Who Are Surgery Program Directors and What Do They Need?

1. Who Are Surgery Program Directors and What Do They Need? Tania K. Arora, MD, Brian J. Kaplan, MD Virginia Commonwealth University Health System Department of Surgery Richmond, Virginia

2. Introduction • Program directors (PDs) play a pivotal role in the educational mission in residency programs. • Several specialties have examined the role and responsibilities of clerkship and program directors. • Dr. Joseph Cofer conducted a national survey of program directors and presented his results at the annual Association of Program Directors in Surgery meeting in 2006. • There is a void in the literature describing the demographic profile of surgery program directors. • There are new revisions to the ACGME program requirements for general surgery.

3. Methods: design, setting, and participants • IRB approved. • A confidential, internet-based survey was administered to 252 PDs of surgery residencies in the US between October and December 2007. • 49 questions configured based on existing literature. • Questions elicited information regarding personal and professional attributes. • Email follow-up.

4. Age : 51 ± 8 (36-75) Gender: Race: Caucasian 86.9% Rank: Associate/Assistant Professor 47.3% Professor 41.8% Results • 58% response rate (n=146, 27 partially complete).

5. Administrative Titles • Concurrent Titles : • 1 additional admin. title: 56.1% • 2 additional admin. titles: 8.9%

6. Demographics • Fellowship Training 63.7% • Trauma 22.6% • Surgical Oncology 17.2% • Background in education • Attendance at teaching/education seminars 63% • Attained previous teaching award 82.9% • Currently conducting education research 52.0% • Scholarly activity • Currently conducting basic science or clinical research 82.9% • Published peer-reviewed articles 96.6% n=146

7. Years as current PD • 46.6% of current PDs are relatively new having served < 5 years.

8. Duration as PD • New revisions to the ACGME requirements: • Duration of PD for at least the duration of the program. • Our study revealed: • 6.7% of PDs estimated total duration is <5 years. Intended total duration of PDs= current duration + years of intent

9. PD support: staff • Average number of staff 4.5 ±1.8 • New revisions to the ACGME requirements: • Programs with > 20 categorical residents require an Associate Program Director • At least one APD: 81.5% • 6 programs with 26-45 residents have no APD n=119

10. PD support: protected time • New revisions to the ACGME requirements: • PDs should have 30% protected time- direct or indirect via salary or release from clinical activities. • PDs that reduced clinical hours when hired: 55.5% • PDs with protected time: 38.7% • % Protected time: 32.5 ±20.6 • PDs working beyond protected time: 84.8% • PDs without protected time: 61.3% • % of time spent on PD duties: 29.3 ±14.4 • PD protected time and Total weekly work hours • Pearson coefficient= -0.299, p=0.0181 n=119

11. PD support: salary compensation • New revisions to the ACGME requirements: • PDs should have 30% protected time- direct or indirect via salary or release from clinical activities. • PDs with % salary compensation: 78.6 % • Average % salary derived for PD position: 32.9 (26.3) • PDs with NO clinical hour reduction, NO protected time and <30% salary compensation: • 28.6% • PDs with NO clinical hour reduction, NO protected time, and NO salary compensation: • 15.1%

12. PD support: salary compensation With protected time 32.9 (25.9) .0015 Without protected time 21.2 (26.1) Current duration as PD> 5 years 31.5(30.1) .026 Current duration as PD≤ 5 years 20.8(22.8) Male PD 26.2(27.6) .89 Female PD 22.6(21.1) Age >50 29.7 (29.4) .15 Age≤50 21.8(23.6)

13. Job Perceptions • Ideal % protected time: • 41.4 ±19.1 • Feel support for professional development: 90.8% • Feel supported by their chairman: 94.1% • Non-chairmen PDs: 92.1% • Intent to remain as PD≥ 5 years: 57.9%

14. Limitations • 58% response rate • Wording of questions may have been open to misinterpretation or may have had a limited scope. • Programs may have been in the process of meeting the new ACGME guidelines that came into effect January 1, 2008.

15. Conclusions • Demographically, PDs are somewhat homogenous. • Most PDs • are fellowship trained • have other administrative titles • They are accomplished in teaching and scholarly activity. • There are inconsistencies in salary and protected time that PDs have. • The ‘ideal’ protected time is 10% higher than current guidelines stipulate.

16. Acknowledgements • Luke Wolfe, MS • Wendy Coates, MD • Debra DaRosa, PhD