ASRA Pain Medicine Update

Mentorship is defined by the Oxford Dictionary as ‘the guidance provided by a mentor, an experienced person in a company or educational institution or the period of time during which a person receives guidance from a mentor.’ A dictionary definition fails to capture all the nuances of a mentor-mentee relationship, but this bond influences many aspects of one’s educational and career growth. ASRA Pain Medicine realized the importance of mentorship on the growth and professional development of its members. The Mentor Match program, created by the Physician Mentorship and Leadership Development Special Interest Group, is a unique networking and career development tool designed to help ASRA Pain members connect and share experiences with others. ASRA Pain members are encouraged to sign up either as mentees or mentors when the Mentor-Match  program reopens in Fall 2024.

In these series of interviews and perspective essays, the Diversity SIG aims to explore the theme of mentorship. Learn about the importance of mentorship and the role it has played in the careers of some of our current SIG members. 

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An Interview with Kwesi Kwofie, MD, FRCPC, and Uchenna Umeh, MD

An Interview with Jacques Chelly, MD, PhD, and Uchenna Umeh, MD

          

Dr. Umeh: Can you tell us your full title, where you work and your current leadership roles at your home institution and other societies or organizations?

Dr. Chelly: I am a professor with tenure in the department of anesthesiology & perioperative medicine and orthopedic surgery at the University of Pittsburgh School of Medicine in Pittsburgh, PA. Currently, I am the director of acute pain research, the director of the Center for Complementary Medicine, and the co-director of the Center for Innovation in Pain Care. From 2002 to 2015, I was the vice chair of clinical research, the director of the regional anesthesia fellowship, and the director of the division of acute pain. I am the former site chief of the acute pain service for University of Pittsburgh Medical Center (UPMC) Shadyside, and currently a member of the acute pain service at UPMC Shadyside Hospital.

Dr. Umeh: Can you speak about the importance of mentorship and how it can help in the development of trainees and junior faculty?

Dr. Chelly: In the past 40 years, first in Houston and after in Pittsburgh, I have trained and mentored over two hundred residents, fellows, and faculty in regional anesthesia and acute pain and related research. For me, mentorship is an essential part of being a leader in any field of medicine. This mentorship has contributed to the development of regional anesthesia and the role that anesthesiologists take in the management of acute pain. Because of our mentorship, many trainees have been able to develop their own successful research program. I also can think of many of our former fellows and junior faculty who move on becoming leaders and instrumental in developing regional anesthesia clinical and education programs outside of UPMC. For me, mentorship represents an essential part of my mission. Often former fellows contact me, despite the fact that they completed their fellowship ten years ago, to seek guidance either for clinical situations or research. Along with taking care of patients, this is a mission that I most value.

Dr. Umeh: You are the professor of anesthesiology, perioperative medicine, and orthopedic surgery at UPMC.  What advice would you offer those interested in being promoted at their institutions?  What are the key steps that people should consider as they follow an academic track? 

Dr. Chelly:  Being promoted in your own institution requires meeting specific milestones, which depending on the track, involves clinical, teaching, and research achievements. Knowing what is expected for a given promotion is essential. Furthermore, promotion requires planning and focus and is best achieved when the requirements are established years before, the achievements are monitored, and a mentor helps someone to stay focused. Too many junior faculty “wake up too late,” and are distracted by secondary recognitions including excessive clinical responsibilities and unfocused involvement in research. Usually, promotion to the next level requires a minimum of four to six years. This gives plenty of time to meet the requirements, but it also means being focused for the long term. Also, its critical expectations are the same for the junior faculty as well as the chair of the department. 

Dr. Umeh: You are an NIH awarded researcher. ASRA Pain Medicine members have an interest in regional anesthesiology and pain medicine related topics. Please tell us some more about your research in this area. 

Dr. Chelly:  Since the late 90s and early 2000s, my research focus has been around regional anesthesia and acute pain. First in Houston and then in Pittsburgh, our protocols were based on clinical based programs, and in many cases, a result of our own research. Besides our own works, we collaborate with many other groups. Ten years after moving to Pittsburgh, I became interested in complementary medicine as a way to complement our multimodal approach to perioperative pain management and opioid sparing approach. Our paper in the Journal of Arthroplasty reported on the benefits of a combination of a continuous femoral nerve block and celecoxib to control perioperative pain and opioid consumption following a total knee replacement. This paper was accepted without any request for change.

