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When the National Institutes of Health (NIH) budget doubled in the late 1990s, it led to a rise in the number of PhD-trained scientists and to increased NIH-funded programs to diversify the biomedical workforce. This trend has seen more PhD scientists take on leadership roles as program directors in academia. These program directors are often highly skilled in research design and data analysis, and they bring a scholarly approach to their administrative duties. Despite organizational challenges, promoting scholarship among program directors offers numerous benefits, including enhanced institutional reputation and better training outcomes. Herein we use examples from peer reviewed literature to illustrate how publications by program directors have influenced national policies and practices in biomedical training. Encouraging more academic institutions to support program director scholarship can yield significant returns for institutions, trainees, and the directors themselves. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to investigate and highlight the most important factors influencing the candidate's selection for residency matching by program directors of surgical and non-surgical specialties in Saudi Arabia. Method: This cross-sectional study was conducted in the Central, Eastern, Western, Northern, and Southern regions of Saudi Arabia from February 1, 2023, to August 31, 2023. A total of sixty-one program directors completed a questionnaire, which was adapted and validated from a previous study with permission and tailored to meet the objectives of this research. Results: The mean age of the study population was 40.2 years, with surgical specialty program directors being older at 41.7 years and nonsurgical specialty program directors being younger at 39.6 years. In both cases, the highest importance was given to 'Applicant's attitude and professionalism', followed in surgical specialties by 'Doing clinical rotations in the PD institution' and 'Performance in clinical rotation during internship' in non-surgical specialties. with a mean score of 4.13 and 4.95, respectively. The importance of 'The impression/opinion of current residents' has had a certain importance in both specialties. While the number of research projects was prioritized more by surgical PDs (38.6%) compared to non-surgical PDs (29.4%). Conclusion: This study highlights the critical role of professionalism and a positive attitude in clinical rotations and interviews for program acceptance in Saudi Arabia. The significance of letters of recommendation and research focus varies between surgical and non-surgical program directors. Program directors should adopt effective recruitment strategies that incorporate practical implications during internships. Key messages: This research focuses on the evolving area of residency applicant selection criteria in Saudi Arabia. In 2024, over 6400 individuals were nominated for residency programs across the country, with approximately 5100 successfully matched following interviews. These statistics underscore the complexity and competitiveness of the matching system in Saudi Arabia, underscoring the urgency for similar research. Such studies are essential to provide guidance to future applicants, helping them navigate the selection process effectively and avoid common pitfalls. [ABSTRACT FROM AUTHOR]

Abstract Background Applying to periodontics programs in Saudi Arabia holds significant importance for both applicants and periodontics program directors. As of today, there has been no investigation into how periodontics program directors (PDs) identify and select potential candidates for their programs. The aim of this study is to assess the factors taken into consideration during the selection process for periodontics programs by PDs in Saudi Arabia. Methods In this cross-sectional study, an electronic survey was sent out to Periodontics PDs of the Saudi Commission for Health Specialties (SCFHS) in Saudi Arabia. Variables of interest included the Grade Point Average (GPA), Saudi Dental License Exam (SDLE), research, interview, service and electives, letter of recommendation, and other miscellaneous factors. A degree of importance scale was used to measure the significance of each factor for PDs. Results This study surveyed 16 PDs with a response rate of 72.7%. The majority of PDs were from the Central and Western Regions. Approximately 56% of the PDs were affiliated with universities. The study identified, from the perspective of PDs, that the most important factors were the reputation and performance of the applicant during clinics or interactions with staff, followed by general research experience. Additionally, interview performance was rated equally with SDLE score and GPA, as well as factors such as undertaking periodontics elective rotations during internship and working in the same department. Regardless of the region or number of years of experience, all PDs considered the most significant factor to be the reputation and performance of the applicant during clinics or interactions with staff. Conclusion This study sheds light on the factors perceived by program directors in Saudi Arabia that influence the selection process for applicants to periodontics programs. By understanding these factors, dental graduate students can better customize their applications and experiences to meet the expectations of admission committees.

Abstract Purpose The aim of this study is to investigate and highlight the most important factors influencing the candidate’s selection for residency matching by program directors of surgical and non-surgical specialties in Saudi Arabia. Method This cross-sectional study was conducted in the Central, Eastern, Western, Northern, and Southern regions of Saudi Arabia from February 1, 2023, to August 31, 2023. A total of sixty-one program directors completed a questionnaire, which was adapted and validated from a previous study with permission and tailored to meet the objectives of this research. Results The mean age of the study population was 40.2 years, with surgical specialty program directors being older at 41.7 years and nonsurgical specialty program directors being younger at 39.6 years. In both cases, the highest importance was given to ‘Applicant’s attitude and professionalism’, followed in surgical specialties by ‘Doing clinical rotations in the PD institution’ and ‘Performance in clinical rotation during internship’ in non-surgical specialties. with a mean score of 4.13 and 4.95, respectively. The importance of ‘The impression/opinion of current residents’ has had a certain importance in both specialties. While the number of research projects was prioritized more by surgical PDs (38.6%) compared to non-surgical PDs (29.4%). Conclusion This study highlights the critical role of professionalism and a positive attitude in clinical rotations and interviews for program acceptance in Saudi Arabia. The significance of letters of recommendation and research focus varies between surgical and non-surgical program directors. Program directors should adopt effective recruitment strategies that incorporate practical implications during internships.

Abstract Background Pediatrics is one of the most important medical specialties in the Kingdom of Saudi Arabia) KSA) since it serves a large population. Therefore, the pediatrics residency program is considered one of the most important and competitive programs. Obtaining acceptance in Saudi programs depends mainly on the Saudi Commission for Health Specialties (SCFHS) score, then the applicant enrolls to do the interviews with the training centers in the accepted region. This study aimed to evaluate the factors used by pediatric program directors (PD) in accepting applicants in their pediatric residency program in KSA. Methods In this cross-sectional study, an online questionnaire consisting of 49 items was distributed among 76 current and former pediatric PDs in KSA. Participants were selected via non-probability convenience sampling. Data were collected and analyzed using the Social Sciences Statistical Package (SPSS version 26). Results Of the sample of PD studied, males represented 77.6%, while females represented 22.4%. Most of the PDs were over 50 years old. Most of them were former pediatric PDs (71.1%). The current study found that the Saudi Medical Licensing Exam was the most important factor [3.87 (0.89)] followed by services and electives [3.86 (0.65)], research [3.84 (0.83)], interview [3.77 (0.89)], GPA [3.50 (0.62)], and letter of recommendation [3.39 (0.76)]. Conclusions For those interested in pediatrics residency programs in KSA, this study recommends that seeking a high Saudi Medical Licensing Exam (SMLE) score, taking pediatric elective rotations during internship, and acquiring excellent basic knowledge in research were the most important aspects of pediatrics residency selection from the pediatrics PD’s perspective.

