The National Institute for Program Director Development (NIPDD) was born in 1994 due to the challenges facing residency program directors and as a result of the passion of the Association of Family Medicine Directors (AFMRD), through collaboration with the American Academy of Family Physicians (AAFP), the American Board of Family Medicine (ABFM), the Society of Teachers of Family Medicine (STFM), and Residency Assistance Program (now known as Residency Program Solutions).
The NIPDD 9-month fellowship provides instruction, education, and formative experiences designed for family medicine physician educators to enhance and develop the knowledge, skills, and attitudes to be effective leaders as directors of residency programs.1
Historically, postgraduate training program directors in family medicine faced many challenges without significant training in finance or administration. For those reasons, and because family medicine directors might not have support from other program directors, the sessions on stress and burnout were always full at the Program Directors Workshop. In 1994, during a strategic planning meeting of AFMRD, the idea of a school for program directors surfaced. At the same time, the ABFM was seeking a way to educate program directors on policies and procedures to assure resident eligibility for the certification exam. With major financial support from the ABFM, the idea became reality. In-kind staff support from the AAFP and AFMRD, and the interface with AFMRD, AAFP, STFM, RAP, and ABFM initiated the creation of the Academic Council by selecting representatives of those organizations to participate as members of the Council and to teach in the fellowship.1 The Academic Council reports to the AFMRD Board of Directors through the Council Chair. Each element of the fellowship receives CME credit from the appropriate medical specialty organizations and the American College of Physician Executives (ACPE).
The first class graduated in 1995 and since then more than 538 participants have graduated from NIPDD I: Fundamentals and 32 from NIPDD II: Advanced, which debuted in 2005–2006. But success is not only based in numbers. The annual turnover rate of program directors in 1994 was 33% and the rate for 2007 was 13%. A follow-up survey in 1999 documented an increase in program director tenure and an overall positive impact on family medicine residency programs. Content importance and relevance to the job consistently rated >4 on a 5-point scale. The ABFM eliminated preauthorization for advanced placement of residents because NIPDD graduates had 100% approval rate.2
One major reason for success has been the ability of the Academic Council and the AFMRD Board of Directors to continuously reassess the needs of the program directors through member and participant surveys. The initial needs assessment paved the way for the fellowship creation, and follow-up surveys guided the curricular content areas through the adaptability and flexibility of the Academic Council. The Academic Council is responsible for the coordination, supervision and evaluation of the NIPDD’s educational programs. Importantly, they are the teachers, lecturers, and mentors for the fellows.
NIPDD II: Advanced, with a focus on professional and personal growth, was presented in 2005–2006 in response to program director demand determined through a needs assessment of the AFMRD membership. NIPDD II: Advanced was developed by the Academic Council to continue the enhancement of leadership skills, incorporating organizational fit, balance, critical thinking and advanced negotiation skills. The debut in 2005 again resulted in scores rated >4 on a 5-point scale.
NIPDD I and NIPPD II give the participant the fundamental and advanced tools needed to be successful as a program director of a residency; even the required academic and financial projects are geared to be meaningful to the home program of the participant.3 The relationships that develop among participants and the Academic Council continue through listserves set up for the classes and via the networking and future interactions after the fellow has graduated.
Former participants report enhanced job satisfaction, reduced job stress, and an expanded network of educational contacts and resources. Residency faculty participants who are not yet program directors report an enhanced capacity for effectiveness in supporting their programs’ directors, and the ability to clarify their career goals. Finally, with the recent financial challenges to residency program viability created by the Balanced Budget Act of 1997 and the ensuing legislation, the curriculum in residency program finance has been expanded and enhanced with a finance project exercise and discussion groups.
Born out of necessity, the fellowship continues out of the passion and dedication of the Academic Council members in the pursuit of excellence. The member organizations also have this “passion” for excellence.
- © 2008 Annals of Family Medicine, Inc.
