1. 90 Days—Enough Time to Learn Anesthesiology?
Douglas R. Bacon, M.D., M.A.
Vice Chair for Faculty Development
Professor of Anesthesiology
and History of Medicine
College of Medicine, Mayo Clinic

2. A Time to Prepare
In the Spring of 1940 the National Research Council and the ASA joined forces
The goal was to improve anesthesia services to the armed forces

3. A Time to Prepare Why worry?
France had been overrun by Hitler’s Forces
Norway had fallen
Europe was largely within the control of the Axis

4. A Time to Prepare
FDR knew the US would eventually be involved in the War
Proposal for several million man armed forces was daunting
Who would provide medical care to the troops?

5. Solution
The National research Council worked with the Specialty Boards to creat courses to teach the fundamentals of practice to young physicians

6. A Little History of Anesthesiology
The ASA along with the ASRA, AMA and the American Board of Surgery had sponsored the American Board of Anesthesiology
First Exam in March of 1939

7. NRC Sub Committee on Anesthesiology
Ralph Waters was the Chair
Emery Rovenstine was the Secretary
The committee: John S. Lundy, Henry Ruth, Henry K. Beecher, Paul m. Wood, Ralph Tovell, Lewis Booth
Tovell would become the consultant for anesthesiology in the European Theater
Beecher would hold the same rank in the Mediterranean

8. NRC Sub Committee on Anesthesiology
There were five American Board of Anesthesiology Directors on the Committee: Waters, Rovenstine, Lundy, Wood and Tovell
This would be important later as some of the work of this subcommittee would count toward board certification after the War.

9. The Problem
How can enough physicians be trained quickly enough to be of use to the military?
Where should they be trained?
Who should train these physicians?

10. The Answers
The Subcommittee developed two curricula—one of 6 weeks duration as a “refresher” and one of 6 months
The proposal was changed to one course for all of 90 days

11. The Answers
Training could occur only in departments with a board certified chairman
The department was to be associated with a medical school

12. The Answers
A curriculum was developed and published in 1942 and 1944 as Fundamentals of Anesthesia
Students were to spend 6 hours a day in the OR and on call for pain questions

13. The Answers
A list was developed of all the known physician anesthetists in the US
Each was rated as to their clinical, administrative, and teaching abilities

14. Lundy’s Book

15. Curriculum Operating Room experience Patient assessment and follow up
Weekly review of the literature
Didactic lectures

16. The Anlet Anlet –AN for anesthesia Let for letters Edited by Lundy
Letters back from Graduates to their program directors
141 letters in 8 issues from August 1, 1943 to August 20, 1945

17. The Anlet Equipment was of various designs and nationalities
Parts were not interchangeable
Letters back told of ways to rig different equipment to work together

18. The Anlet Regional block was very important
Complications and problems discussed
Unique working conditions
Commonly encountered medical conditions

19. The Anlet Suggestions about where to find supplies Oxygen therapy
Transfusions
Data collection
Teaching

20. What happened to the 90 day students after the war?

21. The Mayo Experience
184 short course graduates came through the Mayo Clinic anesthesiology program
78 were ASA members by 1954

22. The Mayo Experience
33 were certified as specialists by the American College of Anesthesiologists
39 were certified by the American Board of Anesthesiology
33 held both certificates

23. Conclusions
What started out as a way to provide medical care for the armed forces changed American medicine
Anesthesiology was accelerated by the influx of young physicians, many of whom had never seen a physician give an anesthetic

24. Conclusions
Surgeons were equally impressed at what these fledgling anesthesiologists could do outside of the operating rooms—blood transfusion, preoperative assessment and stabilization, fluid therapy, and the list is endless
Quite simply, the military enhanced the specialty of anesthesiology in countless ways!