Technical excellence has always been central to anesthesiology. Increasingly, however, the future of the specialty will depend on something equally important: leadership, communication, and the ability to build trust.

In this episode of PDs at SEA, Dr. Marianne Chen welcomes former U.S. Surgeon General Dr. Jerome Adams for a wide-ranging conversation about what anesthesiology educators should be teaching beyond clinical knowledge. Drawing on his experience as a practicing anesthesiologist, state health commissioner, U.S. Surgeon General, and current Director of Purdue University’s Center for Health Equity, Dr. Adams reflects on how trust shapes patient care, public health, and the future of medicine.

The discussion explores why communication deserves to be taught with the same rigor as procedural skills, how advocacy should begin with the needs of patients rather than the profession, and why leadership training can no longer be viewed as optional for physicians. Dr. Adams also shares practical ideas for incorporating communication, systems thinking, artificial intelligence, and leadership development into residency education while encouraging educators to identify and cultivate future physician leaders.

The conversation concludes with reflections on mentorship, service, and the importance of saying “yes” to opportunities early in one’s career. Throughout, Dr. Adams offers a compelling vision of anesthesiologists as clinicians, educators, advocates, and trusted leaders capable of improving not only individual patient encounters but the healthcare system itself.

Key Takeaways From This Episode

• Trust is one of the most important determinants of effective patient care and public health.
• Communication should be taught, practiced, and assessed with the same intentionality as procedural skills.
• Advocacy is most effective when it begins with patients’ interests rather than physicians’ interests.
• Leadership, systems thinking, and health policy should become core components of anesthesiology training.
• Artificial intelligence will change anesthesiology, making adaptability and critical evaluation essential skills.
• Early involvement in organized medicine and advocacy creates opportunities for future leadership.
• Mentorship shapes careers by helping learners recognize possibilities they cannot yet see in themselves.

Especially Useful For

Program directors, associate program directors, clerkship directors, faculty educators, residents interested in leadership and advocacy, department chairs, and anyone interested in preparing anesthesiologists to lead both inside and beyond the operating room.

Related Episodes

• Early Exposure, Better Advice: Medical Student Education and the Future of Anesthesiology
• Everything You Wanted to Know About Being a Program Director
• Global Health Opportunities in Anesthesia

Episode Summary

Residency recruitment is often discussed in terms of outcomes, match rates, fill rates, and competitiveness. Less often is it examined as a continuous, year-round process shaped by strategy, signaling, and evolving applicant behavior.

In this episode of PDs@SEA, Dr. Marianne Chen and Dr. Bryan Mahoney reflect on the most recent Match, sharing initial reactions and what this recruitment cycle reveals about the current state of anesthesiology training. From the sheer volume of work behind recruitment to the increasing competitiveness of the specialty, the conversation highlights how both programs and applicants are adapting in real time.

The discussion explores how signaling continues to shape application review and match outcomes, including emerging trends in gold versus silver signals and the unintended consequences of applicants “gaming” the system. The episode also examines shifts in the applicant pool, including broader interests, growing demand for away rotations, and evolving expectations around career flexibility, innovation, and global health.

These themes are grounded in the operational realities of recruitment: how programs screen applicants with limited data, how away rotations influence selection, and how program directors refine their internal processes over time. The conversation also offers practical insight for new program directors, emphasizing rank list integrity, iterative improvement, and the long-term value of investing deeply in recruitment.

The episode closes with advice for applicants, including the importance of meaningful exposure to anesthesiology and a realistic understanding of the specialty’s day-to-day demands, particularly the unpredictability of clinical work. Taken together, this discussion captures a specialty in transition, where demand is high, systems are evolving, and both applicants and educators are recalibrating expectations.

Key Takeaways From This Episode

• The anesthesiology match remains highly competitive, with strong applicant pools and high fill rates across programs.
• Signaling continues to improve application review and match alignment, with increasing differentiation between gold and silver signals.
• Applicant behavior is evolving, including strategic use of signals and broader interests beyond traditional clinical pathways.
• Away rotations remain the most reliable way to assess fit, while also introducing access and equity challenges.
• Recruitment is a year-round effort, and early, intentional investment in the process improves downstream outcomes.
• There is no single “correct” selection algorithm; programs must define success based on their own priorities and iterate over time.
• Applicants benefit from deeper exposure to anesthesiology, including understanding the unpredictability of clinical practice.

