1. Project Background & Lessons Learned Pascal Vuilleumier, MD

2. No conflicts to declare

3. Who I am? Attending Anesthesiologist in University Hospital Bern, Switzerland Staff in level 1 trauma and transplant center Mainly digestive, oncologic, thoracic and gynecologic anesthesia Research in spinal pain modulation on a Swiss National Grant for 3 years. Leading current projects in volunteer studies within Gaba & Oxytocin receptors, EEG and pain.

6. And why I came to UWMC Learn and understand research on genetics of pain Perform a prospective study in Brazil in the Women’s Hospital of Santa Johana, in Sao Paulo, on the effects of low dose gabapentin and ketamine on post cesarean pain Data analysis on oxytocin receptor genotype and haplotype and post-cesarean pain

7. OB Fellowship A good opportunity to see how others do & perform & An excellent opportunity to combine my primary aim of research with protected research time and a clinical commitment allowing a salary that is adequate to feed and house my wife and now 2 kids

8. Current picture of the projects Brazil: First study protocol written 12.2011, but considered too complex after my fellowship started. A second study protocol was written and complete by 11.2012, nevertheless unknown issues seem to delay study start to unknown date. My clinical commitment seems to make this project impossible to pursue.

9. Current picture of the projects Promise to perform QST measures in regard to opiate hyperalgesia with human volunteers in a project in preparation by Dr. P. Richebe in replacement of the Brazil study Philippe Richebe decided to resign his position at UWMC in early 02.2013

10. Current picture of the projects Oxytocin receptor and post cesarean pain: Abstracts accepted for the SOAP congress and for ASA. Major issues with data quality with > 35% of missing results, making statistic analysis challenging. Data is back in Singapore, where it originated, to be reanalyzed by local statistician in possession of complete database. Outcome, results and publication ?

11. Current picture of the projects Book chapter on post partum hemorrhage written, third author Which book it was for remains unknown

12. Current picture of the projects Review article on pain after delivery written, third author

13. Current picture of the projects Small analysis on post IVF pain and plasmatic estradiol levels (n=9, now n=16). Positive correlation found, presented as poster at the SOAP congress and the UW academic evening. Third place award for excellence in research received Manuscript in preparation

14. Current picture of the projects Epigenetic impact of in utero exposure to opiates in the generation Z’ Project defined as faculty fellow project Sept. 2012 Submitted in my name for a SOAP grant, not received Submitted for ITHS grant, approx 15000 USD awarded to Dr. R. Landau Genetic samples were analyzed in July; results, data analysis and manuscript preparation handed over to a medical student

15. Lessons learned Proper preparation prevents poor performance – Have one or several study protocols ready for IRB submission when starting in your new position – Timing is of prime importance: IRB approvals, grant submissions, writing good study protocols are all extremely time-consuming – If not properly prepared with grants and IRB submissions prospective studies may need 6-12 months to be on track

16. Lessons learned Trust your “gut feeling” – Your mentor is of prime importance to complete a study – Your mentor has to know you, be one of your closest allies, confident and guide, in professional and sometimes also private matters – If there is no professional “love story” there may be difficulties

17. Lessons learned Protected research time – Is not every week after a 24h call – Is not good-will time that is offered to you out of human generosity If you are called in clinic just anytime you perform research duties: you will perform poorly in research

18. Lessons learned No study without grants – Trust your future to groups that have shown excellence in research; – in the US NIH granted groups are the benchmark – Industry or other sponsors are also a good alternative, but there needs to be proper funding for what you aim to study is

19. Lessons learned Why and what to study? – Continuity, personal interests, anesthesia practice What are your aims? – Academic career vs private practice In what does research help in/for your future? – Ranking of publications – Prospective studies vs retrospective data analysis – Original pubications vs reviews

20. Conclusions Research needs a huge investment in time, energy, preparation and patience To trust is ok, to control is better Chose your mentor with care in regard to personality, availability, past publications and received grants Have an aim, and pursue this aim, don’t challenge your aim every other week

21. Conclusions The academic way is long & difficult; fences and obstacles in research are increasing and will be your daily life Do never neglect other really important things in life; without family and/or friends human beings do not survive and perform well on the long run

22. Thank you & Good Luck!