anesthesia and research

[Adcadet]

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hey all -

was wondering if anybody could comment on anesthesiology and research. Are there many anesthesiologists that do research? Many MD/PhDs in anesthesiology? It seems that the lifestyle/work arrangements of anesthesiology would allow one to both practice medicine and do bench research and still maintain some sanity.

Is research experience an important part of being a competitive residency applicant?

Thanks all!
Adcadet

 

[Adcadet]

anybody....?

 

[NaeBlis]

if you want to do research, you have to take an acedemic pathway, work at acedemic hospital. Where will you split your time supervising/teaching residents, and doing research. If you do this you will not make nearly as much as you might working in the private sector. Anesthesia is called a lifestyle speciallity, as is radio, but these things are relative. If you want to make a good salary in the private sector, you work hard for it, and there is not enough time left to do any serious research. As for being a phd, if you mean to do basic bench research, then you really need a phd, but if you plan to do more clinically oriented research you don't.

 

[Adcadet]

it seems some people think that one specialty or another is more conducive to a career spent juggling research and clinical practice (in an academic/university setting). Some here at SDN have commented upon the relative ease of balancing clinical ophthomology and research. Just wondering if anesthesiology tends to be that way. Is it common for anesthesiologists to conduct basic or applied research in addition to doing patient care (at teaching hospitals and universities)?

Second of all, it seems that some residencies appreciate research experience more than others (perhaps very helpful for derm or ortho surg, less so for FP; although I wonder if this is mostly just a function of that specialy's selectivity). I'm wondering if previous research experience/publications/research potential is viewed as an important part of an applicants package when applying anesthesiology, or if it's all about board scores, letters of rec, and anesthesiology rotation.

 

[NaeBlis]

Originally posted by Adcadet
it seems some people think that one specialty or another is more conducive to a career spent juggling research and clinical practice (in an academic/university setting). Some here at SDN have commented upon the relative ease of balancing clinical ophthomology and research. Just wondering if anesthesiology tends to be that way. Is it common for anesthesiologists to conduct basic or applied research in addition to doing patient care (at teaching hospitals and universities)?

It isn't really common at all in anesthesia. You basically have 2 possible routes to take, a clinical or academic path. If you take the clinical route you you will do clinical work all the time and be well paid for it. You may occasionally write up an interesting case and get it published, but that is almost incidental. You will not have the time or facilities to do any research, and the other members in your group won't appreciate picking up the extra slack if you decide to take time off for research. The second path is the acedemic path at a university hospital. There you won't do too much clinical work, and much of what you do will be teaching residents. Some who do bench research don't ever go near the OR. You take a major pay cut for this path. That is why there is a shortage of acedemic MDA's right now, the job market is great, and they are being drawn into it.

Originally posted by Adcadet

Second of all, it seems that some residencies appreciate research experience more than others (perhaps very helpful for derm or ortho surg, less so for FP; although I wonder if this is mostly just a function of that specialy's selectivity). I'm wondering if previous research experience/publications/research potential is viewed as an important part of an applicants package when applying anesthesiology, or if it's all about board scores, letters of rec, and anesthesiology rotation.

It's not really that important right now, even with the process being more competative, because they are looking to train clinicians more than researchers. If you tell them you want to pursue an acedemic path, they will not necessarily take more intrest in you, in my experience they don't at all. That might change as the shortage ofacedemic anesthesiologists grows.

 

[Adcadet]

Thanks, NaeBlis. Kindof depressing to hear that research isn't a bigger deal in anesthesiology. Perhaps the shortage of academic anesthesiologists would explain why my school's anesthesiology dept. looks a bit on the baren side.

 

[hermanodequeso]

hey adcadet,

don't fret...there is lots of interesting research in anesthesiology. in fact, the feasibility of a life combining research and clinical medicine was a huge factor drawing me into the field. true, as an academic, you will not make a kazillion dollars, but there are other rewards in life and being at the forefront of an exciting field of medicine is far more motivating than a big row of dollar signs...to me anyway. i have seen many academic anesthesiologists that have achieved a successful balance between research (both bench and clinical) and clinical careers.

as for residencies looking for applicants with research...it's clearly true that you can match into top notch programs without research or the desire to ever step foot in a lab, but program directors and department chairs are very aware of the future of academic anesthesiology and are itching to recruit and train a new generation. if you're fired up, they will be as well.

best of luck and know that there is a lot of great research being done and yet to be done in the field.