The number of international medical graduates (IMGs) entering radiology residencies and neuroradiology fellowships averaged 9.7% and 20.9% from 2021 to 2023, respectively. We aimed to determine whether IMG graduates are populating leadership roles at a proportionate rate in diagnostic radiology (DR) and neuroradiology. We surveyed 191 DR program directors, 94 neuroradiology program directors (PDs), 192 chairs of radiology, and 91 directors of neuroradiology inquiring about their original citizenship and medical school (American Medical Graduates [AMG] vs IMG). We reviewed institutional websites to obtain missing data and recorded H indices for each person using Scopus. We confirmed the original citizenship and medical school location in 61–75% and 93–98% of each leadership group. We found that 16.2% of DR program directors, 43.7% of neuroradiology PDs, 28.5% of Chairs, and 40.6% of neuroradiology directors were not originally US citizens. The IMG rate was 18/188 (9.6%), 20/90 (22.2%), 26/186 (14.0%), and 19/85 (22.4%) for the same groups respectively. The most common country of origin and medical school cited was India for all leadership groups. IMGs had a median H index of 14 while AMG 10, significantly different (p = 0.021) Compared to the rate of diagnostic and neuroradiology trainees entering from 2021 to 2023, IMGs are proportionately represented at the leadership positions studied. The H index of the IMGs was higher than AMG. We conclude that IMGs have made substantial and proportionate inroads in radiology and neuroradiology leadership. [ABSTRACT FROM AUTHOR]

Background: Pediatrics is one of the most important medical specialties in the Kingdom of Saudi Arabia) KSA) since it serves a large population. Therefore, the pediatrics residency program is considered one of the most important and competitive programs. Obtaining acceptance in Saudi programs depends mainly on the Saudi Commission for Health Specialties (SCFHS) score, then the applicant enrolls to do the interviews with the training centers in the accepted region. This study aimed to evaluate the factors used by pediatric program directors (PD) in accepting applicants in their pediatric residency program in KSA. Methods: In this cross-sectional study, an online questionnaire consisting of 49 items was distributed among 76 current and former pediatric PDs in KSA. Participants were selected via non-probability convenience sampling. Data were collected and analyzed using the Social Sciences Statistical Package (SPSS version 26). Results: Of the sample of PD studied, males represented 77.6%, while females represented 22.4%. Most of the PDs were over 50 years old. Most of them were former pediatric PDs (71.1%). The current study found that the Saudi Medical Licensing Exam was the most important factor [3.87 (0.89)] followed by services and electives [3.86 (0.65)], research [3.84 (0.83)], interview [3.77 (0.89)], GPA [3.50 (0.62)], and letter of recommendation [3.39 (0.76)]. Conclusions: For those interested in pediatrics residency programs in KSA, this study recommends that seeking a high Saudi Medical Licensing Exam (SMLE) score, taking pediatric elective rotations during internship, and acquiring excellent basic knowledge in research were the most important aspects of pediatrics residency selection from the pediatrics PD's perspective. [ABSTRACT FROM AUTHOR]

Background While the number of female medical graduates continues to increase, only a few pursue an orthopaedic career. This is related to challenges regarding pregnancy and the peripartum period during orthopaedic training. Aims To evaluate fertility, pregnancy-related complications and attitudes towards female orthopaedic surgeons in Israel. Methods An electronic anonymous 34-question electronic web-based survey was sent to all Israeli female orthopaedic surgeons. Participation was voluntary. Questions were formulated to determine demographics, obstetrics medical history, teratogenic exposure, medical leave and breastfeeding parameters along with attitude towards pregnancy. Results Twenty-six orthopaedic surgeons complied with the survey, 68% of all registered female orthopaedic surgeons. Participants age was 39.5 (±8.8). The average number of children for a female orthopaedic surgeon was 2.2 (±1.4), with an average of 1.3 (±1.1) deliveries during residency. The average age for a first child was 31.1 (±3.7) years. Four surgeons required fertility treatments and six had abortions. Thirty-eight per cent experienced pregnancy complications. Most surgeons were exposed to radiation and bone cement during pregnancy. The average duration of maternity leave was 19.4 (±9.9) weeks and return to work was associated with cessation of breastfeeding. Seventy-six per cent of surgeons felt that pregnancy had negatively influenced their training, and 12% reported negative attitudes from colleagues and supervisors. Conclusions Orthopaedic surgeons in Israel experience a delay in childbirth and higher rates of pregnancy complications. Most feel that their training is harmed by pregnancy. Programme directors should design a personalized support programme for female surgeons during pregnancy and the peripartum period. [ABSTRACT FROM AUTHOR]

When the National Institutes of Health (NIH) budget doubled in the late 1990s, it led to a rise in the number of PhD-trained scientists and to increased NIH-funded programs to diversify the biomedical workforce. This trend has seen more PhD scientists take on leadership roles as program directors in academia. These program directors are often highly skilled in research design and data analysis, and they bring a scholarly approach to their administrative duties. Despite organizational challenges, promoting scholarship among program directors offers numerous benefits, including enhanced institutional reputation and better training outcomes. Herein we use examples from peer reviewed literature to illustrate how publications by program directors have influenced national policies and practices in biomedical training. Encouraging more academic institutions to support program director scholarship can yield significant returns for institutions, trainees, and the directors themselves.

Abstract Background Annually, medical students vie to secure a seat with an orthopedic residency program. This rigorous competition places orthopedic surgery as one of the most competitive specialties in the medical field. Although several international studies have been published regarding the factors that influence program directors when choosing their ideal applicant, the data for Saudi Arabia in that regard is absent. Methods In this cross-sectional study, we aimed to survey all orthopedic program directors regarding the factors that influence them when choosing their ideal orthopedic surgery applicant. A survey was sent to all program directors via email during the month of August 2022. A reminder was sent 2 weeks later to maximize the response rate. The survey was completed by 22 out of 36 orthopedic program directors, which gave us a response rate of 61.11%. Results In this study, 22 orthopedic surgery program directors responded to our survey. When program directors were asked to rank the factors of residency selection criteria, the top ranked factors were good impression on interviews; prior experience in orthopedic surgery with, for example, electives; and performance on ethical questions during interviews, with means of 9.18, 8.95, and 8.82 out of 10, respectively. Furthermore, program directors preferred letters of recommendation from recommenders that they personally know, clinical experience such as electives taken at the program director’s institution, and the quality of publications as the most important aspects of research. Most program directors (90.9%) relied on their residents’ and fellows’ opinions when selecting candidates, and 77.3% did not think gender has an influence on selection of applicants. Conclusion By providing comprehensive data regarding the factors that influence and attract program directors of orthopedic surgery when choosing residency candidates. With the data provided by this study, applicants for orthopedic surgery have the advantage of early planning to build a strong application that may help persuade program directors to choose them.

