MANY of us think that medicine in general and anesthesiology in particular stand at a crossroads, with significant changes in medicine on the horizon. But it is “a” crossroads and not “the” crossroads, and we have faced such challenges many times in the past. A number of thought leaders and organizations have helped us make the best choices for our specialty and for our patients. We hope the readers of ANESTHESIOLOGY are familiar with the unique role the Foundation for Anesthesia Education and Research (FAER) plays in helping to facilitate careers, especially academic careers, in anesthesiology. We are grateful that the journal has dedicated a significant portion of this issue to honoring FAER's 25th anniversary by publishing research performed by anesthesiologists whose careers began with FAER funding.

“More than 500 anesthesiologists have received funding from the ASA and FAER; of these, more than 180 have gone on to receive National Institutes of Health funding.”

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The roots of FAER began with the American Society of Anesthesiologists' Committee on Research in 1972. In those early years, the committee annually had a total of $10,000 to distribute. The money was divided into 1-yr grants among four or five worthy applicants. From 1972 until 2011, the Consumer Price Index increased by more than 500%, so a $2,000 grant in 1972 would be worth only approximately $10,000 today. Clearly those grants did not go very far in supporting a research project.

In the mid-1980s, there were concerns about industry-sponsored events competing with the educational and scientific sessions at the American Society of Anesthesiologists (ASA) Annual Meeting, so an ad hoc  committee on Funds from Outside Organizations was created in 1984; that group was succeeded by the ASA Committee on Industry Relationships in 1985. Dr. Peter McDermott was chair of the committee and among the other members was Mr. Clifford Parrish (1925–2010), of the Burroughs Wellcome Foundation, who suggested that the ASA develop an arm's-length foundation.

Many people, including retiring FAER President Dr. Alan Sessler, were involved in the formation of FAER. Contributions from the Burroughs Wellcome Foundation, the Parker B. Francis Foundation, and the ASA were instrumental in launching FAER, which was incorporated in 1986 as a 501(c)(3) corporation wholly owned by the ASA, FAER's founding and major annual contributor.

Dr. Martin Helrich, then the retiring chair of the University of Maryland's Department of Anesthesiology, was recruited by FAER's first president, Dr. William Hamilton of the University of California, San Francisco, as the first executive secretary of FAER. Dr. Helrich took this position on a 1-yr trial basis but eventually spent nearly 10 yr in the position. He believed that FAER should provide leadership in guiding and shaping anesthesiology research, not serve merely as a repository of funds.

Because anesthesiologists attend to patients from womb to tomb and encounter virtually every disease state in the practice of anesthesia care, perioperative medicine, critical care, and pain medicine, FAER has defined its mission broadly: “To advance medicine through education and research in anesthesiology.” Our vision statement is also broad: “FAER will be the premier national foundation providing guidance and resources to physician investigators and medical educators focusing on anesthesiology-related issues in the sciences of clinical practice and disease biology.”

In February 1995, Dr. Alan Sessler succeeded Dr. Helrich as executive secretary and eventually moved the FAER office from Baltimore, Maryland, to Rochester, Minnesota. With the reorganization of the FAER office in 2002, Dr. Sessler became the president. Dr. Sessler has been the “face of FAER” for 15 yr. The growth in funding provided by FAER, the increase in the number of programs, and the high regard in which FAER is held by anesthesiologists are in large measure due to Alan's consistent values and leadership.

Over the 25 yr of FAER's existence, the portfolio of grants and programs has grown in quality and quantity. More than 500 anesthesiologists have received funding from the ASA and FAER; of these, more than 180 have gone on to receive National Institutes of Health funding. FAER has also partnered with most of the subspecialty societies to sponsor investigations of mutual interest. Total annual grant funding has increased from less than $500,000 to approximately $2 million. Research funding over FAER's 25 yr history has totaled close to $26 million.

Many of the leaders in our specialty were supported by FAER early in their careers, and this issue of ANESTHESIOLOGY features a sample of both the people and the science that have benefited from FAER. For example, with support from the ASA, FAER recently funded two ground-breaking studies of the use of cerebral function monitors. Several papers have been published, and with the formation of two research groups, we can expect more publications in the near future.

The types of grants offered by FAER have changed to match the evolution of our specialty. Currently, there are several categories of grants: Research Fellowship Grants for residents and fellows; basic science and clinical Mentored Research Training Grants for junior faculty embarking on research careers; and Research in Education Grants for faculty performing research in education. These grants are more fully described on FAER's Web site.*

The Foundation for Anesthesia Education and Research also provides numerous programs. The Resident Scholar Program offers an introduction to the ASA Annual Meeting; since 1969, more than 1,000 residents have participated. In 2005, FAER developed the Medical Student Anesthesia Research Fellowship Program, an 8-week summer research program that matches medical students with departments that offer research training experiences. So far, 290 students have participated, including 56 in 2011. Select students are invited to present their research in a special session at the ASA Annual Meeting.

Mentoring is perhaps the most important component of a research career, whether it is in the clinical or basic sciences; therefore, all of FAER's grants require mentors to take active roles in developing research careers. A few years ago, FAER established the Academy of Research Mentors in Anesthesiology to facilitate the development of mentors in the specialty. This group of more than 50 accomplished mentors is taking an active role in seeking junior investigators who will benefit from the guidance of a senior colleague.

In addition to these programs, FAER promotes anesthesia education and research at the ASA Annual Meeting through a number of activities, including the FAER Panel, the Annual FAER Honorary Research Lecture, a workshop organized by the FAER Academy of Research Mentors in Anesthesiology, and the presentation of the FAER Mentoring Excellence in Research Award during the Celebration of Research. The foundation is also working with subspecialty society meeting organizers to establish other educational opportunities.

The Foundation for Anesthesia Education and Research could not have done all this, and certainly will not be able to continue this work, without significant financial support plus the volunteer time and effort from many sources, including the FAER Board of Directors, the ASA Committee on Research, the FAER Education Study Section, and many ASA leaders and members. We thank all of our donors and advocates for their generosity.

Annual gifts, major gifts, and legacy gifts benefit FAER. The ASA clearly provides the major annual gift to FAER, and subspecialty societies, component societies, and individual donors are crucial to the continued health of the foundation. We are launching a major gift campaign that has been anchored by some generous contributions from current board members. Predominant among legacy gifts were those donated to FAER by Dr. Gertie Marx for support of research and education related to obstetrical anesthesiology. With continued and increased support from our friends through such gifts, FAER will continue its mission of advancing education and research in anesthesiology by facilitating careers in the specialty.

Medicine is clearly at a crossroads now, and we hope that with your support, all of FAER's activities can provide signposts to keep our specialty moving in the right direction, allowing us to continue taking better care of all our patients in the future.