Establish a new medium- and long-term development plan for the Department of Anesthesiology.

1. Strive to secure the discipline’s rightful place within clinical medicine by refining both its substance and structure. The 2018 joint notice issued by seven State Council ministries, “Notice on Issuing Opinions on Strengthening and Improving Anesthesia Medical Services,” along with its accompanying policy interpretation, explicitly states that anesthesiology is an essential component of clinical medicine, a key clinical specialty, and a critical indicator of a hospital’s overall medical standards—capable of contributing meaningfully to disease prevention, diagnosis, and treatment. During this pandemic, nearly every medical discipline has confronted challenges in care delivery and management, offering a stark wake-up call: it is precisely in times of difficulty that a discipline’s strengths are revealed and its shortcomings exposed, prompting reflection on the direction we should take in shaping its future development. I believe we must break free from conventional frameworks, refine our disciplinary structure, and formulate medium- to long-term development plans. To do so, we must ground ourselves in the present, assess the situation carefully, and establish a clear positioning for anesthesiology. But how should we define that positioning? Should it rest on the continuous expansion of anesthesiology’s scope of practice? And is such an expansion truly the path forward for our discipline—a new choice for the future? This is a question worthy of discussion. While anesthesiology must broaden its reach and deepen its impact in serving clinical patients, what matters even more is cultivating depth, excellence, and a distinctive niche in specific areas—particularly in disease diagnosis and treatment—where it can wield influence and assume a leadership role. To achieve this, we need a community of visionary leaders who will advocate for the discipline’s future, securing the necessary top-level design, structural framework, and operational model. Otherwise, even if anesthesiology seeks to rebrand itself as “Anesthesiology and Critical Care Medicine” or “Anesthesiology and Perioperative Medicine,” such transitions will remain difficult to realize—let alone enable the discipline to play a leading role and assume a commanding position in future public health crises.

2. Expand the scope of practice in anesthesiology by moving beyond the operating room and establishing disciplines such as anesthetic therapy, as advocated by Professor Yu Buwei. For example, set up an anesthesia outpatient clinic to ensure patient safety during anesthesia while also providing anesthetic therapeutic services and palliative care; establish an anesthesiology‑intensive care unit to safeguard critically ill patients after surgery and reduce perioperative complications associated with anesthesia and surgery; and develop comfort‑oriented medical care led by the Department of Anesthesiology, involving multidisciplinary collaboration—such as vigorously promoting labor analgesia to alleviate the severe pain of childbirth and offer patients comfortable, pain‑free support. Through the implementation of these initiatives, both the healthcare community and the general public will come to recognize, understand, and appreciate the vital role of anesthesiology in clinical medicine, thereby fostering its sustainable development.

3. Rationally optimize the structure of anesthesia‑related professional and technical personnel, enhance the occupational appeal of anesthesia staff, and attract more outstanding talent to join the anesthesia department. Building a strong workforce has long been a bottleneck and a weak link in the development of anesthesiology. The daily overload of clinical duties leaves most anesthesiologists stretched thin—how can they find the time and energy to pursue their aspirations? Consequently, addressing the shortage of human resources remains an urgent challenge that demands our concerted efforts. Document No. 21, jointly issued by seven ministries and commissions, explicitly calls for establishing a talent supply‑and‑demand balancing mechanism oriented toward clinical staffing needs; increasing the number of anesthesiologists; stabilizing enrollment in undergraduate anesthesiology programs; gradually expanding recruitment for standardized residency training in anesthesiology; and creating additional positions for auxiliary personnel such as nurses and technicians to strengthen the anesthesia workforce. Furthermore, we should, on the internal front, enhance our own medical service capabilities and establish high‑level technical platforms in anesthesiology to boost the profession’s attractiveness. Externally, through public education and outreach, offering anesthesiology courses within other clinical specialties, and integrating anesthesiology knowledge into the standardized training of all clinical disciplines, we can not only equip clinicians with emergency‑care skills and a patient‑centered approach to comfort‑oriented care but also draw more motivated individuals into the ranks of the anesthesia workforce.

