Resident scholarly activity costs money, produces results and does not seem to significantly diminish a resident’s clinical exposure during residency. (Image source: Thinkstock)
Resident scholarly activity costs money, produces results and does not seem to significantly diminish a resident’s clinical exposure during residency. (Image source: Thinkstock)

Research dollars awarded to anesthesiology departments through the National Institutes of Health has increased, yet the amount that anesthesiology departments receive is a small percentage of other specialties.  Research improves the academic standing of our specialty as well as the care of our patients.  The Accreditation Council for Graduate Medical Education (ACGME) encourages research training during anesthesiology residency training.

Dr. Tetsuro Sakai, Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA and colleagues examined the impact this has in terms of resident education and departmental expense (since residents also help manage patients).  Their analysis is presented in the manuscript “The Cost of Resident Scholarly Activity and Its Effect on Resident Clinical Experience” published in this month’s issue of Anesthesia & Analgesia.

The authors reviewed data from their institution from 4 residency classes who graduated between 2009 and 2012.  Their residents were allowed to spend up to 6 months during their residency in a nonclinical research rotation.  Residents had to find their own research mentor(s) and project(s).  The projects could consist of hypothesis-based research, creation of educational material, or preparation of a grant proposal.  During their research rotation, residents had to take one weekend call per month but were not responsible for weekday call.  They were allowed to take vacation during this rotation.

Twenty-four residents completed a resident research rotation (RRR group).  The average length of the rotation was 3.7 months.   These residents had more prior experience with peer-reviewed publications, had additional degrees, had a lower chance of failing a final mock oral examination, and more often entered a fellowship after graduation relative to their peers from the same institution who did not go through this research rotation (Non-RRR group).  When compared with their peers, the RRR group also completed more scholarly projects (5 vs 2), attended more national and regional research conferences (2 vs 1).  Every resident who completed a research rotation satisfied the ACGME requirement for number of cases. As expected, they completed fewer cases (980 vs 1182) than the ron-RRR group. Also as expected, the longer the time spent in the research rotation, the fewer cases were completed.  Specifically, the RRR group performed fewer intrathoracic cases with cardiopulmonary bypass, fewer obstetric cases, and fewer cases of regional procedures combined.  Average departmental cost per resident per month during this research rotation (defined as cost of a CRNA to cover for a resident when away from clinical activity) was $13,500, and for the average time of 3.2 days for conference attendance, this cost the department $2,160.  The total average cost, including CRNA coverage and reimbursement for travel, was $27,467.

This cost might seem high. However, time spent in dedicated research projects produced results. Anesthesiology is more than a clinical specialty. Funding for research can have a substantial return on investment for the individual and the specialty. More fundamentally, our specialty will survive only if we can continue to generate new knowledge and foster the next generation of academic anesthesiologists.