Objectives To evaluate the gender composition of departmental chairs and program leadership of Accreditation Council for Graduate Medical Education–accredited pathology residencies and American Board of Pathology–certified subspecialty fellowships across the United States. Methods In this cross-sectional analysis, we examined the gender of individuals holding leadership positions in academic pathology in the United States. Using publicly available online data, 2 authors independently coded perceived gender (ie, man/woman/other) with 100% concordance. Results In 144 pathology residency programs, more women hold residency program director positions (52.1% [75/144]). Among 11 pathology subspecialties, women overall hold fewer fellowship program director positions (45.0% [212/471]). Among the residency-associated pathology department chair positions identified, women hold fewer positions (31.8% [42/132]). There is some geographic variation in pathology leadership gender composition when stratified using US Census regions. Conclusions Women in academic pathology departments are well represented in residency and overall fellowship program leadership but are underrepresented in department chair and certain pathology subspecialty leadership positions. The disproportionate number of women in department chair positions is observed across medical specialties, highlighting the need for improved gender equity among high-level academic medicine positions. [ABSTRACT FROM AUTHOR]

Changes in residency recruitment have significantly altered how programs and applicants evaluate each other including virtual interviews, discontinuation of the United States Medical Licensing Exam Step 2 Clinical Skills exam, and transition of United States Medical Licensing Exam Step 1 to pass-fail scoring. To improve program-applicant fit, the Electronic Residency Application Service introduced supplemental application features including geographic preference, program signaling, and the opportunity to highlight impactful and meaningful experiences. We sought to evaluate child neurology (CN) and neurodevelopmental disabilities (NDD) program director's (PD) opinions regarding these changes. A 10-question anonymous survey was sent to CN (n=75) and NDD (n=8) PDs. The questions centered on PDs' opinions regarding components of the supplemental application, having a standard application review period and in-person recruitment activities. Answer choices to the questions were all close-ended. Respondents could select questions to complete. Thirty-eight CN residency PDs (49%) and 4 NDD residency PDs (50%) responded to the survey. Among CN PDs, there was strong support for use of the supplemental application questions and for the use of 3 program signals per applicant. Most PDs supported a standardized application review period prior to programs sending interview offers; however, there was no consensus on the appropriate length of time. Nearly half agreed with virtual-only interviews, and 62% agreed with the option of in-person second-look visits. CN PDs generally support many of the recent or proposed changes to residency recruitment. The impact of these changes on recruitment will be a topic of future investigation. [ABSTRACT FROM AUTHOR]

Introduction. Physical therapy professional education program directors (PDs) face stress associated with work roles and responsibilities, which can cause burnout and job turnover. Review of Literature. Burnout and turnover in physical therapy education PD positions are influenced by inexperience, insufficient compensation, decreased support, heavy workloads, difficulty hiring and retaining faculty, and internal conflict. Program directors also receive insufficient training in their roles. Individuals with greater resilience, or the ability to face adversity with positive outcomes, may be more resistant to stress, burnout, and turnover. Therefore, this study's purpose was to explore the relationships among leadership behaviors, demographic and program factors, and resilience in physical therapy PDs. Subjects. Of the 600 physical therapy PDs invited to participate in the study, 126 directors completed the survey (21% response rate). Methods. The survey included demographic questions, the Multifactor Leadership Questionnaire (MLQ-5X), and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Correlational analyses were used to investigate relationships among leadership behaviors, demographic and program factors, and resilience. Results. Participants included 43 physical therapist and 82 physical therapist assistant PDs (79.4% female and 20.6% male participants; mean age, 52.0 ± 8.3 years; mean years in role, 7.3 ± 6.9 years). Mean MLQ-5X scores showed that participants primarily used transformational leadership (TFL) behaviors. The mean CD-RISC-10 score for participants was 33.06 (±4.10). Analysis revealed statistically significant positive relationships between all TFL behaviors and resilience. Exploratory regression analysis revealed that 3 leadership behaviors and one demographic factor may contribute to resilience in participants, although the proportion of variance was modest (39%). Discussion and Conclusion. This is the first study to offer insight regarding the relationships between leadership behaviors and resilience in physical therapy PDs. These results may help lay the foundation for future research in this area, with the goal of decreasing burnout and job turnover through increased resilience. [ABSTRACT FROM AUTHOR]

The number of international medical graduates (IMG) in radiology residencies has varied from year to year even as the number of candidates continues to grow. It is unclear from which countries the IMGs are arriving and what visas are being used to accommodate them. We sent a survey to 195 program directors (PD) in diagnostic radiology (DR) inquiring about the number and nationality of IMG residents in their program, their attitudes about IMG candidates, the performance of their IMG trainees, and the visas that are offered. We received responses from 121 of 195 (62.1%) DR programs (121/149 = 81.2% of actionable emails). 80/121 (66.1%) had at least one IMG in their DR residency program and the countries of origin included India (36), Iran (30), Saudi Arabia (24), Egypt (16), Canada (14), Brazil (14), and Pakistan (9), as the most common. While most programs (76/104, 73.1%) offered J1 visas, 23/99 (23.2%) provided H-1B visas to trainees. IMG DR residents overall performed as well as American graduates, with an equal number of PDs saying IMGs performed better and worse than American graduates. PDs' issues with IMGs centered on visas: (1) expense, (2) lack of familiarity, (3) Educational Commission for Foreign Medical Graduates regulations, and (4) time commitment in submitting paperwork. Most radiology IMG residents originate from India and Middle Eastern countries. Once enrolled, IMG residents perform similarly to US graduates. However, adding IMG candidates to the training program requires overcoming bureaucratic and monetary hurdles around visas. Most DR international medical graduate residents are from India or the Middle East. Although their performance is the same as American graduates in general, PDs note the monetary and bureaucratic hassles accompanying their recruitment. [ABSTRACT FROM AUTHOR]

Purpose: To develop a current profile of prosthodontics program directors (PPDs) in United States dental schools and describe the current challenges and responsibilities of those serving in the position and assess the professional needs of the program directors (PDs) to better support them in their roles. Materials and methods: A survey was sent to 51 participants who were identified as PPDs in North America via Qualtrics in 2019 to assess the professional needs of PDs to better support their roles. The survey consisted of 29 items organized into six sections: (1) demographic information; (2) hours and time spent in various areas of the job; (3) greatest challenges; (4) perceived importance of specific competencies; (5) opinions on the greatest rewards of the position; (6) their needs for support from the American College of Prosthodontists and advice for the future PD. Results: The response rate for this survey was 88.3%. Of the 45 respondents, the majority were white/non‐Hispanic, followed by Asian/Pacific Islanders. The two largest and equal numbers of participants who worked for more than 10 years and between 1 and 3 years were observed with approximately 29% each, and PDs who worked less than a year occupied the least amount. Overall, 34% of PDs are on the tenure track and 80% of those are tenured. Teaching and clinical services took away the greatest time with approximately 42% and 22.1%, respectively. Thirty‐five (78%) PDs listed the greatest challenge they encountered was the workload of the role. Skills listed in leadership and personnel competencies were all rated more important than most of the skills listed in management. Conclusions: There is a wide gender gap and a lack of racial diversity among the PPDs. The biggest challenge faced by them is the amount of workload followed by budget and fiscal constraints. And for their improved efficiency, they gave emphasis on learning time management and continuous clinical training of newer advances. [ABSTRACT FROM AUTHOR]