Strengthen talent development and build a robust second-level discipline in anesthesiology.

As demonstrated during this pandemic, although we have managed tracheal intubation and respiratory support for critically ill patients with considerable proficiency, the number of personnel involved, their roles, and the modalities of participation remain rather limited. In the management of COVID‑19, anesthesiology has lacked a voice and occupied a subordinate position. How can anesthesiologists assume a leading role, shifting from passive compliance to proactive intervention? How can we move beyond mere intubation to actively influence patient outcomes? And how can we better prepare for potential large‑scale public health emergencies in the future? Only by demonstrating competence and taking initiative can anesthesiologists earn their rightful place—and, consequently, command respect. Therefore, the author argues that we should strengthen training in the following areas to refine anesthesiologists’ knowledge base.

1. Focus on cultivating leading talents. A lasting legacy hinges on talent, and anesthesiology is no exception: nurturing top-tier leaders helps unlock the creative potential and professional enthusiasm of team members while guiding the discipline’s advancement. Anesthesiology boasts a distinctive technical framework and an interconnected web of related disciplines, with a strong emphasis on integrating theory and practice. Yet, truly groundbreaking work and achievements that drive medical progress remain scarce, and scientific contributions to addressing diseases that threaten human health are exceedingly limited. Despite our broad theoretical foundation and proud record of clinical expertise and efficiency, we still lack authoritative standing in disease prevention and treatment. Therefore, in fostering future leaders, in addition to a comprehensive knowledge base and exceptional professional skills, it is essential to develop their capacity to generate novel perspectives, ideas, and approaches through the cross‑disciplinary integration, mutual permeation, synthesis, and dynamic interaction of diverse fields—enabling them to produce pioneering research in a specific area and to devise corresponding therapeutic strategies and methods. Furthermore, they must be equipped with robust leadership and social competencies, including outstanding managerial acumen, strong team cohesion, broad societal influence, public recognition, and adept interpersonal skills.

2. Promote the cross-disciplinary integration and collaborative development of various fields, foster a spirit of cooperation and mutual trust among disciplines, and cultivate a large cohort of anesthesiologists with comprehensive clinical capabilities. Strengthen the pivotal role of anesthesiologists in the management of critical and emergency conditions by extending the duration of rotations in internal medicine, surgery, and the ICU for undergraduate students, residency trainees, and fellowship fellows, thereby enhancing their expertise in respiratory management, organ protection, resuscitation, and treatment of critically ill patients. Break down disciplinary silos and establish an integrated educational framework that spans schools and disciplines, seamlessly linking basic science with clinical practice. For example, actively advance problem-based learning (PBL), a pedagogical approach that not only harmoniously integrates foundational, clinical, and humanistic knowledge—facilitating deeper comprehension and retention—but also emphasizes the development of students’ self‑directed and lifelong learning habits and competencies, as well as their capacity for innovation and practical application, thus meeting the contemporary society’s heightened demands for well‑rounded medical professionals. Moreover, through interdisciplinary collaboration, encourage cooperation and mutual trust across specialties, humbly and attentively listen to the perspectives and needs of other departments, and share information openly.

3. Emphasize basic theoretical research that is closely integrated with clinical practice. Breakthroughs in all aspects of clinical work depend on foundational research, and all basic research ultimately serves clinical applications. For example, during the COVID‑19 pandemic, if we had gained a comprehensive understanding—through basic research—of the dynamic interplay between the immune system and the virus, and of the specific signaling pathways through which SARS‑CoV‑2 activates certain immune cells to trigger cytokine storms, we could have effectively prevented mild cases from progressing to severe illness, thereby significantly reducing mortality. Similarly, as surgical techniques advance and the number of elderly, complex, and oncologic patients continues to rise, preventing and minimizing perioperative complications, accelerating postoperative recovery, and improving long-term outcomes will become critical scientific challenges for anesthesiology. What, then, are the core mechanisms underlying multiorgan dysfunction during the perioperative period? What are the mechanisms by which general anesthetics and perioperative stress affect host immune function? And what interventions can be employed to modulate the impact of anesthesia or stress on the immune system, thereby averting disturbances in the internal milieu and imbalances in immune homeostasis? In my view, these are precisely the clinical issues that require vigorous advancement of basic theoretical research to resolve.

