It is my hope that this issue of the Interchange finds you well. 2020 promises to be a year in which SOCCA will continue to evolve and advance the profession of anesthesiologist intensivists.

It is my pleasure to take the helm of editing Interchange, but I must first acknowledge the antecedent efforts of Kevin Hatton. Kevin advanced the content, consistency, and formatting of the newsletter while also soliciting contributions both from the Society’s leadership and membership, alike. It will certainly be my goal to maintain forward momentum in these areas.

Have you visited SOCCA’s Job Board recently? Read members-only job posts—including a position with the Department of Cardiovascular and Thoracic Surgery at the University of Louisville School of Medicine—at SOCCA’s Job Board.

At the recent SOCCA Board meeting prior to the annual Anesthesiology conference, we continued to explore means by which to grow and sustain the organization’s membership. Understanding our membership patterns, and the challenges our members face, is key. One critical issue that we have identified is member loss during transition periods: namely residency to fellowship and fellowship to faculty.

There has been a lot happening at the program director level over the last year, and that is by and large substantively good news. One critical topic that bears reporting is the outcome of the Anesthesiology Critical Care Fellowship match that took place in the spring of 2019. The associated trends here bear close review as the news is not entirely positive.

The restriction of trainee work hours in 2006 transformed post-graduate medical education. While intended to promote work-life balance and wellness, the undesired consequence was limitation of experiential clinical learning opportunities. Simulation Based Medical Education (SBME) has helped fill this gap by providing an opportunity for deliberate practice with immediate feedback, enhancing acquisition of medical knowledge and skills.

The aerospace industry is rightly recognized as a model for the utility of high-fidelity simulation, and the medical education community has sought to apply and extend this experience. However, a staggering amount of research, engineering, and resources underlies the success of aerospace simulation, which is likely underappreciated by physicians.

Since the first organ transplant from a brain-dead donor performed in 1963 by a Belgian surgeon, the topic of organ donation and brain-dead donors has often been a moral and ethical impasse amongst the public as well as physicians. Intensivists, along with Neurologists, have become the primary referring physicians for these donations.

Landmark trials over the past three decades have fostered appreciation for the potentially injurious effects of mechanical ventilation. Current approaches to lung protective ventilation include the limitation of tidal volumes (V_T) to 6 ml/kg PBW, restriction of plateau pressures (Pplat) to no more than 30 cm H₂O, and attention to driving pressures.

Sooner or later, many of us will be faced with an unpleasant reality: a major health problem requiring medical care. Often, this may entail surgery or critical care. In theory, physicians should be well-prepared for this eventuality. After all, we have a great deal of first-hand knowledge about the perioperative environment and should be comfortable negotiating difficult or uncomfortable situations. Why then do we feel so much stress when these problems hit close to home?

If you have an interesting case report, an idea for a pro-con discussion, a review idea, or an opinion on a recently published article, please review the submission guidelines, then submit your proposal/ article to the Newsletter Editor, Craig S. Jabaley, MD at csjabaley@emory.edu on or before January 17, 2020. If your article is chosen for the newsletter, we will contact you for editing and formatting. Thank you.