Objectives: To increase diversity and inclusion in graduate medical education (GME), the Accreditation Council for Graduate Medical Education (ACGME) issued new diversity standards requiring programs to engage in practices that focus on systematic recruitment and retention of a diverse workforce of trainees and faculty. The literature on how program directors (PDs) can incorporate and prepare for this standard is limited. Methods: We developed a diversity, equity, and inclusion (DEI) toolkit for PDs as an example of an institutional GME-led effort to promote inclusive recruitment and DEI awareness among residency and fellowship programs at a large academic center. Results: A survey was sent to 80 PDs before the launch of the toolkit and 6 months afterwards with response rates of 27% (22/80) and 97% (78/80), respectively. At baseline, 45% (10/22) anticipated that the DEI toolkit might provide better resources than those currently available to them and 41% (9/22) perceived that the toolkit might improve recruitment outcomes. At 6 months, 63% (49/78) found the toolkit helpful in the 2021-2022 recruitment season. By contrast, 2% (2/78) of PDs did not find the toolkit helpful, and 33% (26/78) said they did not access the toolkit. When asked if a PD changed their program's recruitment practices because of the toolkit, 31% (24/78) responded yes. Programs that changed recruitment practices started to require unconscious bias training for all faculty and residents involved in the residency interviews and ranking. Others worked on creating a standardized scoring rubric for interviews focused on four main domains: Experiences, Attributes, Competencies, and Academic Metrics. Conclusion: There is a need to support PDs in their DEI journey and their work to recruit a diverse workforce in medicine. Utilizing a DEI toolkit is one option to increase DEI knowledge, skills, awareness, and self-efficacy among PDs and can be adopted by other institutions and leaders in academic medicine. [ABSTRACT FROM AUTHOR]

One of the many challenges that has befallen the Infectious Diseases and Graduate Medical Education communities during the coronavirus disease 2019 (COVID-19) pandemic is the maintenance of continued effective education and training of the future leaders of our field. With the remarkable speed and innovation that has characterized the responses to this pandemic, educators everywhere have adapted existing robust and safe learning environments to meet the needs of our learners. This paper will review distinct aspects of education and training of the Infectious Diseases fellows we believe the COVID-19 pandemic has impacted most, including mentoring, didactics, and wellness. We anticipate that several strategies developed in this context and described herein will help to inform training and best practices during the pandemic and beyond.

The dermatology application process is grueling, that is tough to navigate without the proper guidance. This commentary is meant to shed light on the factors that can help applicants stand out in order to be successful in the match. It includes observations from successful applicants from the most recent match process.

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has changed the landscape of professional activities, emphasizing virtual meetings and social media (SoMe) presence. Whether cardiothoracic programs increased their SoMe presence is unknown. We examined SoMe use and content creation by cardiothoracic surgery programs during the COVID-19 pandemic. Methods: We searched the Accreditation Council for Graduate Medical Education to identify all cardiothoracic surgery residency programs (n = 122), including independent (n = 74), integrated (n = 33), and congenital (n = 15) training programs at 78 US cardiothoracic surgery teaching institutions. We then manually searched Google, Facebook, Instagram, LinkedIn, and Twitter to identify the associated residency and departmental accounts. The timeline for our search was between 10/2021 and 4/2022. March 2020 was used as the starting point for the COVID-19 pandemic. We also contacted the account managers to identify account content creators. The data are descriptively reported and analyzed. Results: Of 137 SoMe accounts from 78 US cardiothoracic surgery teaching institutions, 72 of 137 (52.6%) were on Twitter, 34 of 137 (24.8%) on Facebook, and 31 of 137 (22.6%) on Instagram. Most accounts were departmental accounts (105/137 = 76.6%) versus 32 of 137 (23.4%) training program accounts. Most training program-specific SoMe accounts across all platforms were created after the COVID-19 pandemic, whereas departmental accounts were pre-existing (P

Objective This article characterizes perspectives of ophthalmologists involved in the residency selection process regarding the potential impact of preference signaling on the ophthalmology residency match.

This study aimed to report the training characteristics, academic accomplishments, and motivation of current US academic physical medicine and rehabilitation program directors. A 22-question survey was developed and disseminated via email in May 2020 to 91 current residency program directors who are members of the Association of Academic Physiatrists Residency Fellowship Program Director Committee. Follow-up emails were sent 2 and 4 wks after initial distribution, and the survey was closed after 6 wks in June 2020. Data collected were deidentified. Descriptive analysis was performed. Response rate was 49.5% (45/91); 64.4% of program directors were men, and 35.6% were women. Of the respondents, 75.4% were White/Caucasian, 6.7% were Hispanic/Latinx, 15.6% were Asian, and 2.2% were Black/African American. Moreover, 56% (9/16) of female program directors vs. 0% (0/29) of male program directors reported experiencing sex discrimination in the workplace. Four percent of program directors were full professors in physical medicine and rehabilitation when first appointed, 17% were associate professors, and 72% were assistant professors. Thirty-four percent of program directors had at least six peer-reviewed publications when first appointed. This survey provides insight to the training characteristics, accomplishments, and motivation of current program directors for physiatrists aspiring to enter these ranks and highlights the underrepresentation of women/minorities among leadership positions in physical medicine and rehabilitation. [ABSTRACT FROM AUTHOR]

An informal needs assessment and lack of a national standardized curriculum suggest that there is tremendous variability in the formal teaching of radiation oncology resident throughout the USA. The goal of this study was to characterize formal radiation oncology resident education, in order to identify knowledge gaps and areas for improvement. We developed a 14-item survey consisting of the following domains: program characteristics, teaching faculty, formal teaching time, instructional approaches for formal teaching, curricular topics, and satisfaction with didactics. All 91 accredited US-based radiation oncology program directors received an invitation to complete the survey anonymously by email. Twenty-four (26% response rate) program directors responded. Programs used a variety of instructional methods; all programs reported using lecture-based teaching and only a minority using simulation (38%) or flipped classroom techniques (17%). Other than PowerPoint, the most common electronic resource utilized was quizzing/polling (67%), webinar (33%), and econtour.org (13%). The lack of a national, standardized, radiation oncology residency didactic curriculum promotes variability and insufficiency in resident training. Themes for improvement were diversity in didactic topics, incorporation of evidence-based teaching practices, increased faculty involvement, and sharing of resources across programs. Development of a national curriculum and increased electronic resource sharing may help address some of these areas of improvement. [ABSTRACT FROM AUTHOR]