 

[NaeBlis]

Originally posted by hermanodequeso
hey adcadet,

don't fret...there is lots of interesting research in anesthesiology. in fact, the feasibility of a life combining research and clinical medicine was a huge factor drawing me into the field. true, as an academic, you will not make a kazillion dollars, but there are other rewards in life and being at the forefront of an exciting field of medicine is far more motivating than a big row of dollar signs...to me anyway. i have seen many academic anesthesiologists that have achieved a successful balance between research (both bench and clinical) and clinical careers.

as for residencies looking for applicants with research...it's clearly true that you can match into top notch programs without research or the desire to ever step foot in a lab, but program directors and department chairs are very aware of the future of academic anesthesiology and are itching to recruit and train a new generation. if you're fired up, they will be as well.

best of luck and know that there is a lot of great research being done and yet to be done in the field.

I definately agree that there is alot of interesting research going on out there and the potential for alot more. Not many people know this but we have no clue how inhaled anesthestics work, how the produce anesthesia and analgesia. That alone show how much ground there is to cover.

Despite that, my experience is that PD's aren't eagarly or actively looking for potential acedemics. Many of them even say, we are looking to train clinicians. I think they take a kinda of passive zen approach to it. Those who are meant to do academic work will find the path to it themselves. I think i can understand why that is, it does take commitment, more schooling/training, and a sacrifice in income.

 

[hermanodequeso]

i think it really depends on where you're looking. for instance, at university of washington, the pd flat out told me that the department has met and is actively recruiting resident applicants that are more academically oriented. the traditionally academic places are trying to repopulate, while the more clinically-oriented places are trying to do the same. you just have to figure out what you want and go from there....there are lots of very high quality training programs of each variety, as well as some that advocate both.

i'd be happy to comment on the places that seemed more interested in academically oriented folks.....for anyone interested in this year's match.

 

[NaeBlis]

I guess you're right, probably does vary program to program, I only interviewed at about 10 programs, in a small geographic area. Out of curiosity, are you planning on an acedemic path hermano? I am considering it myself, since it is the science of anesthesiology that drew me to it, but I'm not sure I will be able to resist the money of a clinical path, especially with all my med school loans still hanging over me.

 

[mpp]

I think it would depend on the program. At the Mayo Clinic there are 14 M.D.'s and 1 M.D./Ph.D. that do predominantly anasthesia research in everything from the clinical (cardiopulmonary bypass, coagulation), the practical (muscle physiology and exercise), to the benchtop (cellular toxicology) and this is just at the Rochester campus. (Anesthesiology research website is http://mayoresearch.mayo.edu/mayo/research/anesthesiology/ ). These doctors are supported by many research fellows: both Ph.D.'s and M.D.'s.

I work in anesthesia research and enjoy it immensely. I don't think I want to be an anesthesiologist, but there is definitely a place for those that want to do both clinical and research anesthesiology.

 

[DarksideAllstar]

Originally posted by NaeBlis
I definately agree that there is alot of interesting research going on out there and the potential for alot more. Not many people know this but we have no clue how inhaled anesthestics work, how the produce anesthesia and analgesia. That alone show how much ground there is to cover.

I worked in a lab at UCSF that study the mechanisms of action of inhaled anesthetics (iso, des, halo) and did a few fear conditioning studies with these agents and agonists/antagonists as well.

Some of my observations:
1) New school faculty. My project was centered around a hypothesis proposed by an associate professor. He spent 3-4 days/week in a clinical setting as well as juggled grant writing. He was an MD (no PhD). We collaborated with an MD-PhD from the same department, who just got his own lab over at SFGH. He also split time between the clinical setting and the lab. You wont see many investigators do both clinical and work at the bench.

2)Old School faculty. The PI heading our group was writing a textbook the year I was there. He oversaw the grants, edited papers, etc. He did little (1 day/mo) to no clinical work. He was very involved in the lab on a day-to-day basis.