Especially Useful For

Program directors, associate program directors, residency leadership teams, department chairs, and clinician-educators focused on recruitment strategy and the evolving anesthesiology workforce pipeline.

Related Episodes

• The Truth About Signaling, Letters of Intent, and The Match: A PD’s Unfiltered Guide
  A practical deep dive into signaling strategy, applicant behavior, and how programs interpret interest during the match process.
• So the Applications Just Dropped: How Program Directors Actually Read Them
  A behind-the-scenes look at how PDs screen applications, manage volume, and make interview decisions.

Jo Davies, MBBS, FRCA,

Professor of Anesthesiology and Pain Medicine, University of Washington,

Director of the Society for Education in Anesthesia (SEA) and Health Volunteers Overseas (HVO) Traveling Fellowship with the Committee for Global Outreach

https://www.seahq.org/sea-hvo-traveling-fellowship

Elizabeth T. Drum, M.D., F.A.A.P., F.C.P.P., F.A.S.A., Professor of Clinical Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania

Chair ASA Committee on Global Health, U.S. Program Director for the Resident International Anesthesia Scholarship Program

https://www.asahq.org/charity/programs/scholarship

Bryan Mahoney, M.D., F.A.S.A.

Vice Chair of Education

Director, Residency Training Program

Associate Professor, Department of Anesthesiology, Perioperative and Pain Medicine

Mount Sinai West and Mount Sinai Morningside Hospitals, Icahn School of Medicine at Mount Sinai

Check out the podcast, PD's at SEA (Society for Education in Anesthesia) at: https://www.buzzsprout.com/2554558/episodes

Medical student education in anesthesiology is often treated as peripheral to residency leadership. Less often is it examined as a strategic lever for recruitment, advising quality, and the long-term health of the specialty.

In this episode of PDs@SEA, Dr. Marianne Chen is joined by Dr. Mike Hofkamp and Dr. Christine Vo to examine how early exposure to anesthesiology shapes student interest, preparedness, and competitiveness. Drawing from their experiences as long-standing medical student clerkship directors, they reflect on how externships, early electives, interest groups, and even research participation can meaningfully influence career trajectories.

The conversation explores how medical school curriculum redesign, shortened preclinical phases, and elective flexibility have created new opportunities for anesthesia engagement. The group compares mandatory versus elective anesthesia rotations, highlighting the tradeoffs between intentional participation and broad exposure, and how each model influences student motivation and perception of the specialty.

Attention then turns to the realities of advising in an increasingly competitive match environment. The episode offers candid guidance on away rotations, virtual interviews, and the evolving role of audition rotations as month-long assessments of both programs and applicants. The discussion moves deeply into signaling strategy, unpacking gold versus silver signals, common misconceptions, and how poor advising can inadvertently disadvantage otherwise strong candidates.

These themes are grounded in the lived experience of clerkship leadership: variable institutional support, lack of protected time, and the absence of national standardization for medical student directors. The guests reflect on the inaugural medical student education session at the SAAAPM meeting, identifying an advising gap and the growing need for a national community of practice.

The episode closes with a forward-looking discussion on advocacy, mentorship, and why investing in medical student education is not optional but foundational to sustaining anesthesiology as a specialty.

Key Takeaways From This Episode

• Early exposure to anesthesiology strongly influences student interest, preparedness, and application competitiveness.
• Externships, early electives, and interest groups are powerful recruitment tools, often with unintended positive downstream effects.
• Elective versus mandatory anesthesia rotations each carry benefits and tradeoffs in engagement and discovery.
• Audition rotations now serve as critical bidirectional assessments in a virtual interview era.
• Gold signals drive match outcomes far more than silver signals, and poor signaling strategy can undermine strong applications.
• Advising gaps persist nationally, particularly around signaling, away rotations, and program competitiveness.
• Medical student clerkship directors operate with highly variable support, limiting standardization and sustainability.
• Building a national advising and education community is essential to the future of the specialty.

Especially Useful For

Medical student clerkship directors, residency advisors, program directors, associate program directors, vice chairs for education, and anesthesiologists involved in recruitment, mentoring, or undergraduate medical education.

Related Episodes

Everything You Wanted to Know About Being a Program Director

A candid discussion of PD responsibilities, hidden labor, and the structural pressures shaping residency leadership.

Recruitment in the Virtual Era: Signals, Interviews, and Applicant Experience

Examines how virtual interviews, signaling, and visiting rotations are reshaping anesthesiology recruitment.