The residency program director (PD) position is a valued leadership appointment in academic medicine. PDs are responsible for the success of their program and its residents. The objective of this study is to provide a cross-sectional analysis of baseline demographics and academic backgrounds of current neurosurgery program directors. Data was compiled on neurosurgery PDs and their residency programs, as of the end of May 2021, using publicly available resources including Doximity, FREIDA, and Healthgrades. The Mann-Whitney and Fisher exact tests were used for statistical analysis. Of 113 PDs identified, 91.15% are male (P < 0.01). The majority of PDs (88.5%) received their medical degrees from U.S. medical schools. The average age of current PDs is 54 years, and the average age at appointment was 48 years. Compared to their male counterparts, female PDs are more likely to be younger at appointment (41 vs. 48 years; P = 0.001) and while holding the same position (45 vs. 55 years; P = 0.001). As a result, female PDs experience less time to appointment after residency (8.6 years vs. 14.7 years, P = 0.013). There are no significant differences regarding the gender of the PD and university affiliation, current appointment, completion of a fellowship, and resident gender ratios. The position of neurosurgery residency PD is dominated by fellowship-trained men in their late 40s to 50s. The gender ratio of neurosurgery residents is consistent with the underrepresentation of women in this position. With increasing female representation in neurosurgery, more women may assume this leadership position and begin to hasten the gender balance. [ABSTRACT FROM AUTHOR]

Abstract Background Many residents experience their transitions, such as from medical student to resident, as demanding and stressful. The challenges they face are twofold: coping with changes in tasks or responsibilities and performing (new) social roles. This process of ‘learning the ropes’ is known as Organizational Socialization (OS). Although there is substantial literature on transitions from the perspective of residents, the voices of program directors (PDs) who facilitate and guide residents through the organizational socialization process have not yet been explored. PDs’ perspectives are important, since PDs are formally responsible for Postgraduate Medical Education (PGME) and contribute, directly or indirectly, to residents’ socialization process. Using the lens of OS, we explored what strategies PDs use to facilitate organizational socialization of newcomer residents. Methods We conducted semi-structured interviews with 17 PDs of different specialties. We used a theory-informing inductive data analysis study design, comprising an inductive thematic analysis, a deductive interpretation of the results through the lens of OS and, subsequently, an inductive analysis to identify overarching insights. Results We identified six strategies PDs used to facilitate organizational socialization of newcomer residents and uncovered two overarching insights. First, PDs varied in the extent to which they planned their guidance. Some PDs planned socialization as an explicit learning objective and assigned residents’ tasks and responsibilities accordingly, making it an intended program outcome. However, socialization was also facilitated by social interactions in the workplace, making it an unintended program outcome. Second, PDs varied in the extent to which they adapted their strategies to the newcomer residents. Some PDs used individualized strategies tailored to individual residents’ needs and skills, particularly in cases of poor performance, by broaching and discussing the issue or adjusting tasks and responsibilities. However, PDs also used workplace strategies requiring residents to adjust to the workplace without much intervention, which was often viewed as an implicit expectation. Conclusions PDs’ used both intentional and unintentional strategies to facilitate socialization in residents, which may imply that socialization can occur irrespective of the PD’s strategy. PDs’ strategies varied from an individual-centered to a workplace-centered approach to socialization. Further research is needed to gain a deeper understanding of residents’ perceptions of PD’s efforts to facilitate their socialization process during transitions.

Abstract 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.

ObjectiveBurnout is a widespread issue in healthcare for many years. Lebanon combatted political and economic crises before the coronavirus disease 2019 (COVID-19) pandemic, in addition to the port explosion in August 2020. The study aimed to identify the determinants of personal burnout, patient-related burnout, and work-related burnout among postgraduate medical trainees (PGMT) and evaluate its relationship with sociodemographic characteristics.DesignA cross-sectional study utilized the Copenhagen Burnout Inventory (CBI) involving electronic, voluntary, and anonymous survey. The survey was completed by 188 PGMT including residents and fellows from all specialties and all levels of training.ResultsThe prevalence rates are 68.6% for personal burnout, 63.3% for work-related burnout, and 35.1% for patient-related burnout.ConclusionResults improve our understanding of the phenomenon of burnout, and the role of program leadership in shaping the impact of burnout on training and promoting wellbeing of PGMT. Discussion focuses on providing potential wellbeing strategies for program directors to follow for mitigating burnout.

Introduction: Obstetrical emergencies are a high-risk yet infrequent occurrence in the emergency department. While U.S. emergency medicine (EM) residency graduates are required to perform 10 low-risk normal spontaneous vaginal deliveries, little is known about how residencies prepare residents to manage obstetrical emergencies. We sought to profile the current obstetrical training curricula through a survey of U.S. training programs.Methods: We sent a web-based survey covering the four most common obstetrical emergencies (pre-eclampsia/eclampsia, postpartum hemorrhage (PPH), shoulder dystocia, and breech presentation) through email invitations to all program directors (PD) of U.S. EM residency programs. The survey focused on curricular details as well as the comfort level of the PDs in the preparation of their graduating residents to treat obstetrical emergencies and normal vaginal deliveries.Results: Our survey had a 55% return rate (n=105/191). Of the residencies responding, 75% were in the academic setting, 20.2% community, 65% urban, and 29.8% suburban, and the obstetrical curricula were 2-4 weeks long occurring in post-graduate year one. The most common teaching method was didactics (84.1-98.1%), followed by oral cases for pre-eclampsia (48%) and PPH (37.2%), and homemade simulation for shoulder dystocia (37.5%) and breech delivery (33.3%). The PDs’ comfort about residency graduate skills was highest for normal spontaneous vaginal delivery, pre-eclampsia, and PPH. PDs were not as comfortable about their graduates’ skill in handling shoulder dystocia or breech delivery.Conclusion: Our survey found that PDs are less comfortable in their graduates’ ability to perform non-routine emergency obstetrical procedures.

