SAAC/AAPD Restructures to Meet Changing Times

he Society of Academic Anesthesiology Chairs (SAAC) and the Association of Anesthesiology Program Directors (AAPD) are undergoing an organizational restructure to respond to the changes in program director requirements by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Anesthesiology (ABA) as well as the proliferation of accredited anesthesiology subspecialty training programs. Historically, there were approximately 150 core anesthesiology training programs. Members of SAAC/AAPD were all chairpersons of departments, as the ABA required the designation of the departmental chair as the core program director.

The annual meeting of SAAC/AAPD has been a rich opportunity for departmental chairs to share common issues such as faculty development, educational structure and innovations, resident selection, accreditation of residency programs, board certification, and facilitation of research, leadership development and managing the economics of running a department. The challenge created by the complex structure of academic medicine and factors such as the Medicare teaching penalty has resulted in an annual chair turnover rate of 20 to 30 percent. Hence, SAAC/AAPD has been an important resource for new chairs to learn and share in handling the problems of organizing and leading an academic anesthesia department. Additionally, SAAC/AAPD has been an important voice of academic anesthesia to the ASA, ABA, ACGME and the Residency Review Committee (RRC) for Anesthesiology. A member of SAAC/AAPD (currently Steven J. Barker, M.D., Ph.D.) sits on the ASA Board of Directors. Traditionally, faculty members most closely associated with running the residency program at the local program level have attended SAAC/AAPD meetings as guests.

Now, the faculty person who most closely manages the residency training program can be recognized by the ACGME and ABA as the program director. No longer is the department chair required to be the program director. Additionally, there has been a proliferation of subspecialty programs. Currently there are 132 core programs, 50 critical care programs, 45 pediatric programs and 92 pain medicine programs accredited by the ACGME. The goal of the SAAC/AAPD restructure is to recognize these changes and preserve the value of the association and annual meeting — the assembly of chairs and program directors to share challenges and opportunities and have a voice in the course of national academic affairs. Accordingly, the SAAC/AAPD restructure will have new official groupings or associations under the aegis of a new association council. There will be the Association of Academic Anesthesiology Chairs, the Association of Anesthesiology Core Program Directors and the Association of Anesthesiology Subspecialty Program Directors. The new council will draw from leadership of all groups. The plan for the near future is for the annual meeting to continue in the same format as before: a three-day meeting that includes a day for separate association meetings and then a day and a half for meetings with all groups combined. We anticipate that at this fall’s meeting beginning October 31, 2008, in San Antonio, Texas, the councils of the new associations will be elected.

SAAC/AAPD hopes to weigh in on several issues that are of importance to ASA. For example, there is an increasing movement toward subspecialty certification. Currently there is a proposal to ABA for subspecialty certification in pediatric anesthesia. The implications of this are complex and far-reaching. We plan to vet this issue this year at our council and national meeting and provide input to ABA. Additionally, we plan to discuss, consider and provide input on a proposal from the United States Medical Licensing Examinations and the National Board of Medical Examiners to change the timing and reporting structure of these examinations to pass/fail. Our goal is to ensure that a nationally-based summative assessment of medical student performance will occur by October of the senior year of medical school. Additionally, we want the results of this assessment to be reported in a fashion that will facilitate appropriate discrimination of medical school candidates who stand the highest likelihood of being successful in anesthesiology resident training.

Charles A. Vacanti, M.D., is Vandam/ Covino Professor of Anaesthesia, Harvard Medical School, Brigham and Women’s Hospital, Boston.

Stephen M. Rupp, M.D., is Chief, Department of Anesthesiology and Medical Director of Perioperative Services, Virginia Mason Medical Center, Seattle.