April 3, 2025

Jessica Spence, MD, PhD, FRCPC, IARS Board Member

Although most of her career has been dedicated to clinical research, Jessica Spence, MD, PhD, FRCPC, was not aware of the International Anesthesia Research Society (IARS) until Dr. Michael Avidan, an emeritus IARS Board Member, invited her to give a presentation at the IARS Annual Meeting in 2018. He provided the gateway to learning more about the IARS and its essential resources for researchers like her. After attending her first meeting, she was surprised to discover so many anesthesiologists conducting research just like her and found a platform for interconnection at IARS that she had not found in her home country of Canada. Now an assistant professor in the Departments of Anesthesia, Critical Care, and Health Research Methodology, Evaluation, and Impact at McMaster University; and a scientist for Population Health Research Institute in Hamilton, Ontario, Canada, Dr. Spence continued to develop her relationship with IARS and this global community of researchers in the following years by becoming a member, joining multiple committees and contributing knowledge at various IARS Annual Meetings. Along the way, Dr. Spence applied for and received a 2021 IARS Mentored Research Award (IMRA) for her research, recognizing her contributions to anesthesiology and scientific knowledge. Dr. Spence is now taking that support and guidance she has found within the IARS community to the next level by becoming one of the newest members of the IARS Board of Directors. Her passion for advancing scientific knowledge, her dedication to giving back to the specialty and commitment to mentoring the next generation will prove a boon for future IARS initiatives and continuing to develop this valuable research community that initially attracted Dr. Spence back in 2018.

When approached to join the IARS Board, Dr. Spence jumped at the chance to work closely with high-profile leaders who are making a huge difference in academic anesthesia but also the opportunity to be a part of shaping the vision of the organization which played such a crucial role in her career. “This is my tribe,” Dr. Spence emphasized. “One of the things that is really important is bringing in the perspective of young investigators. IARS is really sensitive to the need to bring people in but maybe not as familiar with the struggles you deal with as an early-career person.” Dr. Spence hopes to provide that crucial perspective on the Board as well as her global perspective as a Canadian. She hopes to emphasize the importance of this global focus in future IARS initiatives.

Her accomplishments and career advancement today would not be possible without a lot of hard work and a skill for juggling multiple priorities with ease. Approximately 60-70% of Dr. Spence’s time is dedicated to clinical research through the Population Health Research Institute (PHRI). Affiliated with McMaster University, PHRI is a large multidisciplinary organization that facilitates international clinical trials and large epidemiologic studies, which represents perfectly the intersection of Dr. Spence’s research. Her specialties include cardiac surgery as well as patients undergoing noncardiac surgery, while her investigations focus specifically on the effects that non-surgical interventions have on postoperative patient outcomes, especially neurocognitive and functional outcomes. “Patients want to know about how we do surgery and conduct anesthesia and how it will affect them functionally, and how decision-making around those things will impact their day-to-day lives,” Dr. Spence shared. “Historically, we’ve studied the effect of interventions on morbidity and mortality, but not actually how it affects somebody’s life.” The major objective of her research is to better understand what leads to adverse neurocognitive and functional outcomes and then develop intraoperative strategies to improve how patients fare post-surgery.

In addition to her research obligations, Dr. Spence works clinically one week a month in the cardiac surgery intensive care unit, which means she’s on call 24 hours per day for that entire week. Dr. Spence also finds time to give back and share her knowledge and insights by providing review work for several peer-reviewed journals and volunteering on committees with member societies like the IARS and the Society of Cardiac Anesthesiologists (SCA). Additionally, she serves on the Board of Directors for SCA.

Over the years, Dr. Spence has consistently contributed to programs and committees with IARS, including serving on the IARS Outreach, Retention and Engagement Subcommittee and presenting research posters and sessions at several IARS Annual Meetings. However, her journey evolved further in 2021 when she was selected as an IMRA grant recipient for her research, “Genetic risk prediction of new atrial fibrillation after cardiac surgery.” With the support of this award, she was able to focus on genotyping the VISION Cardiac Surgery Biobank to enable the creation of a polygenic risk score for the development of new postoperative atrial fibrillation after cardiac surgery. This award represented a key stepping stone in her career and an opportunity to enrich her capabilities as an independent researcher. She has since gone on to obtain national and international funding for her research endeavors. The IMRA grant provided the foundation for future clinical trials to identify interventions to prevent and mitigate postoperative cognitive and functional decline. Additionally, the award’s requirement that each awardee have a dedicated senior mentor helped Dr. Spence develop her research skills and provided a vital opportunity for her to grow as a clinician-scientist.

