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From the Department of Anesthesia, The Ottawa Hospital, The Ottawa Heart Institute, and University of Ottawa, Ottawa, Ontario, Canada.
Address correspondence to: Dr. Donald R Miller, Department of Anesthesia, The Ottawa Hospital General Campus, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada. E-mail: dmiller{at}ottawahospital.on.ca
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Abstract |
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Methods: The CAS Research Committee database of past RGCSFP recipients was reviewed to identify all past award recipients from the time of program inception in 1985 until the year 2005. A questionnaire was mailed to all past recipients with retrievable addresses. The questionnaire asked specific questions regarding past and current research, publications, grant procurement and mentoring of trainees. In addition, opinions regarding the program’s effectiveness were solicited.
Results: Of the 100 mailed survey forms, 66 (66%) were completed and returned. The number of original published articles per respondent was 30.1 ± 28.5 (mean ± SD) at the time of the survey, and the life-time number of all publication types was 38.5 ± 34.6. Cumulative research funding increased in relation to the number of years in research, and amongst past recipients with > 15 years in research, individual research funding from all sources was $585,747 ± $773,716. Ninety-six percent of respondents agreed or strongly agreed that the program was valuable.
Conclusions: The RGCSFP has supported a large number of new and established anesthesia investigators in Canada, and these individuals have demonstrated high research productivity. The program is considered to be very valuable according to past recipients.
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Introduction |
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Over the ensuing years, industry-sponsored operating grants, a research fellowship, two career scientist awards, and a resident’s research award were added incrementally, as the need for more grant funding and salary support for research within the specialty became increasingly apparent. Indeed, CARF funds alone were unable to match the growing demands from a steadily increasing number of applications and escalating grant budgets. The inclusion of industry-sponsored research grants and salary awards now account, at least in part, for a large increase in cumulative dollar value of the program observed in recent years. Collectively, the CARF and industry-funded awards constitute the Research Grants, Career Scientist and Fellowship Program (RGCSFP) of the CAS (Table I
). Regardless of the funding source, applications for all operating grants and salary awards are subject to the same rigorous peer assessment through the Research Committee of the CAS.
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Methods |
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Survey forms were distributed to all past recipients of the program with retrievable addresses for the period 1985 – 2005. As the Resident’s Research Award encourages resident research without providing funding at the level of an operating grant, responses from past resident recipients were not solicited. Respondents were asked to complete the forms and return them in pre-addressed, stamped envelopes. To enhance the response rate, confidentiality of the information was ensured, and two subsequent mail-outs were forwarded to all non-respondents, approximately one and three months after the initial mailing.
Data from the questionnaires were collated and entered onto Excel spreadsheets. For recipients who had received more than one CAS research award, data were attributed to the first award which that individual received in that program, to avoid double-counting. Summary data were generated using SPSS 11.0 for Windows (SPSS Inc, Chicago, IL, USA), and are presented as mean ± SD or percentages as appropriate.
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Results |
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Grants
The number of awards presented annually progressed from one in 1985, to 12 in 2005. The increase in cumulative monetary value of the awards presented annually is shown in Figure 1. While the survey data base was closed in 2005, as of June, 2006, $3.685 M in funds had been disbursed through the CARF to support 159 separate research grants, fellowships or career scientist awards from the RGCSFP.
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. All but two (who practice in the United States) have a current faculty appointment at a Canadian Academic Health Sciences Centre. Notably, 32 of the 66 respondents had either a Master’s or a PhD degree in addition to their medical degrees, with formal research training averaging 2.5 ± 2.2 yr (range 0–10 yr). Amongst past recipients, 35% of respondents were Full Professors, while 26% were Associate Professors at the time of the survey.
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). The cumulative amount of research funding of past recipients from all peer-reviewed sources was analyzed according to the number of years in either full-time or part-time research. Total research funding increased in relation to the number of years in research (Figure 2), and amongst past recipients with more than 15 years in research, the mean individual research funding had accumulated to $585,747 ± $773,716 (range $20,000–$3,321,087). The most frequently identified sources of peer-reviewed grant funding outside the CAS/CARF program included: the Canadian Institutes of Health Research (n = 23), the Heart and Stroke Foundation of Canada (or the Foundation’s provincial counterparts) (n = 17), Physician Services Incorporated (n = 11). Past recipients were competitive internationally as well, with grants from the National Institute of Health (n = 3), the American Society of Anesthesiologists (n = 2), the Deutsche Forschungsgemeinschaft (n = 2), the International Anesthesia Research Society (n = 2) and the Society of Cardiovascular Anesthesiologists (n = 1).
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Opinions of the research program
Ninety-six percent of respondents indicated their agreement or strong agreement that the RGCSFP was of personal benefit to them (4% did not answer the question), and 96% agreed that the program was well organized and that the grant review process was fair (49% strongly agreed; there was no disagreement). Ninety-six percent agreed or strongly agreed that the Research Fellowship is important, and 96% of respondents also agreed that the Career Scientist Program is important. Fifty-four percent of respondents indicated that the number of operating grants is adequate, while only 39% indicated their agreement or strong agreement to the statement that the amount of research funding offered by the program is adequate.
Free-text comments
Eighteen respondents provided free-text comments, which were uniformly complimentary of the program. Four past recipients wrote that the RGCSFP is essential in providing funding for young investigators, and that the program lends credibility when applying to other agencies such as the Canadian Institutes of Health Research. One recipient commented that the program was an important factor in his decision to return to Canada following research training in the United States. Three respondents indicated that more grants are required, and that small operating grants are often non-productive use of valuable research funding. Three individuals wrote that the monetary value of the operating grants needs to be increased, while another indicated the need for investigator salary support and protected time to do research. Finally, another past recipient expressed the need to be able to fund large randomized controlled trials to address important clinical outcome issues in anesthesia, as commonly done in other specialties such as cardiology.
