Not What You Might Expect: A Resident’s Perspective on the AUA Annual Meeting

Matthew J. Griffee, M.D.

y first question upon being invited to the Association of University Anesthesiologists (AUA) Annual Meeting as a resident guest was the same one many of you probably would have: What is AUA? The next question is equally predictable: Why would a resident just beginning a career in anesthesia have any role in attending a meeting of senior faculty and well-established researchers in the field?

In attending the AUA Annual Meeting this past May 6-8 in Baltimore, Maryland, I found that the surprising answer is that the interests, goals and dialogue of the AUA meeting are vitally important to all anesthesiologists, and not just the purview of a small group of leaders in anesthesiology education, research and policy.

Answers to these questions can best be illustrated by a series of assumptions regarding academic anesthesiology that I held going into the meeting. I found my preconceived notions to be challenged by new information from the meeting, and I emerged with a radically different perspective on AUA and academic anesthesiology.

Assumption 1: Most academic anesthesiologists and their departments are probably more or less homogeneous in their clinical interests and educational goals.

Observation: On the contrary, a wide variety of personalities in academic anesthesiology go along with an equally wide variety of research topics and perspectives on anesthesiology education and practice. Ranging from mathematical modeling of gas emboli, attitudes toward end-of-life care and effect of anesthetics in C. elegans, interests also span to include more familiar topics of anesthetic pharmacology and clinical anesthesiology research. In addition to the wide range of research topics, questions on residency requirements, fellowship structure or certification examination structure generate vigorous debate rather than a sentiment of widespread consensus that I had expected.

Assumption 2: Academic anesthesiologists are focused on what happens in university departments and are rather indifferent to changes outside the ivory tower affecting the private sector.

Observation: Again, on the contrary, I learned that AUA members are very invested in sustaining a positive perception of anesthesiology among other specialties and from the public. Speakers were blunt in expressing concern about the need for preparation of all anesthesiologists for economic changes and anticipatory adaptation for the impact of advances in technology. Similarly many participants spoke about proactive strategies to increase support for anesthesiology outside of university departments, from sources such as the National Institutes of Health and in terms of outreach to medical students, and respecting collaboration with other departments and disciplines.

Assumption 3: The attitude to residents interested in research would be, “Learn to pull yourself up by your boot straps.”

Observation: The conference attendees conveyed an inspiring and comprehensive vision of mentoring to future anesthesiology researchers. From sponsoring medical student participation in anesthesiology research to funding junior faculty research, there is a compelling and realistic program for building a research community in anesthesiology. A particularly attractive aspect of this vision is the support for innovation and development of individual interests. There is an attitude that a wide variety of approaches and interests can find a viable place in anesthesiology research.

Assumption 4: There is really only interest in having people go into basic science.
Observation: Because of the complex marketplace of both medical practice and research, I witnessed a very high level of support expressed for broadening the scope of practice of anesthesiology. As a resident, this perspective among academic researchers is a strong incentive to consider subspecialty training or to developing unique areas of practice such as perioperative medical care and palliative care.

In summary, the observations from the conference that contradicted my assumptions led to the following conclusions for a resident:

1. Since there is not really a standard profile for an academic anesthesiologist, a wide variety of residents should keep an open mind about academic careers.
2. There is much more interdependence between private practice and academia than is apparent in residency.
3. There are many tools for getting started in research and a wide variety of potential topics.
4. Anesthesia practice in the near future will have many structural differences from current and past practices.

For residents it would be a good idea to be proactive about the changes coming to all anesthesiologists.

For more information, visit the AUA Web site at <www.auahq.org>.

Please send any topic ideas, sample articles or questions to the editors of “Residents’ Review” at <residents.review@ASAhq.org>.

Matthew J. Griffee, M.D., is a CA-1 resident at Oregon Health and Science University, Portland, Oregon.