4. Encourage scientific and technological innovation. Innovation is the soul of a nation and an inexhaustible driving force for social development, and medical professionals in particular must possess both boundless imagination and down-to-earth execution. With the advancement of modern technologies and the application of 5G in healthcare, new momentum is being generated for the future development of anesthesiology—particularly in areas such as artificial intelligence and smart medicine. We should seize this opportunity to cultivate students’ global perspective, innovative mindset, research curiosity, and translational thinking, and to conduct innovation‑driven research oriented toward clinical challenges, public health issues, and pharmaceutical concerns, thereby integrating more innovations into anesthesiological practice. For example, in the realm of equipment innovation, the development of anesthesia robots, visualization‑assisted endotracheal tubes, anesthesia machines with detachable circuits that are easy to disinfect, and the integration of AI with ultrasound technology can all make our anesthetic care more precise and efficient. Moreover, during the management of infectious disease outbreaks, these advances can reduce personnel movement and contact, offering protective benefits to anesthesiologists. In terms of technological innovation, we should encourage the exploration and application of cutting‑edge anesthetic techniques, including airway management, hemodynamic monitoring, respiratory support, and advanced ultrasound utilization. As for drug‑ and mechanism‑level innovation, we can leverage anesthesiological expertise and principles to address common yet refractory clinical conditions, such as treatment‑resistant insomnia, severe substance dependence, immune‑mediated disorders, geriatric syndromes, and cancer‑related pain.

5. Strengthen the humanistic spirit in medicine. At the National Education Conference, General Secretary Xi Jinping emphasized that defining the kind of people to cultivate is the primary question of education. Physicians possess two wings: one is a solid foundation of medical knowledge and superb clinical skills, and the other is noble humanistic values. The humanistic spirit in medicine integrates humanistic literacy with medical ethics throughout the educational process, underscoring respect for and care toward patients, and striving to make medicine more humane. Its core values are people‑centeredness, respect for life, and reverence for life. Anesthesiologists, long regarded as “guardians of life,” should even more so embody this lofty humanistic spirit, becoming well‑rounded medical professionals who excel in moral integrity, intellectual ability, physical health, aesthetic appreciation, and practical skills. They must always place patients’ interests first, truly alleviating physical suffering and promoting optimal health, and devote themselves wholeheartedly to safeguarding the health of the people.

Strengthen public education and outreach in the field of anesthesiology.

Professor Xie Rong, the founding father of anesthesiology in China, once remarked: “Anesthesia education is the path through which anesthesiologists can realize greater personal fulfillment—a noble yet arduous mission.” In the past, many people viewed anesthesia merely as “a shot and a sleep,” unaware that it is far more complex than that. This underscores the critical importance of public outreach and education in anesthesiology. How can we leverage such efforts to draw greater attention and support from hospitals and society at large, thereby amplifying the innovation and impact of anesthesiology and encouraging more individuals to join and strengthen the field? These are questions that demand our thoughtful consideration.

The road is long and arduous, but perseverance will lead us to our destination; as long as we keep moving forward without pause, the future holds promise. The development of anesthesiology is not merely a matter of advancing a single discipline—it also drives the overall progress of national healthcare. As a pivotal platform and cornerstone of clinical medicine, anesthesiology is increasingly shouldering greater social responsibility and commitment. The journey ahead is long and fraught with challenges, yet I shall search high and low in pursuit of knowledge. I am confident that, by standing together and forging ahead, the future of Chinese anesthesiology will shine ever more brightly.