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Discussion |
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Other societies have embraced the need for programs to fund research within the specialty of anesthesia. In 1983, the International Anesthesia Research Society (IARS) established the Anesthesia Award & Grant Funding Program, which to date has awarded > US$7,000,000 funding for 100 projects in anesthesia. A survey of IARS members undertaken in 1998 identified that financial support from other sources was disappearing, and that IARS’ continued support of education and research would be crucial to the specialty.A In 1986, the American Society of Anesthesiologists established the Foundation for Education and Research (FAER), to "stimulate, develop, promote, authorize, commission or contract for, and finance education and research in subjects germane to the provision of anesthesia care and perioperative medicine".B
Since 1986, FAER has awarded over 400 grants, and in 2004, provided over $2,000,000 in research funding. A survey of past recipients of that program was published in 1998.3 Measures of success in that survey included time currently spent on academic pursuits; number of times anesthesiologists had been mentors to less experienced investigators; promotion to higher academic ranks, and subsequent research funding. At the time of the FAER survey, 97% of recipients held academic rank, and the former recipients indicated that funding from FAER made a critical difference in their careers. These findings are similar to the results from the current survey, which identify that 91% of past recipients from the Canadian program hold academic rank.
A common theme of all these programs, including RGCSFP, is that with an increasingly competitive environment for funding scientific research, the role of national and international specialty societies in the support and development of academic anesthesiologists has grown. Yet despite significant strides in anesthesia research over the past century, which have contributed greatly to an advanced level of clinical care of patients in the perioperative setting, some ambivalence towards the research enterprise of the specialty has been expressed by practicing clinicians and indeed, some grant reviewing agencies as well. It is notable that major medical procedures have been made possible through landmark innovations in anesthesia during the 20th century. Great strides in perioperative medicine, pain management, understanding of the physiological and pharmacological response to anesthetics and analgesics, and regional anesthesia have been made through the body of knowledge advanced through research, and anesthesia is safer than ever before. Despite such progress, investment in the training and research infrastructure of new and established investigators remains critical to advancing the body of knowledge to ensure that the specialty can compete with others, while advancing new discoveries in medicine. For example, the important mechanisms of anesthetic action, drug interactions, and the mechanisms of postoperative neurocognitive dysfunction remain elusive. The challenges of translational research and applying the biology of genomics into the clinical area of the perioperative medicine are as important now as ever before. As highlighted in previous editorials in the Journal,4–6 research into education, outcomes research, pain medicine, simulation, transfusion medicine and perioperative patient safety are additional examples of areas where significant knowledge gaps remain to be filled.
Salary support for dedicated Career Scientist Awards has been an important addition to the program since 2000. In contrast to the impressive monetary value of these awards, the available funding for operating grants, which provide support for the direct costs of conducting bench research or clinical trials, is relatively modest (Table I
). Even the highest-valued operating grant in this program, ($40,000) is often limited to the provision of "seed-funding" for many projects. The direct costs of undertaking rigorously-conducted randomized controlled trials can extend from hundreds of thousands, to millions of dollars for large multicentre studies. Clearly, closing the gap between funding availability and the costs of conducting outcomes-based research will require substantial future investment if the specialty is to remain competitive.
This survey has several limitations. First, the number of past recipients is small, and this naturally limits the ability to generalize the results. Second, mailing addresses were not available from all past recipients, and a 66% response rate was somewhat disappointing, particularly in view of the small number of potential responders. The elusive issue of responder bias is a factor which is difficult to measure, as the success rate of grant procurement of past recipients who did not respond is unknown. We attempted a PubMed search to identify past publications of non-respondents and respondents, but this was problematic, as some respondents returned their completed forms anonymously. Accordingly, we chose to document the number of self-reported ‘total’ and peer-reviewed publications based on the results of the survey. Another limitation in evaluating the effectiveness of the RGCSFP using this methodology is the lack of an identified historical control group; i.e., Canadian anesthesiologists who never applied for, nor received an award from this program. The difficulty inherent in undertaking such a comparison is the inability to capture the relevant data in a systematic manner.
In conclusion, this survey demonstrates the extent to which the RGCSFP has supported, and continues to support, a large number of new and established anesthesia investigators in Canada, and provides a measure of significant research productivity from past awardees. Past recipients consider this program to be very valuable, while the need to increase the monetary value of individual awards was identified. Despite the methodological limitations, there is compelling evidence from this survey to justify ongoing support of the CAS and CARF, and to consider expanding the awards of the RGCSFP.
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Acknowledgments |
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Footnotes |
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This article has been peer reviewed.
Accepted for publication November 28, 2006. Revision accepted January 9, 2007.
A (http://www.iars.org/researchawards/research_awards.shtm - accessed September 1, 2006). 
B (http://www.iars.org/researchawards/research_awards.shtm - accessed September 1, 2006).
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References |
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2 Bevan DR, Craig DB. The Canadian Anaesthetists’ Society Research Award. Can Anaesth Soc J 1985; 32: 460–2.
3 King SP, Hug CC Jr. Survey of former recipients of research funding from the American Society of Anesthesiologists and the Foundation for Anesthesia Education and Research. Anesthesiology 1998; 88: 519–24.[Medline]
4 Knill RL. Anesthesia research: needs for the nineties. Can J Anaesth 1992; 39: 411–9.
5 Orser BA, Miller DR. New opportunities for anesthesia research in Canada. Can J Anesth 2002; 49: 895–9.
6 Bevan DR. The future of academic anesthesia departments in Canada. Can J Anesth 2006; 53: 533–9.
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