Due to Covid-19, fellowship programs could not conduct in-person interviews during the 2020–2021 interview cycle and were forced to implement virtual interviews. We conducted two nationwide surveys of residency and fellowship Program Directors (PDs) involved in the Obstetrics and Gynecology (Ob/Gyn) Subspecialty Fellowship match cycle to gain a better understanding of virtual interviews from each of their perspectives. 1) Fellowship PDs' confidence in using a virtual platform to holistically evaluate applicants during the 2020–2021 match cycle, 2) Residency PD's perception of virtual interviews and impact on their program's operations, and 3) to assess the desire of fellowship and residency PDs to continue virtual recruitment during forthcoming interview seasons. Two separate nationwide web-based surveys were administered to 1) Ob/Gyn fellowship PDs and 2) residency PDs through SurveyMonkey from July-September 2020 to assess the impact of virtual interviews form each parties' perspective. Surveys solicited demographic information, four-point Likert scale questions, and free response questions Of programs meeting inclusion criteria, 75/111 (67.6%) fellowship PDs and 67/117 (57.3%) residency PDs responded to their respective surveys. Most fellowship PDs believed that they could confidently assess applicants' professionalism (88%) during a virtual interview and (90.7%) felt confident in making a rank-order list. However, only 73.3% were just as confident in preparing a rank list after a virtual interview as they have been with in-person interviews. Most residency PDs (69.9%) believed that virtual interviews made it easier for their program to comply with duty hours, and 76.8% agreed that virtual interviews allowed their residents to accept more interviews than an in-person format. Most fellowship PDs found virtual interviews convenient. However, difficulty in observing social interaction and gauging applicant interest may be the biggest challenge moving forward. [ABSTRACT FROM AUTHOR]

Background: Many residents experience their transitions, such as from medical student to resident, as demanding and stressful. The challenges they face are twofold: coping with changes in tasks or responsibilities and performing (new) social roles. This process of 'learning the ropes' is known as Organizational Socialization (OS). Although there is substantial literature on transitions from the perspective of residents, the voices of program directors (PDs) who facilitate and guide residents through the organizational socialization process have not yet been explored. PDs' perspectives are important, since PDs are formally responsible for Postgraduate Medical Education (PGME) and contribute, directly or indirectly, to residents' socialization process. Using the lens of OS, we explored what strategies PDs use to facilitate organizational socialization of newcomer residents. Methods: We conducted semi-structured interviews with 17 PDs of different specialties. We used a theory-informing inductive data analysis study design, comprising an inductive thematic analysis, a deductive interpretation of the results through the lens of OS and, subsequently, an inductive analysis to identify overarching insights. Results: We identified six strategies PDs used to facilitate organizational socialization of newcomer residents and uncovered two overarching insights. First, PDs varied in the extent to which they planned their guidance. Some PDs planned socialization as an explicit learning objective and assigned residents' tasks and responsibilities accordingly, making it an intended program outcome. However, socialization was also facilitated by social interactions in the workplace, making it an unintended program outcome. Second, PDs varied in the extent to which they adapted their strategies to the newcomer residents. Some PDs used individualized strategies tailored to individual residents' needs and skills, particularly in cases of poor performance, by broaching and discussing the issue or adjusting tasks and responsibilities. However, PDs also used workplace strategies requiring residents to adjust to the workplace without much intervention, which was often viewed as an implicit expectation. Conclusions: PDs' used both intentional and unintentional strategies to facilitate socialization in residents, which may imply that socialization can occur irrespective of the PD's strategy. PDs' strategies varied from an individual-centered to a workplace-centered approach to socialization. Further research is needed to gain a deeper understanding of residents' perceptions of PD's efforts to facilitate their socialization process during transitions. [ABSTRACT FROM AUTHOR]

Program director (PD)-resident relationships are important in shaping resident experiences and educational outcomes. Yet, there is limited literature on the development or meaning of these relationships, particularly from the PD perspective. Through qualitative interviews, we explore how PDs navigate their role to develop and maintain relationships with their trainees, and elucidate how these relationships impact the PDs personally and professionally. Qualitative study using individual semi-structured interviews of former and current PDs (n = 33) from multiple specialties and hospitals in accredited residency programs in Qatar, Singapore, and the United Arab Emirates. We used attachment theory and narrative analysis to investigate how PDs perceive and describe relationship building with their residents amidst tensions of familiarizing themselves with their new role. PD-resident relationships are complex and multidimensional, shifting over time, changing patterns and evolving to respond to different contexts. PDs initially negotiate their own roles, while navigating their relationships with residents and other stakeholders to create their professional identities. PDs develop professional alliances, defining for the resident the profession and its expectations. As residents negotiate the various challenges of their training, the role of the PD emerges into one of providing emotional support and advocacy. The support and attachment are often enduring and extend beyond the period of residency training. Our study examines the experiences of program directors as they negotiate complex educator-learner relationships. The PDs described roles that extended beyond their job description. Although all interviewees reported that the PD position was challenging, they focused on the rewarding aspects of the job and how their relationships helped sustain them through the difficulties. Through their reflections, the PDs described the personal satisfaction and benefits of their interactions with the residents, and how the engagement contributed to personal and professional success. [ABSTRACT FROM AUTHOR]

There is limited information on rationale for the current training structure within combined Pediatrics-Medical Genetics and Genomics Residency (MGG) residency programs. This study addresses the benefits and drawbacks of different training structures. Program Directors (PDs) and Associate PDs of combined Pediatrics-MGG residency programs were surveyed to evaluate perceived benefits of different structures and the relative importance of particular pediatric rotations for combined training. Programs varied in terms of how many times a typical resident transitioned between Pediatrics and MGG during training (range 4 to > 9). PDs varied in their opinions of which training structure would be most ideal for training a future Clinical Geneticist within a combined Pediatrics-MGG program. However, the majority of PDs indicated that consecutive training (completing two years of Pediatrics, followed by MGG) would support particular aims of training including continuity of patient care and research productivity. The top six out of twenty pediatric rotations that were ranked as most important in order of importance were neonatal intensive care, development and behavior pediatrics, term newborn, pediatric intensive care, neurology, and inpatient pediatric wards. Particular structures may facilitate distinct aims within training; however, there was not widespread consensus on which program structure would be best. Specific pediatric rotations were highlighted as very important, which could influence future curriculum development., (© 2024 Wiley Periodicals LLC.)

Objective: Thoracic surgery program directors (PDs) are key mentors for the next generation of cardiothoracic surgeons and surgeon-scientists. This study evaluates the industry payments to PDs compared to other practicing thoracic surgeons to assess potential conflicts of interest and their influence., Methods: PDs were identified using the Electronic residency application system (ERAS) and their National provider identifiers (NPIs). Industry payments from 2015 to 2021 were extracted from the OpenPayments (cms.gov) database. We analyzed the number and types of payments, including consulting fees, speaking engagements, and research-related contributions. Payments were compared by PD characteristics such as gender, specialty, and academic metrics using the Chi-square test and Kruskal-Wallis test., Results: All 77 identified PDs (66 males and 11 females) received industry payments, totaling $14,094,422 across 8,028 transactions. The median payment was $16716, with maximum reaching $2,661,001. Male PDs and those in cardiac specialties received significantly higher payments. Research funding for PDs was predominantly awarded to males (100%). Significant disparities were observed in industry payments to PDs compared to non-PDs, especially in food and beverage, and educational activities. PDs initially received more than double the research payments compared to non-PDs in the early years. This disparity reduced significantly by 2021, reflecting a move towards more equitable research funding., Conclusion: The substantial payment to PDs reflects their significant role in thoracic surgery, yet raises concerns regarding potential influence on trainees. These findings underscore the need for increased transparency and measures to address disparities in industry support, particularly concerning gender and specialty., (Copyright © 2024. Published by Elsevier Inc.)

