The ABA Research Committee facilitates studies to evaluate the efficacy of our programs to support strategic and operational decisions, to provide more transparency about the administration and scoring of ABA assessments and to provide information that advances medical education and physician well-being. Recent ABA articles published in Anesthesia & Analgesia offer important insights to residency training and anesthesiologist demographic trends with implications on the future of the specialty.
The first study, “Anesthesiology Residents’ Experiences and Perspectives of Residency Training,” is the result of a cross-sectional survey of anesthesiology residents polled between 2013 and 2016 to gauge experiential factors that could inform program improvements. Residents were asked to identify the most important factor in their choice of residency program, which aspects of the clinical base year (CBY) best prepared them for anesthesia clinical training and how well their residency had prepared them for proficiency in six Accreditation Council for Graduate Medical Education (ACGME) Core Competencies.
Of more than 4,700 residents who responded to the survey, most said they were satisfied with their choice of specialty (4.4–4.5 on a 5-point scale among cohort-training levels) and with their specific residency program (4.0–4.1). Residents responded that the most important factors they considered when choosing a residency program were the quality of clinical experiences (4.7–4.8) and departmental commitment to education (4.3–4.5), with location, reputation and work-life balance rounding out the top five.
Seventy percent of residents said their CBY prepared them well for anesthesiology residency. Residents in their first and second years of anesthesiology training reported that they considered rotations in critical care, anesthesiology and surgery/perioperative procedure management their most valuable CBY experiences. According to the survey, a positive CBY experience gave residents the opportunity to care for a diverse patient population, which helped them improve their bedside manner and communication skills. These CBY experiences also helped residents understand what to expect in terms of work volume and hours in future training years.
Residents in their second and third years of clinical anesthesia training reported favorable perceptions of their professional life. Those who did report concerns were most likely to be struggling with academic aspects of training rather than emotional, interpersonal or technical aspects. Most third-year residents said they were confident they would pass their certification exams on the first attempt and that they believe their residency program adequately prepared them for independent practice.
While the survey showed that anesthesiology residents were satisfied with their training experiences and were confident that they would master core competencies established by ACGME, more studies are needed to compare these perceptions to their performance as demonstrated in board certification exams. It would be helpful to know whether attending anesthesiologists, mentoring faculty members and program directors share the residents’ high confidence in their skills. All these factors together will help inform the evolution of anesthesiology training.
A second ABA study published in Anesthesia & Analgesia, “Demographic Trends from 2005 to 2015 Among Physicians with Accreditation Council for Graduate Medical Education-Accredited Anesthesiology Training and Active Medical Licenses,” offers insight on the dramatic decrease in anesthesiology residency graduations around the turn of the millennium and the resulting implications on our specialty in the years since. The study outlines the demographic changes in the 2005-2015 anesthesiology workforce and provides national and state densities of these physicians in relation to the total populations, temporal changes in the densities and medical license retention by mid- and later-career anesthesiologists.
Although the numbers of residency graduates have long since recovered, concerns about a shortage of anesthesiologists persist due to factors such as an aging population and an increased demand for healthcare. The data make a compelling case for today’s mid-career anesthesiologists to step up for leadership opportunities.