April 3, 2025

Shahzad Shaefi, MD, MPH, IARS Board Member

Shahzad Shaefi, MD, MPH, first heard about the International Anesthesia Research Society (IARS) from his mentor Dr. Monty Mythen while completing medical school at the University College London Medical School in London in 2001. However, he didn’t fully grasp the scope of the organization’s role for the Anesthesiology specialty until he moved to the US in 2009 after completing residency and began his fellowship in Anesthesia critical care and later cardiothoracic anesthesia at Columbia University Medical Center under Dr. Robert Sladen, an IARS board member at the time. Dr. Sladen, a universally respected physician, served as a role model for Dr. Shaefi and instilled in him a drive to contribute meaningfully on a deeper level to IARS and to the specialty as a whole. This led Dr. Shaefi to immerse himself in all the resources available through IARS from the Annual Meeting to webinars and engage significantly in the IARS community. Now the Vice Chair of Professional Affairs for the Department of Anesthesia, Critical Care and Pain Medicine and Co-Director of ECMO Services at Beth Israel Deaconess Medical Center (BIDMC) and Associate Professor at Harvard Medical School, Dr. Shaefi is motivated to continue to contribute to that community by joining the IARS Board of Directors as one of its newest members. With his well-rounded background as a cardiac anesthesiologist and intensivist and clinician-scientist with experience in basic, translational and clinical science, he offers a unique perspective and passion for patient-centered care that will greatly benefit the IARS Board as they guide the diverse community of clinician-scientists to advance the science and practice of medicine.

“The IARS is the premier organization for anesthesia clinicians, clinician-educators, clinician-scientists and researchers, certainly globally,” Dr. Shaefi relayed. “We are moving into an important time where interaction, dissemination, networking and fellowship as a community is rightly so being increasingly sought after. I would love to add value for our global profession with a view to professionally, geographically and culturally diverse backgrounds.” Although Dr. Shaefi believes the IARS does a fundamentally outstanding job at outreach, he hopes to lean on his extensive network, built while training in the United Kingdom, to expand that reach. Extremely conscientious about the importance of the IARS Board role, he is motivated to develop more initiatives and support for the IARS community to benefit the clinician-scientist in all stages of their career.

Mentorship and serving as a vital resource for the over 300 members of faculty, trainees and CRNAs in his department is consistently prominent in Dr. Shaefi’s mind throughout his work and administrative role as the Vice Chair of Professional Affairs at BIDMC. He strives to provide a wealth of knowledge to meet the most crucial needs of his anesthesiology community. This guidance covers a wide range of topics including mentoring, sponsorship, academic promotion and leadership development. Dr. Shaefi recognizes it is crucial for early-career clinician-scientists to develop their careers outside clinical practice as they search for their path in the anesthesia research specialty.

Having defined himself as a clinical anesthesiologist with a strong commitment to provide exceptional care to patients in the operating room and intensive care unit, Dr. Shaefi himself did not find his way to research until he was already a junior faculty member. However, compelling questions around oxygen use during cardiac surgery continued to surface for him and he was motivated to seek those answers. His first foray into research began with a clinical randomized controlled trial characterizing the relationship between administered intraoperative oxygen levels to postoperative neurocognition in cardiac surgical patients, in 2016, funded by a Foundation of Anesthesia Education and Research Mentored Training Research Grant. This initial investigation turned out to be an importantly negative study which led him to even more questions and spurred his curiosity. “I look back as an investigator at that initial study and smile at my naivete. Importantly, it led me to think more about the mechanisms at play,” Dr. Shaefi reflected.

This initial funding acted as a springboard for a succession of grants that followed including a GEMSSTAR award from the NIH and NIA in 2018 and a K08 from the NIH and NIGMS in 2019, spurring his growing passion for research. Through these early grants, he gained experience in both clinical research, translational multiomics approaches and bench science. Eventually, he returned to clinical trials and began a series of NIH-funded clinical trials looking at neurological and renal outcomes in cardiac surgery, as well as exploring shock and septic shock and aspects of endotype characterizations on the ICU. “Septic shock mortality rate has remained relatively constant over the last 40 years. Essentially, the vast majority of critical care clinical trials in sepsis have been negative and there really is a high priority that has been echoed by the NIH and other funding organizations to really go back to the drawing board,” he explained. “I certainly see that in our patient population and think about it a lot more.”

Now leading a busy research lab focused on clinical trials both in cardiac surgery and critical illness, Dr. Shaefi considers himself extremely fortunate to have found a research portfolio in his career that has spanned all spectra of research from basic to translational to clinical trials. “That really helps me in my administrative role to be able to give some input to folks as they piece through their investigative questions,” he shared.

Dr. Shaefi recognizes there are many areas that still need to be uncovered, particularly neuroscience and critical illness. “Critical illness is still somewhat immature in its understanding and characterization. We haven’t really made any huge in-roads into specific interventions that confer survival benefit in intensive care. There has been a series of large clinical trials that have largely been negative. Now, there is a growing acknowledgement that taking a heterogeneous population who happens to be housed in the ICU forms a somewhat flawed basis for a ‘lumped together’ interventional population,” Dr. Shaefi contemplated. “IARS certainly has supported through its grant mechanisms a lot of varied work and importantly a lot of neuroscience research which is absolutely key.” He points to the neuroscience of mechanisms of anesthetic action and the neurocognitive sequelae of perioperative insult that require further study. “We are certainly the masters of controlling that domain in the perioperative space, and therefore we can and must have continued to pioneer what is a cornerstone of our practice,” he stressed.

Despite the significant time Dr. Shaefi has spent pursuing essential research questions, he considers his role and responsibility as a clinician and intensivist looking after critically ill patients with great personal gratification and the defining trait of his career. “Every day with a new patient, or working with residents, fellows or CRNAs, there are many things that are anticipated and unanticipated. Our profession is challenging but also fulfilling in always reminding us of that responsibility and humility,” he expressed. Looking outward at the wider anesthesiology community, Dr. Shaefi acknowledges that for the younger generation of physicians and researchers finding a balance of clinical practice with purposeful career development can at times be amorphous, a gap he continues to aim to fill.

“The future is very bright. Anesthesiology remains a highly competitive specialty. Aspects of physician fulfillment and wellbeing are conversations that are being had now and I believe these will be further addressed in time,” he reflected. “Aspects of how care is going to be delivered and the care teams we are currently involved with will change and will morph, and that will require some degree of expected nimbleness.” Dr. Shaefi remains optimistic and curious to discover what the future holds for the anesthesiology specialty, one he will certainly continue to shape positively at his institution, through his global anesthesiology networks and as a new IARS board member.