For many years, my research was focused on sponsored research. I became interested in NIH funded research under the mentorship of Dr. Aman Mahajan when he joined our department, and Dr. Senthil Sadhasivam who recently joined our department as the executive vice chair for clinical research. Applying for NIH funding was a totally new experience. Thanks to the support and guidance of my mentors, I got an R01 in 2022, Reduction of opioid requirements associated with auriculo-nerve stimulation following open surgery, followed this year by an R21, Telemedicine-delivered digital cognitive behavioral intervention to decrease post-operative opioid use among patients undergoing total knee and hip arthroplasty, an R41, Enhancing pain management for knee replacement patients through an innovative non-invasive and opioid-sparing device, and an R44, Fast Track SBIR/STTR resilient life science. Developing a wearable medical device to detect opioid overdose. This is an incredible journey made possible by incredible teamwork. Other research in complementary medicine recently conducted includes aromatherapy, music therapy, hypnosis, and auriculotherapy. The NIDA has been very receptive to our research proposals.

 Dr. Umeh: Who has served as an inspiration in your life?

Dr. Chelly:  My mother. Both of my parents were born in Sfax, Tunisia. My mother received an education, which was rare at that time for a woman. She became a teacher in a public elementary school in Sfax. She believed in education and always pushed us toward education and excellence in anything we did.

Dr. Umeh: Who inspires you to be a leader?

Dr. Chelly: Prof. Alain Carpentier, who is a world-famous cardiac surgeon, a member of the French Academy of Medicine, with whom I had the honor to work as an anesthesiology and cardiac intensivist in Paris. He was one of the hardest workers and the most innovative cardiac surgeons I have never met, always trying to improve his techniques and provide patients with new and improved alternative techniques. He was instrumental in the development of plastic techniques to remodel the heart, and biological valves. He worked 24/7 and was always available. He and his family lived on the top floor of the cardiac surgery building at Broussais Hospital in Paris.

An example to illustrate his energy: one day he was invited to participate in a meeting organized by Danton Cooley in Houston. He arrived in Houston at one p.m., gave his lecture at seven p.m., took the flight to return to Paris, and operated on the same day. If you wanted to be a part of his team, you needed to show the same commitment to his patients that he did.

In anesthesiology, Dr. J. Gable was an anesthesiologist who had a great deal of influence early in my carrier. He was a Harvard trained anesthesiologist and intensivist. He was a charismatic hard worker and visionary. I was privileged to meet him in Houston. He taught me persistence and hard work. He was always looking for an opportunity to improve the impact of our specialty.

Dr. Umeh: What factors impact one's ability to lead others? 

Dr. Chelly:  I believe in leading by example and guiding others based on experience and knowledge. Training includes several phases. Although, it is not always easy, I first teach hands on and after try to serve as a resource. As much for clinical work than for research within a certain domain, trainees develop their own skills by trial and errors. This is also where labs and workshops are so important. They offer a controlled environment.

Dr. Umeh: What challenges have you faced so far as a physician and anesthesiologist?  How did you overcome them?

Dr. Chelly: From a professional point of view, I see myself as a builder of new programs. In the late 90s, regional anesthesia and acute pain was not very developed at UT. One of the most important challenges was to get other anesthesiologists to buy into developing a new regional and acute pain program. We had to convince not only other anesthesiologists but also surgeons and the hospital administration. It was very rewarding to see everyone on board after a few months. I knew we succeeded when the main orthopedic trauma surgeon at Herman Hospital came to me and asked me for a regional technique for his knee replacement. Because he was old school, he asked one of his longtime colleagues to do the surgery. His anesthesia was based on a continuous femoral and single sciatic. His friend could not believe that he was completely awake and felt nothing.

Twenty plus years later, I am still in contact with orthopedic surgeons, like Dr. Terry Clyburn with whom I worked to introduce the use of continuous femoral and cox2 inhibitors for the perioperative management of pain following TKA and THA, as well as Tom Clanton, an ankle surgeon who helped me introduce blocks in his patients. Today, our approach is referred to as ERAS. Because I wanted to gain momentum with other surgeons, we published our first study in Journal of Arthroplasty. This was in 2001.

Equally impressive was getting the support from the hospital to start our fellowship program. At the time, we had one fellowship position in regional anesthesia. Our first fellows were Dr. Tamim Alsamsam and Dr. Jenny Greger. All of this was made possible by showing commitment, dedication, and expertise. In Houston, I was lucky to be helped by a number of anesthesiologists, especially Dr. Maria Matuszczak and Dr. Ralf Gebhardt. They embraced the vision and contributed greatly to the success of the program. Today, they are considered leaders in the field of regional anesthesia and acute pain.

Dr. Umeh: What career accomplishment makes you most proud?

