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ASA Committee on Academic Anesthesiology, formed in
2004, is a manifestation of our Society’s vision
and commitment to the needs of academic departments
and their training programs. The committee ensures
that the academic community has an official, consistent
voice in the Society’s discourse and affairs.
It is charged to address key issues of importance
to academic anesthesiology departments, including
future work force and training needs and the preparation
of anesthesiology trainees for careers in both academic
and community practices.
Within its charge, the committee serves to foster
discussion and collaboration between ASA’s leadership
and the academic community. It strives to address
the challenges facing academic anesthesiology departments
and to develop clinical and academic leaders for our
specialty. At its meeting during the ASA 2006 Annual
Meeting, the committee addressed a number of important
issues for the specialty as a whole and the academic
community in particular. Members discussed what they
believe are the most important issues facing academic
departments and brainstormed how the committee, the
Foundation for Anesthesia Education and Research (FAER)
and ASA can be of assistance.
Mark A. Warner, M.D., Chair of the Residency Review
Committee for Anesthesiology (RRC), provided the committee
with an overview of RRC activities and described new
initiatives being proposed by both the RRC and the
Accreditation Council for Graduate Medical Education
(ACGME). In addition to monitoring compliance with
the resident duty hour limitations, the RRC is committed
to ensuring that residents fulfill the competencies
as defined by ACGME. The RRC is identifying “best
practices” that can then serve as examples for
teaching departments. Additionally it is reviewing
proposals from residency program directors for innovative
educational initiatives that will provide residents
with broad-based clinical training as well as research
opportunities to prepare them for successful academic
careers.
A great deal has been said and written about the future
of the specialty in the ASA NEWSLETTER and
elsewhere. The committee has ongoing discussions about
the future of the specialty and how the academic community,
with the support of ASA and other organizations, can
best respond to the changing environment.
In October 2004, ASA formed a Task Force on Future
Paradigms of Anesthesia Practice to study factors
related to the future of our practices and profession.
Led by Ronald D. Miller, M.D., the group’s initial
recommendations were both visionary and challenging
to ASA membership and leaders of the specialty. The
task force’s vision of the future did not, however,
include several dramatic changes that are occurring
in the practice of medicine in general and surgical
specialties in particular. These changes will have
major impact on anesthesia practices in both academic
and community settings.
For example the impact on anesthesia services of the
continuing shift toward minimally invasive surgery
and endovascular stenting procedures remains unknown.
As fewer surgeons have experience with “open”
surgical procedures, will they be comfortable transitioning
from a noninvasive approach to an open laparotomy?
Will they recognize adverse surgical events sufficiently
early to intervene before significant hemodynamic
changes or other problems ensue? What will be the
role of anesthesiologists in the acute identification
of these problems and, when appropriate, subsequent
development of recommendations to change surgical
management processes? How will these changes affect
our patient safety concerns and professional liability?
Surgical specialty groups are tackling these challenging
issues. It is imperative that we work collaboratively
to address the changes affecting our practices and
the quality of care for our patients. The committee
members discussed how to ensure that the specialty
continues to make advances in clinical care and patient
safety.
With unrelenting pressure to provide more clinical
care, most academic departments struggle to include
research training and resident and faculty “nonclinical”
time to pursue scientific activities. There are no
easy answers. FAER has been instrumental in supporting
research and is considering the “Centers of
Excellence” designation to identify and acknowledge
those departments that demonstrate clinical and scholarly
excellence. To advance the scientific output of our
academic departments, additional resources will be
required. The committee will discuss ways to support
academic departments in this mission and assist them
in identifying potential research and funding opportunities.
The committee discussed educational opportunities
and mentorship for faculty who aspire to leadership
positions. The committee recognized the need to provide
training in administration, management and finance,
and research program development for future department
chairs. In addition the committee supports better
preparation for program directors whose tasks and
responsibilities have escalated. The Society of Academic
Anesthesiology Chairs and Association of Anesthesiology
Program Directors (SAAC/AAPD) have addressed these
needs and seek resources to assist chairs and program
directors in strengthening their programs. ASA Immediate
Past President Orin F. Guidry, M.D., indicated that
ASA also will assist in this effort, and program directors
are encouraged to let ASA know what is needed and
how ASA leadership and staff can assist them.
As I assume the helm as chair of the ASA Committee
on Academic Anesthesiology, I offer my sincere thanks
to FAER President Alan D. Sessler, M.D., for his guidance,
vision and commitment to academic anesthesiology and
for his support of research and educational opportunities
for the specialty. Chaired by Dr. Sessler since its
inception, this committee has a solid foundation upon
which to build. His devotion to the future of our
specialty is well known to all, and his leadership
has been invaluable. I am pleased to have been asked
to chair the committee, recognizing that as the “new
kid on the block,” I have some very large shoes
to fill. I also want to take this opportunity to thank
Mary M. Schrandt, Associate Director, without whose
assistance the committee would have floundered.
Please forward comments or suggestions to me about
how the committee can most effectively address the
needs of the academic departments <cohenn@medsch.ucsf.edu>.
We look forward to hearing from you!
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Neal H. Cohen, M.D., is Vice-Dean, Professor of
Anesthesia and Medicine, University of California-San
Francisco School of Medicine, San Francisco, California. |
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