Aware of the incredible mentors she has been fortunate enough to have helping her to develop her life and career, Dr. Spence has made guiding the next generation of clinician-scientists a major priority. “My first, most seminal mentor was PJ Devereaux, who was my PhD supervisor and who’s a cardiologist. A lot of people find it kind of interesting that as an anesthesiologist doing research about cardiac anesthesia, my primary research mentor is a cardiologist,” Dr. Spence reflected. “When I think of the people who I would call mentors, there’s a large number of people and only a small number of them are anesthesiologists. It’s actually made my research more relevant.” As an anesthesiologist, she acknowledges that it is easy to get limited to the operating room and to only understand that perspective.

However, by finding mentors from other specialties and other professions, including Dr. Devereaux, Richard Whitlock, a cardiac surgeon and a clinical trialist, and Dr. Stuart Connelly, an arrythmia physician, she has been able to understand how patients do in the long term outside of the hospital and outside of the context of surgery. She credits Dr. David Mazer as her key cardiac anesthesia mentor who has proved to be a crucial sounding board for her ideas. “All of them were absolutely key people in helping me understand how to put together a good question that’s relevant, and that funders are going to be willing to pay for,” she acknowledged. They helped her to focus on the questions that patients wanted answered and then provided the guidance on how to actually complete the research by pulling together international teams. This mentorship has proved instrumental in growing Dr. Spence as a clinician, trialist and clinician-scientist.

Dr. Spence believes mentorship is important at all stages of one’s career. “Everybody runs into roadblocks or questions or uncertainty and issues, and it’s so important to have people who have experience to turn to to brainstorm and figure out ways forward,” she shared. She has tried to pay that guidance forward as mentor for early-career anesthesia residents and medical students. Dr. Spence regularly makes time to mentor several students in health research, epidemiology, anesthesia and critical care, guiding them to develop and conduct their own research. “These are the people who are really at the stages where you can mentor them and encourage them to choose these more investigative, academic pathways where they’ll be able to contribute to generating knowledge in the future for our specialty,” Dr. Spence reflected. While some choose not to pursue this path, many do and continue to contribute to Dr. Spence’s research to advance the science and practice of perioperative medicine.

In order to allow her to provide undivided attention to her research for her time outside the cardiac ICU each month, Dr. Spence built a shed in her yard which became her research home. Building this space was a necessity during the COVID-19 pandemic as Dr. Spence discovered that trying to conduct research in her home office led to consistent interruptions from her children. She spends much of her time in her research home conducting meetings with her project teams, research coordinators and assistants coordinating clinical trials. A few times a month, Dr. Spence will also meet with her research team at PHRI for troubleshooting and brainstorming.

Although today, she works clinically in the cardiac surgery intensive care unit and as a cardiac anesthesiologist, prior to medicine Dr. Spence worked as an occupational therapist, where she focused on helping individuals to complete the basic tasks they needed to function in their day-to-day lives. This spurred her initial interest in medicine. Initially, she wanted to be a neurosurgeon and conducted a lot of research in neurosurgery and neuroradiology. However, when she began her clerkship and began to rotate through different clinical services, the ICU and anesthesia caught her attention. She was drawn to the detail-oriented nature and focus on physiology, and anesthesia pulled all her interests together. “I had this aha moment where everything just kind of fell into place. Now it makes a ton of sense how my research focus evolved from my original background training. It actually gives me a unique perspective,” Dr. Spence recalled. “For somebody to have open heart surgery, we literally saw open their chest, arrest their heart, and put all their blood through a machine for a few hours, and then stop putting the blood through the machine, give it all back to them, and then sew them back together. But we’ve never actually studied the effect that something so invasive has on somebody’s ability to do their day-to-day tasks like put on their pants, which is bananas.” This fascination with really complex, involved and invasive procedures and how they affect patients was the underpinning for her career and research path.

Although her career journey in academic anesthesiology has proved fulfilling, it was not without challenges. “There is always the challenge of balancing between clinical demands, which is why we exist, and dedicating and protecting time for academic endeavors and productivity,” Dr. Spence shared. “As decision-making and healthcare becomes more driven by the bottom line, and budgets get tighter and funding gets cut, it’s going to be more and more challenging to carve out a place. The only way that we can grow and evolve as a specialty is through academic endeavors and research.”

In her role as a newly elected IARS Board Member and through her many research and clinical responsibilities and mentorship priorities, Dr. Spence will continue to search for solutions to protect the time for those conducting academic anesthesiology while creating a vital community to build up the young anesthesiologists and scientists in the specialty who are searching for a research home like she found in IARS.