Background: Collegiate Recovery Programs (CRPs) play a vital and expanding role in supporting students in recovery from substance use disorders and behavioral addictions at higher education institutions. Despite their importance, there is a lack of comprehensive research characterizing CRPs, including their program directors and the nature and influence of their funding streams., Methods: A survey was administered to 70 CRP directors across the US and Canada. Directors reported on their CRPs across a variety of site physical features, policy and program offerings, and funding sources, with "sustainable" funding defined as two or more sources., Results: CRP directors were predominantly non-Hispanic, White, and female, with representation from gender and sexual minorities. The highest concentration of directors responding were in the US states of North Carolina, California, and Texas. CRPs with more than one funding source served twice as many students and had significantly more space, drop-in facilities, and relapse management policies. CRP directors had positive perceptions of harm reduction principles. Additionally, results highlighted the robust availability of All Recovery meetings and the wide diversity of mutual-help group meetings offered within CRPs and directors' positive perceptions of these meetings., Conclusion: This research lays a foundation for enhancing CRPs within higher education settings, emphasizing the significance of sustained funding and an inclusive support framework for the program directors that run CRPs. Future studies should further explore the effectiveness of CRPs and their impacts on the schools and students they serve.

Background: Given the concurrence of medical residency and fellowship training with typical childbearing years, trainees often must make difficult decisions regarding family planning, requiring the support of their residency and fellowship program directors (PDs) to guide them. Objective: Our hypothesis was that PDs have knowledge gaps and varying levels of support in terms of their trainees' fertility, and the goal of our study was to assess the knowledge and support of residency and fellowship PDs in the United States toward trainees' reproductive needs. Methods: Cross-sectional survey distributed to all residency and fellowship PDs providing contact information through the Accreditation Council for Graduate Medical Education website in August 2019. Results: Of 299 respondents, the most common lengths of leave reported were 6?8 weeks of maternity leave and under 2 weeks of paternity leave. A total of 57.2% did not know their program's insurance for infertility treatment, and 68.6% did not know fertility preservation coverage. A total of 52.2% of PDs were unaware of if their trainees faced infertility. PDs supported residents' needs through moral support (68.2%) and time off for appointments (65.2%). Similarly, most PDs (66.2%) never had a trainee express interest in fertility preservation to them but offered moral support (59.2%) and time off (48.5%). Respondents felt it was important to increase resources for trainees by increasing their awareness of needs (47.5%) and establishing reproduction-related policies (34.1%). Conclusion: The study found variations regarding PDs' knowledge and support levels for trainees' fertility needs. Most were unaware of their trainees' fertility needs, and many PDs felt it would be important to improve resources by increasing personal awareness and creating policies for support to promote reproductive health equity for trainees.

Abstract Background The COVID-19 pandemic has deeply impacted healthcare and education systems, including resident education. The impact of the pandemic on the different types of pedagogical activities, and the displacement of pedagogical activities to online modalities have not yet been quantified. We sought to evaluate the impact of the COVID-19 pandemic on formal pedagogic components of otorhinolaryngology–head and neck surgery (ORL–HNS) residency, the switch to distance learning and program director’s perceptions of the future of teaching and learning. Methods A nationwide online survey was conducted on Canadian ORL–HNS program directors. The use of standard didactic activities in-person and online, before and during the pandemic was rated with Likert scales. Perceptions of the pandemic were described with open-ended questions. Results A total of 11 of the 13 program directors contacted responded. The analysis were conducted using nonparametric statistics. There was a significant drop in overall didactic activities during the pandemic, regardless of the teaching format (3.5 ± 0.2 to 3.1 ± 0.3, p

Due to Covid-19, fellowship programs could not conduct in-person interviews during the 2020–2021 interview cycle and were forced to implement virtual interviews. We conducted two nationwide surveys of residency and fellowship Program Directors (PDs) involved in the Obstetrics and Gynecology (Ob/Gyn) Subspecialty Fellowship match cycle to gain a better understanding of virtual interviews from each of their perspectives. 1) Fellowship PDs’ confidence in using a virtual platform to holistically evaluate applicants during the 2020–2021 match cycle, 2) Residency PD’s perception of virtual interviews and impact on their program’s operations, and 3) to assess the desire of fellowship and residency PDs to continue virtual recruitment during forthcoming interview seasons. Two separate nationwide web-based surveys were administered to 1) Ob/Gyn fellowship PDs and 2) residency PDs through SurveyMonkey from July-September 2020 to assess the impact of virtual interviews form each parties’ perspective. Surveys solicited demographic information, four-point Likert scale questions, and free response questions Of programs meeting inclusion criteria, 75/111 (67.6%) fellowship PDs and 67/117 (57.3%) residency PDs responded to their respective surveys. Most fellowship PDs believed that they could confidently assess applicants’ professionalism (88%) during a virtual interview and (90.7%) felt confident in making a rank-order list. However, only 73.3% were just as confident in preparing a rank list after a virtual interview as they have been with in-person interviews. Most residency PDs (69.9%) believed that virtual interviews made it easier for their program to comply with duty hours, and 76.8% agreed that virtual interviews allowed their residents to accept more interviews than an in-person format. Most fellowship PDs found virtual interviews convenient. However, difficulty in observing social interaction and gauging applicant interest may be the biggest challenge moving forward.

Objective: Social media popularity and utilization have increased in recent years. Past studies have shown high usage of video-sharing platforms such as YouTube as a surgery preparation tool for residents. The growth of social media presents opportunities in orthopaedic resident training, marketing, and networking. The purpose of this study was to determine how orthopaedic surgery residency programs are utilizing social media as a component of their educational curricula. Methods: An anonymous survey was distributed to program directors for Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic surgery residency programs who are also a part of the Collaborative Orthopaedic Education Research Group (COERG). Program directors completed the survey and forwarded a resident-specific link to residents in their program. Data was collected between September and October 2021. Descriptive statistics were analysed. Results: A total of 9 program directors (5 M, 4 did not report gender) and 71 (53 M, 8 F, 2 non-binary/gender non-conforming, 8 did not report gender) orthopaedic surgery residents participated in this survey with a majority of participants from the Northeastern United States (3 of 5 program directors, 60.0%; 42 of 64 residents, 65.6%). Residents identified YouTube (24.8%), Instagram (20.0%), and podcasts (20.0%) as the most popular social media platforms. Four of 8 (50.0%) program directors felt that social media use improved their residents’ preparedness for cases, while 3 of 8 (37.5%) felt that it improved teaching of residents. Concerns reported with social media incorporation included confidentiality issues and costs of developing and maintaining social media programs. Conclusion: Differences exist in the perceived benefits of social media use between orthopaedic surgery residents and program directors. While both groups felt that incorporating social media into training improved case preparedness, only residents felt that their surgical outcomes were improved due to social media use. Most residents viewed the importance of social media incorporation into their training as neutral. This study can serve as a pilot for future studies regarding social media use in orthopaedic surgery resident training due to the improved insight it provides into which social media are being utilized by residents and programs and the attitudes held towards these media.