Other faculty members that shared some bench space with us were almost never there. They wrote grants, checked on a project's progress, but generally spent most of their time at clinic.
Also, the way that I understood the process was that the more grant money you brought in, the less your clinical responsibilities become.

In short I think it varies whether or not you spend your time in the clinic vs in the lab. I have seen some do both, but I would tend to say that faculty who have decent grant $$ coming in hire a "staff scientist" (not to generalize, but the ones I have seen have been from China) to give the techs and the post-docs help on a day to day basis with experiments, etc while they are in clinic. Also, by no means do you need to have a PhD to do research, but it helps so that you know how to think about, plan, and carry out a series of experiments properly. I think that for the most part an MD w/o a sufficient amount of research training would be a little "immature" in this regard, but you can always work hard and make up for it.

Anyway, hope this post was helpful, and by no means is it the same at every institution, just something I noticed while I was at UCSF.
later

 

[Veritas]

Sorry for bumping up an old thread, but I had a couple questions about this too. I have zero research experience and am not really interested in getting any. Thing is, I really want to try to get into a residency back home in California. Looking around though, looks like these programs are all pretty competitive. UCSF I know is a longshot no matter what, but does anybody know anything about Stanford or Davis? Would a lack of research experience be considered a big negative there? What about LA programs? Any replies would be greatly appreciated.

 

[Emily2009]

i guess that i'm replying an old thread. however the question they were discussing is very interesting to me.

my question here is:

i'm very interested in anesthesia. my research is basic research, about the chromatin structure. so it is really not relevant to anesthesia. i will get my phd from a fairly good graduate school later this year. i wonder whether this type of research could help me with application to anesthesia.

 

[fakin' the funk]

i guess that i'm replying an old thread. however the question they were discussing is very interesting to me.

my question here is:

i'm very interested in anesthesia. my research is basic research, about the chromatin structure. so it is really not relevant to anesthesia. i will get my phd from a fairly good graduate school later this year. i wonder whether this type of research could help me with application to anesthesia.

This issue is pretty well addressed in the FAQs (I think). In any case, a few points I learned on the interview trail, being a non-PhD research-oriented person with substantial anesthesia research:

Anesthesia is not a big research field.
Very few applicants are MD/PhDs.
Very few applicants have done substantial anesthesia research.
More, but still a minority (I'm estimating), have done substantial research in any field.
Many have done some kind of research somehow for whatever amount of time.
Most say they're interested in research.
Programs like, or at least say they like, academically-minded residents.

It's all about how you sell it. If you go to WashU or UCSF and say "I'm an MD/PhD, my career goal is to have my own basic science lab after anesthesia residency" they will look kindly on you since such institutions recruit a certain number of future academicians each year. However if you go to Podunk Hospital and say the same they are going to wonder why you're interviewing there.

As a MD/PhD from a non-anesthesia research focus you certainly could have an advantage at certain top research programs, but don't forget, anesthesia is all about being a likable person and a good resident so lacking in that area can hose you as well.

Best of luck.

 

[Emily2009]

Thanks for your kind reply.
I appreciate it.

This issue is pretty well addressed in the FAQs (I think). In any case, a few points I learned on the interview trail, being a non-PhD research-oriented person with substantial anesthesia research:

Anesthesia is not a big research field.
Very few applicants are MD/PhDs.
Very few applicants have done substantial anesthesia research.
More, but still a minority (I'm estimating), have done substantial research in any field.
Many have done some kind of research somehow for whatever amount of time.
Most say they're interested in research.
Programs like, or at least say they like, academically-minded residents.

It's all about how you sell it. If you go to WashU or UCSF and say "I'm an MD/PhD, my career goal is to have my own basic science lab after anesthesia residency" they will look kindly on you since such institutions recruit a certain number of future academicians each year. However if you go to Podunk Hospital and say the same they are going to wonder why you're interviewing there.

As a MD/PhD from a non-anesthesia research focus you certainly could have an advantage at certain top research programs, but don't forget, anesthesia is all about being a likable person and a good resident so lacking in that area can hose you as well.

Best of luck.

