P056: CURRENT TRENDS IN LEADERSHIP AMONGST CRITICAL CARE ANESTHESIOLOGY FELLOWSHIPS
Alexandra E Goldman, BS1; Mikahla E Gay, BA1; Brayden Tolman, BS1; Jose G Lima, BS1; Javier J Garcia, MD2; Terrie Vasilopoulos, PhD2; Brenda G Fahy, MD, MCCM2
1Herbert Wertheim College of Medicine; 2University of Florida
Introduction: Critical care anesthesiologists provide pivotal leadership in the management of critically ill patients which requires intensive, dynamic care to ensure optimal recovery. Fellowship directors (FDs) hold a versatile role as leaders in this field through clinical mentorship, curriculum advancement, and innovative research for the next generation of critical care anesthesiologists. This study aims to assess trends in demographic characteristics and training experiences among adult critical care FDs in the United States.
Methods: The Society of Critical Care Anesthesiologists (SOCCA) was queried for critical care programs to identify current FDs. Once identified, demographic and training information was obtained for each FD. The variables collected included international medical school graduate (IMG) status, training institutions, year of training completion, year of hire, year of FD appointment, Hirsch-index (h-index), number of publications, number of citations, and Alpha Omega Alpha (AOA) membership. Medians (25th – 75th percentiles) and counts/proportions were utilized to summarize the data. Wilcoxon tests and Spearman’s rho correlations were used to analyze associations.
Results: Seventy-two critical care FDs were identified. Three were excluded due to program closure. Demographic data was available for 69 FDs (95.8%). Among all FDs, 18.8% were IMGs and 20.3% completed an additional fellowship, most commonly cardiothoracic anesthesia. The most common residency training institutions were Brigham and Women's, Massachusetts General Hospital, and University of Chicago (n=3). The most common fellowship training institution was Cleveland Clinic (n=5). The median time from fellowship graduation to FD appointment was 6 years (n=68). The median time from hire to FD was 4 years (n=67). Institutional loyalty was defined as FDs who were appointed at an institution in which they completed training, either residency or fellowship, which was demonstrated by 48% of FDs. Further analysis revealed that 39% became FDs at their critical care or additional fellowship institution, 32% became FDs at their residency institution, and 23% were appointed at the institution where they completed both residency and fellowship. The FDs had a median H-index of 5 (2-9, n=67), a median number of publications of 11 (5-21, n=67), and a median number of citations of 110 (35-425, n=67). Time from fellowship graduation to FD appointment was positively associated with number of citations (rho=0.31, p=0.012) and H-index (rho=0.24, p=0.056). Of the 69 FDs included, 9% were inducted into AOA. FDs in AOA (n=6) had a higher median H-index (10 vs 4, p=0.061), number of publications (20 vs 10, p=0.144), and citations (425.5 vs 102, p=0.17).
Conclusion: Our study found that most FDs were U.S. medical graduates appointed 6 years after fellowship completion. Nearly one-third completed residency at the same institution where they became FDs, but more returned to the institution of their fellowship training in critical care or cardiothoracic anesthesia. Our findings indicate that this group places value on institutional loyalty and specialized training, demonstrating a strong commitment to mentorship, expertise, and advancement of the field.