Dr. Chelly:  Although I am very proud to have started a major program in Pittsburgh, in 2002 with the support of John Williams, who at the time was the Chair of the Anesthesiology at Pitt/UPMC, and Mark Hudson who was the chief of Anesthesia at UPMC Shadyside Hospital, as well as surgeons like Larry Crossett and Sinha Raj who received me with open arms when I joined UPMC. The main difference between Houston and Pittsburgh was that in Pittsburgh, the use of regional anesthesia was already developed, especially by. Dr Brian Williams for ambulatory surgery. Equally important was the fact that the CEO of UPMC, Mr. Jeff Romoff, was also a great supporter of regional anesthesia as was Mrs. Sandy Rader, who is today the CEO of UPMC Shadyside-Presbyterian Hospitals. However, what make me proudest personally is the incredible impact that we have had in terms of our ability to train a large number of residents and fellows. We started the fellowship program in 2004 with Dr. Lopa Misra. We increased the number of fellows up to 15 in only a few years. This gave us an opportunity to train over 200 fellows and allowed us to have a profound impact on the use of regional anesthesia and acute pain in this country. Many of our former fellows are in private practice and their impact is equally important. Of those who are in academia, many of them occupied leadership positions in their respective regional and acute pain program in their institutions. Often, I review their articles and grant proposals. I am so proud of what each of our former fellows has achieved and their continued commitment to the promotion of regional anesthesia and acute pain.

Dr. Umeh: What advice would you give to trainees and young physicians as they navigate their careers?

Dr. Chelly:  Be focused. Establish with the support of a mentor, a realistic pathway of accomplishments, and review it after one, three, five, and ten years. Make sure that the design plan is reviewed and approved by the leadership of their department. Practically be engaged, successful, and recognized for your excellence by the surgeons and patients you work with. Finally, be a part of a team.

Dr. Umeh: Is there anything else you would like to note?

Cultivating Success: The Role of Mentorship in Career Guidance

By Christopher O. Fadumiye, MD

Mentorship is a profound and dynamic relationship that extends beyond mere professional guidance. It is a mutually beneficial journey where both the mentor and mentee grow, learn, and develop together. Mentorship means investing in someone’s potential, helping them navigate their career path, and providing the support they need to overcome challenges and seize opportunities. It embodies the sharing of knowledge, experiences, and wisdom to foster the personal and professional growth of the mentee while also enriching the mentor’s perspective and reinforcing their own values and skills.

 At its core, mentorship is about connection, trust, and empowerment. It is the act of being present, listening actively, and offering tailored advice that addresses the unique needs and aspirations of the mentee. Mentorship means recognizing and nurturing the strengths of the mentee, setting boundaries, helping them to see possibilities they might not have envisioned on their own, and encouraging them to step outside their comfort zones.

My journey in academia and my professional field has been significantly shaped by the mentors I have had and continue to be mentored by. One such mentor is Dr. Lois Connolly, who has been an invaluable mentor, profoundly shaping my professional and personal growth. Her unwavering guidance, constant presence, and willingness to listen have provided a solid foundation for my career development. Dr. Connolly’s advocacy on my behalf and her role as a confidant have fostered an environment of trust and support, allowing me to navigate challenges with confidence. As a leader, she exemplifies the qualities I strive to embody, inspiring me through her dedication, wisdom, and compassion. Her influence has been pivotal, and I am deeply grateful for her mentorship. A second notable mentor is Dr. Christina Diaz, who also has been an invaluable asset to my career development. She has provided mentorship and coaching that have significantly shaped my professional trajectory. Her down-to-earth and relatable nature makes her guidance accessible and impactful. Dr. Diaz consistently goes above and beyond, offering insightful coaching strategies and a wealth of resources that have empowered me to self-develop and grow in my field. Her presence and commitment to my success have been instrumental in navigating the complexities of my career with confidence and resilience. Mentors such as Dr. Diaz and Dr. Connolly have significantly shaped my perspective on mentorship and training, and now, I am dedicated to providing the same level of support and guidance to junior faculty and trainees.

In my current role as an Assistant Professor of Anesthesiology at the Medical College of Wisconsin, I am committed to mentoring junior faculty and trainees by creating an environment of trust, care, open communication, and continuous learning. My approach to mentorship is centered around the individual needs of each mentee. I believe in active listening, providing constructive feedback, setting boundaries and fostering a growth mindset.

I employ a variety of methods to mentor effectively. Regular one-on-one meetings, collaborative projects, and informal check-ins are crucial to me in maintaining a strong mentor-mentee relationship. I also encourage my mentees to set personal and professional goals, and help them create actionable plans to achieve these objectives. Additionally, I emphasize the importance of networking, community, wellness, and self-care.

Mentorship is a cornerstone of professional development, and its significance cannot be overstated. My mentors have shaped my career by providing guidance, support, and opportunities for growth. As a mentor, I am dedicated to giving back by fostering a nurturing environment for junior faculty and trainees, guiding them through challenges, and celebrating their achievements. I strongly believe, through mentorship, we not only contribute to the growth of individuals but also strengthen the foundations of our professional community.

