Part 1 of this article appeared on page 36 of the July 2004 ASA NEWSLETTER.


ince its establishment, the Foundation for Anesthesia Education and Research (FAER) has provided more than $10 million in support for education and research to more than 400 individual anesthesiologists. FAER continuously evaluates the results of its efforts, and, in 1987, a survey of past FAER grant awardees was conducted which demonstrated that recipients of FAER awards had successfully acquired additional peer-reviewed grants exceeding 11 times the dollar amount provided by FAER. Additionally the survey showed that more than 80 percent of FAER awardees had remained in academic practice. A new survey is currently under way.

The Grants
FAER annual awards have increased in amount from an initial $3,000 to as high as $140,000 for a current mentored Research Training Grant. The research awards are structured into three categories: Research Fellowship Grant, Research Starter Grant and Research Training Grant. They each differ as to eligibility, time commitment and amount of funding. The one-year, $50,000 Fellowship Grant is offered to anesthesiology trainees who also take the American Board of Anesthesiology (ABA)-allowed opportunity for six months of research activity (Clinical Scientist Track) during their clinical residency and do so in continuity with the one-year FAER grant. The two-year Starter Grant funds $35,000 the first year and $50,000 the second and is available to assistant professors who will spend 40 percent of their time devoted to the FAER-funded research project. The two-year Training Grant also is awarded to assistant professors spending 80 percent of their time involved in their FAER research proposal with $75,000 support for the first year and $100,000 for the second. The time commitment for mentoring, a principal expectation for the training grant, has led FAER to provide a $40,000 annual stipend to the mentor for the duration of the grant with the expectation of a minimum of 40 percent nonclinical time devoted to research. Research applications submitted to FAER are subjected to a very rigorous review process by the ASA Committee on Research that utilizes defined objective criteria mutually agreed upon by the committee and the FAER board.

FAER also provides support to education research in the form of a two-year Research in Education Grant to examine, evaluate and develop innovative educational programs. This grant replaces the former Education Grant; it provides a two-year award of $50,000 annually and is available to faculty at any level of seniority. Research in Education grants are subjected to a similar rigorous review by FAER’s Committee on Education Grant Review. Awarding of all FAER grants is widely recognized for fairness, integrity and excellence of the funding mechanism. The current budget for FAER includes an annual expense of $2,400,000 for these awards. FAER recognizes the essential need to disseminate new information as a necessity to advance our specialty as we incorporate new knowledge into clinical practice.

Importance of Mentors
It has become increasingly evident that the success of FAER’s efforts can only be realized if a mentoring capability exists at the local level to encourage, direct and supervise the awardee in her/his research project. Without the guidance of an experienced, successful and motivated research mentor, the young trainee will not achieve the goal of becoming an independent investigator capable of competing for peer-reviewed research funding from the National Institutes of Health and other sources. Therefore, in its newly revised award structure, FAER has placed increased emphasis on mentoring as a requirement for the award. It also is recognized that the time and effort required for research mentoring and training create an additional need for faculty funding from nonclinical sources; thus FAER has included financial support for mentors as part of its mission. FAER also has established an Academy of Mentors in recognition of the extraordinary contribution of highly successful mentors. This new organization exists not only to provide recognition for outstanding contributors to the training of future investigators but also a forum to discuss and develop implementation strategies to increase the numbers and effectiveness of mentors in our specialty.

Support for FAER is derived from the generosity of ASA, the anesthesiology community, including individual anesthesiologists, subspecialty and component societies, the Association of University Anesthesiologists (AUA) and donations from medical corporations. In 2003 the Foundation received $1,884,558 in donations from these sources. The major donor continues to be ASA with an annual commitment of $1,050,000. ASA continues to demonstrate commitment to the academic community and its recognition of the essential need to continue to develop new knowledge and educational activities to sustain anesthesiology’s major role in the future of medicine. Reliance on corporate donations has become increasingly difficult with the downturn in the economy and the mergers and consolidation of many companies.

If FAER is to be able to maintain its mission for individual career development and to increase its role in the growth of a vigorous mentoring program with a more widespread distribution of research activity, it must begin to assess alternative funding opportunities and to become more aggressive and innovative in encouraging support from the anesthesiology community at large. FAER has and will continue to recognize the need to increase its administrative support both in space and personnel as well as seek the advice of consultants and establish a development program staffed by experienced individuals with demonstrated success in soliciting contributions from various sources.

Obscurity or Prosperity?
If we do not expand our influence beyond the operating room, if we do not aggressively support the acquisition of new knowledge, if we are unable to advance the science of our specialty and if we allow our academic programs to do little more than provide clinical service and function only as a training ground for clinical anesthesiologists, we have clearly committed anesthesiology as a medical specialty to eventual obscurity. We must be committed to more than simply maintaining economic survival. Although such an approach may provide security for the present, it will only lead to an abrogation of our responsibility for the future and become testimony to the lack of appreciation of the necessity for our contribution as physician specialists in anesthesiology. None of us wishes to be remembered as having failed to provide the necessary environment for physician anesthesiology and having brought about its extinction by our inaction.

Renewed interest in anesthesiology as a career by medical students, the availability of competitive funding for established investigators and the recognition of the necessity to focus on scientific productivity as the key to the growth of physician-led anesthesiology present major opportunities for progress and growth of this medical discipline. Deficiencies are evident, but enthusiasm for change is present among the academic and political leaders in our specialty. FAER, ASA and other academic societies and related organizations need to demonstrate enthusiastic leadership and provide direction as motivators and supporters of this effort.

FAER-sponsored retreats among the leaders of major anesthesiology organizations took place in August 2003 and June 2004. The results of these two-day meetings were the development of implementation strategies to enhance the growth and contributions of academic anesthesiology. The demonstrated enthusiasm and dedication of the participants at the retreats and the recent establishment of an ASA Committee on Academic Anesthesiology have created a sense of optimism for the exciting opportunities that exist for the prosperity and future success of our academic programs and our specialty.

Myer H. Rosenthal, M.D., is Professor of Anesthesiology, Medicine and Surgery, Stanford University School of Medicine, Stanford, California.