 

[QofQuimica]

i guess that i'm replying an old thread. however the question they were discussing is very interesting to me.

my question here is:

i'm very interested in anesthesia. my research is basic research, about the chromatin structure. so it is really not relevant to anesthesia. i will get my phd from a fairly good graduate school later this year. i wonder whether this type of research could help me with application to anesthesia.

I am also an MD/PhD-to-be (PhD in chemistry) in my third year of med school. I have been looking at residency programs, and I have found some that are research residencies looking for applicants with significant research backgrounds. Some are residency + fellowship, and some have protected time during residency. One user named spacedman is an MD/PhD who just matched into anesthesiology, and he had a thread a while back about anesthesia research programs. If you do a search in this forum you should be able to find it, and it will give you the names of some of the research residencies we had linked. Hope this helps, and best of luck if you're applying this summer. 🙂

 

[lushmd]

I'm an MD/PhD (PhD in cancer biology/cell cycle regulation) that matched in anesthesiology last year. The caliber of programs that you'll likely be interested in will find your research background enticing and it will help differentiate you from other candidates. The key is to show that your PhD training, while in a specific area of basic science, can be more broadly applied. After all, the ultimate goal of a PhD is more than developing/addressing a scientific question, publishing, etc... Be prepared to answer questions re if/how you plan to apply your PhD to anesthesiology, etc... Having said that, as FTF pointed out, regardless of the field that you apply to you need to be someone that people want to work with. Let me know if you have any other questions.

 

[Spacedman]

i totally agree with the above posters - basic science is a huge plus when applying to anesthesiology departments at major research universities, but the clinical aspect of your application has to be solid as well. Also, without exception, every program i visited emphasized that excellent clinical skills were the priority in residency training - i.e. very little in the way of "fast tracking", with the possible exception of UCSF's "innovative research residency" track.

as far as your interest in basic research, if you have papers to show for it, i think you'll get a very warm reception. just as an example, the chair of brigham (c. vacanti) is very well known for work in tissue engineering, which doesn't have the most obvious link to anesthesiology. IMHO, the most forward thinking departments see an applicant/resident with a successful basic science background as a way to expand the scope of anesthesiology.

FWIW, here's a past thread - some of the links may be dead, but it has some basic information.

feel free to PM me if you have any questions.

 

[Brunette1981]

This thread is very interesting to me - I'm in a similar situation, MD/PhD student at top 5 medical school, OK scores/grades (not awesome, not bad, sorta middling for my school), good publication/research award record.

I have a PhD in Pharmacology and I'm deciding between applying in IM and anesthesia. I loved my anesthesia rotation and I am starting to dislike the endless rounding of IM but I might like a more procedural IM field like GI.

I haven't done specific anesthesia research but I do basic science stuff on designing therapeutics and determining drug mechanism. I definitely do not want to go into private practice, really want academics and a bench/clinical balance.

Anyone else have any thoughts on physician scientists in anesthesia? Our MSTP PD is not encouraging of the field.

Also, it doesn't really matter to me, but does anyone know what the pay range is for starting academic anesthesia? I don't mind making significantly less than PP but I don't want to make 90,000 either...

 

[Emily2009]

Thanks so much, QofQuimica, lushmd, Spacedman, for your nice post and positive information!

I wonder whether anyone would comment on the percentage of female anesthesiologist-researcher?

all the anesthesiologist-researchers i know are male. i know some female chairman, but not any female anesthesiologist-researcher...

i just don't want to be over-ambitious. since i do want to have a family in the near future...

thanks for any inputs!!

 

[QofQuimica]

Thanks so much, QofQuimica, lushmd, Spacedman, for your nice post and positive information!

I wonder whether anyone would comment on the percentage of female anesthesiologist-researcher?

all the anesthesiologist-researchers i know are male. i know some female chairman, but not any female anesthesiologist-researcher...

i just don't want to be over-ambitious. since i do want to have a family in the near future...

thanks for any inputs!!

I know one full-time female anesthesiologist basic science researcher at my institution as well as some others who do clinical research or are primarily clinicians and do clinical research part time. None of them are MD/PhDs though, if that's what you're asking. But then again, women MD/PhDs are underrepresented in general, as are MD/PhDs in anesthesiology.

