Program Director Wellness Taskforce Updates – Fostering the Well-Being of Residency Program Directors: A Call for Awareness and Action

Nguyet-Cam Lam; Afsha Rais Kaisani; Parastou Farhadian

doi:10.1370/afm.3111

Residency program directors (PDs) play a vital role in the health care system, from overseeing the training of future physicians to navigating the complexities of administering their residency program and ensuring continuous delivery of care to their communities.¹ Programs have faced increased challenges in light of the recent COVID-19 pandemic, such as fluctuating patient volumes, shifting to virtual interviews, modified factors in assessing resident readiness, and coping with workforce disruptions and shortages, taking a toll on the PDs’ well-being. National data reveals the average tenure for program directors stands at 4.5 years, emphasizing the need to address the factors contributing to their burnout.^2,3

Program director burnout is not only a personal struggle, as it has extensive consequences for the leadership of graduate medical education (GME) and the future of family medicine.¹ The resilience and well-being of PDs serves as the foundation for the overall health of residency programs, ensuring the continued delivery of compassionate and comprehensive care to the patients in their communities. By proactively addressing factors that impact PD well-being, we can strengthen their professional roles and empower them to lead and train future family physicians effectively.

Recognizing the significance of PDs’ well-being, the Association of Family Medicine Residency Directors (AFMRD) formed the Program Director Wellness Task Force in the summer of 2022. This task force commenced on a mission to explore options for providing wellness support to AFMRD members and recommending initiatives to the AFMRD Board of Directors. The task force members conducted extensive literature research on residency program director/leadership wellness at the initial meeting in October 2022, discovering a notable gap in literature addressing PD well-being. In response, the task force recommended and subsequently developed a Program Director Wellness survey, administered through AFMRD membership, to conduct a needs assessment. Amongst shared concerns by fellow PDs nationwide, the task force put forth several recommendations.

Raising Awareness Locally and Nationally

Advocate for the awareness of the critical issue of PD wellness, reaching out to organizations such as the Accreditation Council for Graduate Medical Education (ACGME), American Academy of Family Physicians (AAFP) and the Society of Teachers of Family Medicine (STFM), to aid in the development of resources supporting PD well-being. Resources should include understanding of organization funding for academic positions, time management in an educational setting, and enhancing the culture of program leadership wellness in residency programs.

Review Administrative Time Requirements

Recommend ACGME review and reassess the new requirements regarding the administrative time for PDs and faculty, acknowledging time and resource constraints as major concerns for residency programs. This recommendation has since been addressed.

Develop an Annual PD Wellness Survey

Suggest ACGME develop and implement an annual survey for PD wellness assessment, ensuring ongoing monitoring and support for their well-being.

Encourage Dialogue and Collaboration

Recognize diverse resource challenges faced by community residency programs and encourage open dialogue and collaboration with organizations and sponsoring institutions.

The PD Wellness Task Force submitted its initial report to the AFMRD Board of Directors on March 1, 2023. In response, the Board requested specific actions and outcomes to guide the future trajectory of the task force. Cognizant of the need for ongoing support, the task force presented 2 key recommendations:

Incorporate the Program Director Survey into the ACGME Annual Survey: The task force recommends AFMRD appeals to ACGME to add a dedicated comprehensive PD Survey to the Annual ACGME Survey, encompassing general questions related to the Common Program Requirements and specific inquiries regarding PD well-being.
Request for longer-term extension for the task force or similar: Recognizing the complexity of the issue at hand, the task force requested this extension for ongoing support to achieve the following outcomes:
- Analyze meaningful metrics on PD well-being to better identify primary drivers influencing program director well-being, facilitating the development of targeted and meaningful interventions
- Hope to increase PD tenure beyond the current 4.5 years, ensuring stability and continuity in leadership for improved residency education

By advocating for these recommendations, the AFMRD and the PD Wellness Task Force aim to address the immediate concerns and lay the groundwork for continued improvements in program director well-being. Incorporation of a dedicated survey and extension of the task force reflects a commitment to fostering a supportive environment for those actively shaping the future of GME and patient care. In doing so, AFMRD endeavors to support the foundation of residency programs, ensuring optimal training for future family physicians and enhancing patient care in communities nationwide.

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