Christopher Fadumiye is an Assistant Professor of Anesthesiology at the Medical College of Wisconsin, Milwaukee. He received his medical degree from Howard University College of Medicine and his Anesthesiology Residency training at Rush University Medical Center. In his current role at the Medical College of Wisconsin, he has been actively involved in the education and training of residents and medical students. His teaching philosophy centers on a hands-on, patient-centered approach, ensuring that learners gain practical experience and confidence in performing regional anesthesia techniques. 

My Journey Through Medicine with Mentorship

By Shivani Mehta, BS

As a fourth-year medical student on the cusp of applying for residency in anesthesiology, I find myself reflecting on the journey that led me here and the pivotal moments that shaped my path. Central to this journey is a profound appreciation for the mentorship I have been fortunate to receive over the years—a guiding light illuminating my trajectory towards a medical career grounded in empathy, integrity, and purpose, ultimately guiding me to discover the field where my true passion lies.

My decision to enter the medical field was sparked by a deeply personal experience of loss and uncertainty. The unexpected loss of my grandfather served as a catalyst for my dedication to medicine. His reluctance to seek medical care, rooted in a profound mistrust of health care providers and a fear of the unknown, changed my perception of health care. Unfortunately, this apprehension towards physicians transcended generations, as my parents’ fear of unfavorable diagnoses deterred them from seeking timely medical care. Witnessing the preventable tragedy of my grandfather's passing, I was determined to become the first physician in my family.

My undergraduate studies in health administration deepened my awareness of health care disparities, which manifested before me while I served as a case manager at a community health center in Newark, NJ. Here, I encountered patients from diverse backgrounds grappling with multifaceted issues such as addiction, homelessness, and abuse. Their reluctance to seek medical care stemmed not only from practical barriers but also from a profound fear of judgment and stigma. It was in these moments of vulnerability that I realized that my family’s apprehension was shared by many. However, it was in these moments I also realized the power of empathy and compassion in healing.  

The physician at the clinic was dedicated to advocating for equality and epitomized the qualities I aspired to embody. Under his mentorship, I learned the importance of cultivating a compassionate demeanor to foster patient trust and engagement. Observing his ability to break down communication barriers with patients at the clinic was inspiring. Patients who were initially reluctant began to confide in him, enabling a more comprehensive approach to their care. Beyond clinical interactions, his mentorship provided invaluable insights into the pervasive disparities within the health care landscape, offering me a blueprint for the kind of physician I aspired to become and wished my grandfather had.

Upon entering medical school, I remained open to various specialties, but I remained guided by a desire to alleviate fear and provide comfort in moments of uncertainty. However, it was when a dear friend underwent unexpected surgery that my interest in anesthesiology began. Terrified by the outcomes of the procedure, the anesthesiologist handling the case instilled a deep sense of relief in my friend through her calm and reassuring demeanor. In that moment, I saw the transformative potential of anesthesiology—a specialty uniquely positioned to alleviate fear and uncertainty during vulnerable perioperative moments.

With increasing interest, I decided to find mentorship within the field, sending emails to anesthesiologists who seemed to have a passion in mentorship. With luck on my side, I received a response not just from an anesthesiologist, but one who shared my interest in learning about disparities and promoting equity within health care. Little did I know that this cold email would create a mentorship that would prove to be a cornerstone of my journey.

Under her guidance, I became involved in research projects aimed at understanding and mitigating health care inequalities and advocating for diversity within anesthesiology. Her mentorship not only broadened my perspective, but also solidified my passion for the specialty. Moreover, her unwavering support and encouragement bolstered my personal and professional growth, propelling me towards greater involvement within the field.

Subsequently, I assumed roles as an ASA delegate for my medical school and became involved with ASRA Diversity SIG committee. Together with my mentor, I seized opportunities to attend conferences, networking with leaders in the field and fellow medical students who shared similar aspirations. Her guidance not only nurtured my development as a medical student and future physician, but also allowed me to see all the potential within my grasp.

As I embark on this next chapter of my journey, I am filled with a sense of purpose and gratitude, cognizant of the profound impact of mentorship on my trajectory thus far. In choosing anesthesiology, I not only embrace a specialty that resonates with my passion for compassionate care, but also honor my grandfather and the countless individuals who have grappled with fear in the face of illness. It is a full-circle moment—a culmination of experiences that have shaped my understanding of medicine as a deeply human endeavor, rooted in empathy, compassion, and trust. 

Above all, I am deeply grateful for the mentors who have guided my path and nurtured my growth. It is through their unwavering support and encouragement that I have found the courage to pursue my dreams and advocate for positive change within the health care landscape. As I journey forward, I am committed to honoring their legacy by paying it forward, extending mentorship to future generations of aspiring physicians, and fostering a culture of compassion, equality, and excellence within health care. 

Shivani Mehta, BS, is a fourth-year medical student at Rutgers New Jersey Medical School in Newark, NJ. She currently serves as the ASA Delegate for her medical school. She enjoys baking for her home-run bakery during her free time.