and Critical Care (SNACC). During this past year, SNACC completed the Intraoperative Hypothermia for Aneurysm Surgery Trial (IHAST). This large National Institutes of Health-funded study was an international multicenter trial that had wide input and involvement by SNACC members from the United States to the United Kingdom to Australia. The trial concluded that hypothermia (33 degrees Celsius) was not beneficial in improving outcomes. This evidence-based trial, involving wide participation from the neuroanesthesiology community, is the first of its kind in neuroanesthesiology. The structure of investigators and learning centers is now in place to lend itself to future outcome studies. This study will clearly impact the way in which we can care for a high-risk patient population. Our subspecialty societies provide a unique forum for designing and implementing clinical studies.

Other committee responsibilities
Additional duties include nominating subspecialty organizations to the House of Delegates for delegate (and alternative delegate) representation and to review periodically the appropriateness of the subspecialty organization representation in the House of Delegates.

Looking ahead
The Committee on Anesthesia Subspecialties is privileged to serve as the liaison between ASA and its subspecialty societies. The future of both ASA and its subspecialties will be enhanced by this collaboration. I would like to thank all of the members of the committee for their participation, dedication and commitment.

Roberta L Hines, M.D., is Nicholas M. Greene Professor and Chair, Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut.