Colleagues, next year’s annual meeting will be in Denver, Colorado, on April 14, 2023. We have received many excellent submissions for next year’s annual meeting, and now the education committee has the difficult task of putting together the program. Some panels not selected for the annual meeting will be shifted to SOCCA webinars in 2023. More to follow.

Two years ago under the leadership of Drs. Robert Stevens and Matthew Warner the SOCCA Research Committee formed the SOCCA Data Subcommittee which was charged with expanding the portfolio of survey information that would be of interest and utility to our membership.

The SOCCA Membership Committee has been hard at work putting together a variety of programs for all of our members at various stages of their careers. For our graduating fellows, we put together a new “SOCCA Fellowship Exit Brochure” to make sure all of our newly minted intensivists are aware of everything SOCCA has to offer to them. This brochure was distributed with the help of the Program Directors committee. Our fellowship subcommittee also planned  our annual Job fair, which occurred on October 5.

The strength of SOCCA is the wealth of talent and energy of its members. One of the ways to serve the Society is through volunteer activities. The SOCCA Nominations Committee annually evaluates nominees and develops an election ballot for available Officer and Director positions. This election cycle we will be electing 3 members for the Board of Directors (3-year term). Further details about the governance structure of SOCCA are described in our Society Bylaws.

SOCCA is pleased to announce the debut of the Innovators Award.

Created through a generous anonymous donation, we plan to award one deserving recipient $10,000 for a true innovation, that is, something that introduces a new device or technique, changes clinical practice, or could improve clinical outcomes. 

I was exposed to research early in my training as an anesthesiology resident at the University of Maryland in the late 1990s, where I had the fortune of training with Dr. Jane Matjasko, our department chair. As a pioneer in neuroanesthesia, she worked diligently to understand the complexities of anesthetic effects on the brain. She was one of the inaugural members of SNACC (Society of Neuroscience in Anesthesiology and Critical Care) and among the first graduates of the Women’s Medical College of Pennsylvania (now Drexel University). She inspired me to become an academic anesthesiologist who was passionate not only about patient care but also about asking questions, being industrious, and finding the answers through research.

Introduction

Anesthesia Critical Care Medicine (ACCM) is the oldest ACGME board-certified subspecialty within Anesthesiology and has seen tremendous growth over the past decade.  In an effort to organize, streamline, and create a fair and equal process for fellowship recruitment, ACCM fellowship programs have participated in the SFMatch process since 2014.  Over the past nine years we have increased the number of fellowship programs offering positions in the match by 35% and increased the number of positions by 58%.  Despite the expansion at the programmatic level, the interest in the field has yet to catch up to the need, and we remain with unfilled positions throughout the country. 

A milestone in transplantation was recently announced by United Network for Organ Sharing (UNOS) commemorating the completion of over one million transplants in the United States.¹ This achievement reflects a steady increase in annual transplant volumes with over 400,000 transplant recipients alive today. It is commonly understood that anesthesiologists are instrumental in peri-operative care of both organ donors and organ recipients. Less widely recognized, but equally important, is the involvement of anesthesiologists in patient selection, risk assessment, coordination of care for pre-operative optimization, and post-operative care. This includes the provision of critical care services for potential transplant candidates with end-stage organ failure, care of high acuity post-operative patients, management of post-transplant complications, and supportive care for organ donors.²

Does Fluid Administration During Induction and Intubation Prevent Cardiovascular Collapse?

Russel DW, Casey JD, Gibbs KW, et al. Effect of Fluid Bolus Administration on Cardiovascular Collapse Among Critically Ill Patients Undergoing Tracheal Intubation. JAMA. 2022;328(3):270-279. doi:10.1001/jama.2022.9792

Nearly one in five patients suffers from cardiovascular collapse while undergoing intubation in the intensive care unit. This is defined as severe hypotension necessitating vasopressors, cardiac arrest, or death. The PREPARE II investigators sought to determine if the administration of a 500ml bolus of intravenous crystalloid solution prior to induction might prevent this collapse. The study was conducted at Vanderbilt University Medical Center in Tennessee, University of Alabama at Birmingham, Louisiana State University School of Medicine and Ochsner Medical Center in New Orleans, Lahey Hospital and Medical Center in Massachusetts, Hennepin County Medical Center in Minnesota, University of Mississippi Medical Center in Jackson, Wake Forest Baptist Medical Center in North Carolina, Oregon Health and Science University in Portland, University of Washington in Seattle, and Baylor Scott & White Medical Center in Texas.

As I sit here writing a piece about work-life balance for women critical care physicians, I feel compelled to paint the picture of my current situation: in-house on call at 9pm on a Friday night, an AirPod in one ear teleconferencing my children to say goodnight, strapped into a portable breast pump, eating the fastest thing I could get from the hospital cafeteria (which is invariably fried), all while typing away at this piece in the physician work room. I am awash in irony. Is this the image of the prototypical woman intensivist? Not at all. Am I currently burned out? Actually, I don’t think so. Have I been burned out at some point during my medical career thus far? Definitely. How do I refine my career plan to achieve work-life balance and sustainability for a satisfying and productive professional career? Unclear, check back later.

Our realities changed during the pandemic and many people asked a very important question, possibly for the first time in their lives: what brings me joy and fulfilment? Is my choice of career a good fit for me? Outside of medicine, it is this feeling of being unfulfilled that has led to what is being dubbed ‘The Great Resignation’. Amongst physicians, the lack of connectedness and satisfaction with one’s specialty has led to high rates of burnout. Pre-pandemic literature on burnout suggested that engaged physicians tend to have less burnout. Engagement outside of clinical work can be driven by continued learning, faculty development and mentorship, having a social network and many more things. For me, engagement included interacting with my trainees, seeking ways to improve my clinical practice and finding mentorship from other physicians in my area of interest. This is where the role of belonging to a professional organization became very important.

A 2018 viewpoint published in JAMA Internal Medicine highlighted four archetypes of “mentorship”: the traditional mentor, the coach, the sponsor and the connector.¹ The authors explain, “To put it simply, the mentor guides, the coach improves, the sponsor nominates, and the connector empowers, but always the mentee benefits.” As I read this article, I was struck by how rare it is for one person to be able to fulfill all these needs, and how I was lucky enough to have a mentor, Dr. Hannah Wunsch, who can and does embody all four roles.

Where We Are

Over the past decade, the need to promote gender diversity in medicine has been embraced by several medical societies. In the USA in 2017, 33% of critical care trainees and 26% of ICU physicians were women. There are many reasons for this disparity and work is being done to understand these reasons to some extent. It was noted in literature that an explicit focus on “eliminating gender inequity will help to gradually change societal views of the roles played by women and men critical care physicians so that it will become the norm for women and men to be both critical care physicians and leaders in critical care.”

Read members-only job posts.

If you would like to post a job, please email a short description and/or PDF flyer including location, contact information, and closing date to SOCCA Society Director, Vivian Abalama, IOM, CAE at vabalama@iars.org.

Interchange seeks to deliver timely, relevant, and high-quality content to SOCCA members. Contributions from members are not only welcome but essential to ensure that Interchange meets these goals. If you are interested in authoring content concerning clinical challenges, emerging research findings, member accomplishments, or anything of general interest to the membership, please reach out to vabalama@iars.org.

SOCCA is pleased to announce the debut of the Innovators Award. Created through a generous anonymous donation, we plan to award one deserving recipient $10,000 for a true innovation, that is, something that introduces a new device or technique, changes clinical practice or could improve clinical outcomes. The innovation should be expected to have an immediate effect on health care delivery. This award is an extension of the Society’s growing interests in research, education and engagement. We encourage interested members to apply.