Can we get there if we don't know where we're going?

摘要

JERRY Reves' 2006 Rovenstine lecture, which is published in this issue of Anesthesioi.ogy, accurately describes the diminutive research portfolio of American academic anesthesiology departments; among medical specialties, only family medicine garners fewer National Institutes of Health grant dollars per faculty member. His lecture identifies the "root causes" for low research productivity, including failure to attract research-oriented trainees, low research expectations of residents and faculty, inadequate research mentorship, and antiresearch financial incentives. Reves' plan to improve anesthesiology research calls for (1) scholarships to recruit M.D., Ph.D. students to anesthesiology residencies; (2) increased research time during anesthesiology residency; (3) incorporation of a mandatory research year into all subspe-cialty fellowship programs; (4) changes in academic compensation plans to reward research; and (5) abolition of the Medicare teaching rule for anesthesiology. This lecture is a cogentprecis of many of the "systems problems" that obstruct research training in anesthesiology and should be required reading for every anesthesiologist.