Setting the Right Course for a Future in Anesthesiology

By Douglas A. Colquhoun, MB ChB, from the IARS, AUA and SOCCA 2019 Annual Meetings*

The Scholars’ Program aimed to look to the horizon and contemplate how early-career anesthesiologists can prepare effectively and proactively for the future of anesthesiology during the last session of the day, Preparing for the Future of Anesthesiology Now. Moderated by Kate Gurba, MD, PhD, Washington University in St. Louis, the panel featured presentations from George A. Mashour, MD, PhD, University of Michigan, and Beverley A. Orser, MD, PhD, University of Toronto.

Dr. Mashour focused his presentation around the translational science and the impact that engaging in such work has for our specialty and beyond. He specifically highlighted the role he plays as a leader of the Michigan Institute for Clinical and Health Research (MICHR), the Clinical & Translational Science Award Program at the University of Michigan. This role is not traditionally held by an anesthesiologist, according to Dr. Mashour. He described how this experience has broadened his horizons for medical research. This positioned the anesthesia department at University of Michigan to be seen as a source of vibrant research endeavors within the institution.

In addition, the nationally collaborative nature of the CTSA program clearly positioned the specialty of anesthesia as one which is at the cutting edge of scientific progress. He continued to highlight the ways in which the CTSA programs, found at many academic institutions, enabled scientific progress through their programs. He particularly focused on an example of how at University of Michigan the CTSA aided clinicians to navigate through the FDA Expanded Access Program to allow rapid access to an experimental treatment. Recognizing that roles such as this have also caused his energies to be divided, he reflected on how he has been able to continue his research endeavors by investing and mentoring his research team, but also recognized the impact on his clinical work and personal life.

In Dr. Orser’s presentation, she carefully discussed her career journey, including significant moments that drew her into anesthesia and decisions that led to the development of her research career. She shared her journey and the importance of mentors and advisors who aided her.

Within her research efforts, she described how her quest to understand the question “How do anesthetics work?” led to careful work on understanding the expression of GABA receptors to patented drug discovery of an agent which might prevent cognitive complications of anesthesia. Her career has allowed her to participate in the full cycle of translational work through her broader participation in the perioperative brain health initiative. Dr. Orser continued by explaining how this work shares commonality with processes seen in traumatic brain injury, infection and dementia research and discussed how her discoveries may be impactful beyond the immediate perioperative period.

In her closing remarks, she advised scholars to look for good mentors and observe them carefully, to ensure they are doing the best experiments they can, not the easiest, and having carefully recognized personal biases in interpreting the data, critically analyze the data from these experiments remembering that unexpected results are the basis of discovery.

A lively Q&A session followed where scholars had the opportunity to question Drs. Mashour and Orser. In a question regarding the challenge of developing a focus of work versus attempting to maintain a broad base in the event that particular scientific discoveries are not successful, Drs. Mashour and Orser discussed structuring multiple lines of scientific inquiry to ensure that work is balanced between high risk and low risk endeavors.

A number of questions addressed the mentor-mentee relationship. In responding to these, Dr. Orser highlighted the importance of the mentee having a specific role in mind for their mentor, being thoughtful about how they are approached and being respectful of their time. She noted that mentor-mentee relationships are bidirectional endeavors with constraints and objectives. She commented that she considers her mentors to be a “personal board of directors.” Dr. Mashour added that mentees should seek the strongest possible mentors and should choose their mentor thoughtfully with specific skills in mind.

One of the closing questions focused on managing relationships with industry. Both panelists carefully recognized issues around conflicts of interest. Dr. Orser discussed how these relationships can be grown over time and require dedicated effort. Dr. Mashour noted that working with industry can lead to exposure to expertise in conduct of sophisticated clinical trials, but also remarked that commercialization of scientific discovery is absolutely necessary for clinical impact as commercial devices or pharmaceuticals become relevant.

*Coverage from the Scholars’ Program: Preparing for the Future of Anesthesiology Now during the IARS 2019 Annual Meeting