This issue of balancing career and family in medicine comes up on a regular basis, and there is no easy answer to it. Here's my take: there's no way to get around the reality of the fact that there are a finite number of hours in a day. If you want to have a family that you see on a regular basis, you will have to make sacrifices to do it. For example, you will not be able to devote the time to your career that a woman like me with no family can. There will also never be a perfect time to have your children, and people have children at all levels of training. The one thing I have observed that maximizes a woman's success at balancing it all is that she needs to have *a lot* of support. So your husband/partner needs to be on board, you need good child care, and you need to be prepared for contigencies such as if your child gets sick while you're at work, etc.

If you're interested in discussing these issues with other women in medicine who have children, I recommend that you come check out the Nontraditional Student forum. If you do a search there, you will find multiple threads about the work-family balance. Hope this helps, and best of luck. 🙂

 

[xjohns1]

Thanks so much, QofQuimica, lushmd, Spacedman, for your nice post and positive information!

I wonder whether anyone would comment on the percentage of female anesthesiologist-researcher?

all the anesthesiologist-researchers i know are male. i know some female chairman, but not any female anesthesiologist-researcher...

i just don't want to be over-ambitious. since i do want to have a family in the near future...

thanks for any inputs!!

i can't quote you a percentage of female anesthesiologist-scientists but they are very much out there. jeanine wiener-kronish is a superb example. she is an anesthesiologist-intensivist, NIH funded, and has interests that are not directly related to or anesthesia. she is now the chairman at the massachusetts general hospital. there are several female investigators at my program but clearly women are underrepresented in the specialty as a whole.

 

[xjohns1]

This thread is very interesting to me - I'm in a similar situation, MD/PhD student at top 5 medical school, OK scores/grades (not awesome, not bad, sorta middling for my school), good publication/research award record.

I have a PhD in Pharmacology and I'm deciding between applying in IM and anesthesia. I loved my anesthesia rotation and I am starting to dislike the endless rounding of IM but I might like a more procedural IM field like GI.

I haven't done specific anesthesia research but I do basic science stuff on designing therapeutics and determining drug mechanism. I definitely do not want to go into private practice, really want academics and a bench/clinical balance.

Anyone else have any thoughts on physician scientists in anesthesia? Our MSTP PD is not encouraging of the field.

Also, it doesn't really matter to me, but does anyone know what the pay range is for starting academic anesthesia? I don't mind making significantly less than PP but I don't want to make 90,000 either...

i think the field is rich with opportunity for research. and, like was mentioned, the best departments will foster broad research, not just the traditional how-do-volatile-agents-work sort of thing (though, this remains important work). some of our most prominent research faculty have major programs not closely related to clinical anesthesia. also, the best departments will pay on a scale at or very competitive with that of the clinicians in the department (though at least in my department, this comes with some clinical commitment). there is at least one faculty in our department that sits on the MSTP governing body at ucsf and there are several mstp graduates both on the faculty and in the residency program--never mind your mstp pd. if you're broadly strong and genuine you'll be warmly welcomed by the best departments. look carefully for departments with a long history of supporting research and with faculty that could be potential mentors. in my opinion, having options for strong mentors is among the most important factors in deciding where to begin a research career.

 

[Emily2009]

Thanks, QofQuimica! You sound very nice and positive. I'm sure that you will be a great doctor!

Also, Thanks, xjohns1, for the examples!

I will try my best now and see where life is taking me later on.

Keep in touch!

 

[211498]

A little OT, but maybe you can help me with my question.

I'm a future FMG (graduation late 2011) from Germany who would like to go to the US later and do an anesthesiology residency.

I'm currently a member of a clinical radiology reseach group, when the project is finished next year I'll probably end up with one (maybe two) co-authorships. I haven't taken Step 1 yet, but I'm looking fowad to do that during this years fall. Next year I'm planing to do some visiting GAS electives in the states.

I think that I'd like to do some reseach at an anesthesiology dept. in the US for a year or so before applying for residency.

Could someone tell me how hard (or easy) it is to find a postdoc job at an anesthesiology dept. in the east or midwest with my backround (no anesthesiology research, no basic lab knowledge), I'd need a visa obviously.