Why Family Medicine Program Directors Leave Their Position

"We've Really Built Something": Why Family Medicine Program Directors Stay in Their Positions-A Qualitative Study

BACKGROUND

Program directors (PDs) are essential to more than 12 000 residency and fellowship programs accredited in the United States. Short PD tenure may affect overall program quality. Reasons why PDs leave the position are multifactorial, and little is known about the reasons why PDs stay in the position.

OBJECTIVE

The authors explored factors related to retention and why family medicine PDs have stayed in their positions long term.

METHODS

This was a qualitative study of PDs in their roles for 12 or more years drawn from a national sample of family medicine residency PDs. Interviews with semi-structured and structured questions about long-term PD experience were conducted in October and November 2020. Multiple cycles of comparative coding and code network analysis produced constructs describing reasons why some PDs stay in the position long term.

RESULTS

Among 17 respondents with a mean tenure of 17.4 years, 3 interrelated constructs consistently emerged that supported PDs: developing the program, support systems, and job rewards. Program development reinforces internal and external support systems and enhances experiencing rewards of the job. Strong support systems enable further program development and job rewards.

CONCLUSIONS

Family medicine residency PDs who have been in the role 12 or more years continuously work to develop the program, benefit from strong internal and external support systems, and describe many important rewards of the position that help sustain them in the role.

The use of emotional intelligence skills in combating burnout among residency and fellowship program directors

BACKGROUND

Current rates of burnout among physicians are alarming when compared to nonphysician U.S. workers, and numerous interventions have been introduced to mitigate the issue. However, no interventions have specifically targeted the 30% burnout rate among physician program directors. The complex and demanding role of program directors necessitates building relationships, solving crises, securing jobs for residents and maintaining well-being of trainees. The aim of this study is to investigate the impact of emotional intelligence (EQ) on burnout levels among program directors.

METHODS

A cross-sectional survey was administered from May 17 to June 30, 2021 to program directors and assistant/ associate program directors at an academic medical center in south-central Pennsylvania. A self-report questionnaire was used to collect data. The survey included an open-ended question along with the Trait Emotional Intelligence Questionnaire- Short Form (TEIQue-SF), Copenhagen Burnout Inventory (CBI), and demographic questions. All data were analyzed using SAS Version 9.4.

RESULTS

Of the 109 program directors and assistant/associate program directors invited in the survey, 34 (31.20%) responded. The findings indicate that there is a moderate inverse association between EQ and burnout, suggesting EQ as a protective factor against burnout. We also found that program directors who were considering leaving their position demonstrated higher levels of burnout compared to those who did not. Results from the open-ended question suggest that perceived lack of support, micromanagement, criticism, and extra duties with less payment were among the reasons program directors and associates were considering steeping down from their position. The results showed no association between EQ skills and years of practicing.

CONCLUSIONS

Burnout among program directors and assistant/associate program directors is not as alarming as rates of burnout among physicians-in-training. However, despite high level of EQ skills and low burnout level, nearly 43% of program directors were considering leaving their position. Nurturing EQ skills may be useful in improving retention and reducing turnover among medical leaders.