Program directorship is often framed as an administrative role or temporary leadership assignment. Less often is it examined as a structurally vulnerable position, balancing the needs of residents, faculty, institutions, and accreditation requirements.

In this episode of PDs@SEA, Dr. Marianne Chen and Dr. Bryan Mahoney reflect on the candid “Everything You Wanted to Know” session from the SAAAPM annual meeting, surfacing experiences program directors across the country rarely articulate publicly. The conversation opens with a striking finding: only a small minority of program directors anticipate staying in the role beyond six years, prompting discussion about burnout, identity, and the hidden labor of residency leadership.

The discussion explores how artificial intelligence is entering PD workflows, from letters of recommendation and promotion reviews to early scheduling experiments, alongside a clear-eyed assessment of where automation helps and where human judgment remains essential. Recruitment practices are also examined, including signaling, interview volume, second looks, and the tension between efficiency, equity, and applicant experience.

These themes are grounded in the daily realities of program leadership: evaluations, duty hours, follow-ups, and persistent administrative load. Practical strategies emerge around organization, delegation, habit formation, and boundary-setting, as well as how perspective shifts with experience.

The episode closes by asking whether the growing competitiveness of anesthesiology will translate into a sustainable pipeline of future leaders, and what institutions must do to support those entrusted with raising the next generation professionally.

Key Takeaways From This Episode

• Program director burnout is largely structural, driven by the role’s position between residents, faculty, institutions, and accreditation requirements.
• Short PD tenures signal sustainability challenges that cannot be solved through individual resilience alone.
• AI is beginning to reduce administrative burden for PDs, but only when paired with deliberate human oversight.
• Recruitment mechanisms such as signaling and second looks improve efficiency while introducing new equity tradeoffs.
• Administrative overload remains a central stressor and requires systems-level solutions, not incremental fixes.
• Sustainable PD leadership depends on habits, delegation, and boundaries rather than constant availability.
• Program directors shape the future of the specialty by “raising residents professionally,” extending their impact beyond individual programs.

Especially Useful For

Program directors, associate program directors, residency leadership teams, department chairs, and clinician-educators focused on the sustainability of graduate medical education leadership.

Related Episodes

• Why Residency Leadership Is Burning Out (And Why It Still Matters)
  A direct examination of PD burnout, structural pressures, and why sustaining leadership roles requires institutional support rather than individual endurance.
• Passing the Torch: How a Residency Survives (and Grows) Through Leadership Change
  Explores leadership transitions, continuity, and what departments can do to protect programs during periods of PD turnover.

This episode marks a major milestone for PDs @ SEA. We celebrate our tenth episode and welcome our new co-host, Dr. Marianne Chen, Residency Program Director at Stanford. Marianne joins host Dr. Bryan Mahoney to talk about leadership transitions, the realities of running a residency, and how signaling and recent ERAS changes are reshaping recruitment across anesthesiology.

Together, they compare early data, share how signaling is affecting the depth and fairness of application review, and reflect on the role of team-based recruitment. They also discuss the value and limits of the new applicant essay prompts and how programs interpret gold and silver tier signals differently.

This conversation offers practical insight for program directors, faculty, clerkship directors, and educators navigating this year’s recruitment season. It also highlights the shared commitment across programs to support trainees and build strong, inclusive learning environments.

This episode was recorded, produced, edited and published by Larry Chu, MD and the Stanford AIM lab.

In this episode of PDs at SEA, Dr. David Stahl reconnects with two former colleagues from The Ohio State University to reflect on what happens when leadership changes hands in a residency program. Dr. Amy Bauman, now the program director at OSU, and Dr. Jared Spear, outgoing chief resident, join the conversation to discuss the practical and emotional dimensions of program director transition from three different vantage points: the departing PD, the incoming PD, and the residents navigating the shift.

The discussion explores why program directors move on, how successors step into leadership roles they may or may not have felt ready for, and what residents experience when the person who recruited them is no longer the one leading the program. The conversation also addresses the realities of the job itself: the steady presence of daily fires to manage, the challenge of maintaining boundaries and perspective, and the ways in which mentorship, communication, and shared values carry programs through change.

Despite the inherent uncertainty of leadership turnover, the episode emphasizes continuity of culture, trust, and purpose. It offers reassurance to applicants and residents alike that transitions are common, that strong programs remain strong, and that the work of training physicians continues to be deeply meaningful.

This episode was originally published September 15, 2025 on YouTube