While combined pediatrics and medical genetics and genomics residency programs are growing in number and applicants, there are still workforce shortages within the medical genetics field. Medical students would benefit from additional information on the training pathways and insight into the application process itself. Program Directors of combined pediatrics and medical genetics and genomics residency programs were surveyed to characterize factors that influence interview selection and rank list decisions, application logistics, recruitment, and training pathways. When evaluating applicants, representatives from both pediatrics and medical genetics are involved in the screening process. Additionally, both groups value prior research experience, but do not have a clear preference for a particular subcategory or domain of research. Most program directors think that all currently‐available training pathways can provide optimal training. Further action is needed to provide medical students with the knowledge to make more informed decisions about their career and medical school advisors with objective data to counsel students. There was support among program directors to initiate consideration of creating a pathway for medical students to match directly into a medical genetics and genomics residency. [ABSTRACT FROM AUTHOR]

Background: Orthopedic fellowship positions continue to be increasingly competitive, with most orthopedic residency graduates pursuing fellowship after completion of residency. Shoulder and elbow fellowship training represents an increasingly competitive and relatively smaller cohort of applicants than other subspecialties; there are only 29 programs with a total of 40 offered positions. The purpose of this survey is to identify and rank factors considered most important by shoulder and elbow fellowship directors when identifying potential fellowship candidates. Methods: A web-based survey was emailed to all 29 orthopedic shoulder and elbow fellowship directors recognized by American Shoulder and Elbow Surgeons. Demographic information was collected regarding program size, total number of applicants interviewed, and total number of applicants subsequently ranked. The survey also included a list of twelve applicant characteristics which each program director was asked to rank in a sequential order (most important to least). The median score of each factor was calculated, and a weighted score was applied to the top five (of twelve) categories selected by each program. Five points were given to the top-ranked factor. Four points were given to factors ranked 2nd, three points to factors ranked 3rd, two points to factors ranked 4th, and one point to factors ranked 5th. The weighted scores were then used to determine the most highly desired applicant characteristics. Results: Twenty-two of 29 (76%) orthopedic shoulder and elbow fellowship programs responded to the survey. Fourteen of 22 (64%) programs interview 20 or fewer applicants each year. No programs ranked more than 25 applicants. Twelve of 22 (55%) of program directors rated the interview as the most important factor, whereas 6 of 22 (27%) selected letters of recommendation. Based on the weighted score calculation, interviews, letters of recommendation, and personal connections to the applicant/letter writers comprised the top three categories, respectively, and captured 193 of 330 (58%) of the total available points in the weighted score. Strength of shoulder/elbow experience in residency, ties to the geographical area, and comments made regarding technical competence scored among the lowest factors. Conclusion: Orthopedic shoulder and elbow fellowship directors consistently ranked interviews, letters of recommendation, and personal connection to applicant/letter writer higher than other factors when ranking applicants. This information provides both program directors as well as applicants with important information to consider when navigating the shoulder and elbow fellowship application process.

Objectives: Recently, the decision was made to transition the United States Medical Licensing Examination (USMLE) Step 1 score from a three-digit numerical score to a pass/fail system. Historically, Step 1 scores have been important for otolaryngology resident applicant selection. The purpose of this study was to understand and evaluate otolaryngology residency program directors' (OPDs) opinions on the impact following the change in Step 1 score reporting. Methods: A 22-question survey administered through Qualtrics was sent to 113 academic otolaryngology residency program directors in April 2020. Information about demographics, impressions on the new Step 1 score format, anticipated changes in applicant selection, impact on mental health, and importance of various other factors in selecting applicants were queried. Descriptive statistics were used to analyze survey results. Results: A total of 41 out of 113 (36.3%) OPDs completed this survey. A majority of surveyed OPDs (80.5%) do not support the decision to change Step 1 to a pass/fail system. In the absence of a three digit numeric USMLE Step 1 score, OPDs indicated prioritization of away rotations, letters of recommendation (LORs), personal prior knowledge of the applicant, grades in required clerkship, and class ranking or quartile. 53.7% of OPDs anticipate requiring USMLE Step 2 Clinical Knowledge for interview consideration following this change. Conclusion: OPDs believe a pass/fail Step 1 score will decrease the importance of this exam and that this change will lead to the implementation and evaluation of additional metrics such as a required Step 2 CK score. [ABSTRACT FROM AUTHOR]

The Accreditation Council for Graduate Medical Education oversees graduate medical education in the United States. Designed to provide broad based training in all aspects of imaging, the diagnostic radiology residency program must provide educational experiences that not only provide technical, professional, and patient centered training, but also meet accreditation standards. With the breadth of material to cover during training, carefully orchestrated educational experiences must be planned. This manuscript offers residency program leaders resources to meet the challenges of the new Accreditation Council for Graduate Medical Education Diagnostic Radiology Milestones 2.0 and highlights potential opportunities for future educational endeavors. [ABSTRACT FROM AUTHOR]

Background: Internal medicine residents are responsible for providing much of the direct care for palliative and terminally ill patients in teaching hospitals in the United Arab Emirates (UAE). To date, little systematic information is available on the prevalence of palliative care (PC) programs or faculty in UAE academic hospitals, or on the nature of PC education in internal medicine residency programs in the country. Methods: Semi-structured interviews were conducted with program directors of all 7 internal medicine residency programs in the UAE. Qualitative content analysis was conducted to identify recurring themes. Results: All program directors agreed that PC knowledge and skills are an essential component of training for internal medicine residents, but have had variable success in implementing the components. Three themes emerged, namely lack of structured PC training, perceptions of resident preparedness, and barriers to implementing a PC curriculum. Conclusion: Internal medicine residency programs in the UAE currently lack structured, mandatory PC curricula and have limited opportunities for formal teaching and assessment of PC knowledge and skills. The planned development of comprehensive oncology and palliative care centers and ongoing curricular reform in teaching hospitals in the country will provide important opportunities to train a cadre of competent health professionals to provide high quality palliative and end-of-life care to UAE patients and their families. [ABSTRACT FROM AUTHOR]

Background Standardized letters of recommendation (SLOR) have become common features of the medical school to residency transition. Research has shown many advantages over the narrative letter of recommendation including improved letter-writing efficiency, ease of interpretation, and improved reliability as performance predictors. Currently, at least four specialties require fellowship SLORs. Internal medicine adopted its SLOR in 2017. Previous research showed fellowship program directors’ satisfaction with the 2017 guidelines. Little is known about residency program directors’ acceptance and adherence to the guidelines. Objectives The study sought to assess the adoption rate of each component, barriers to adoption, time commitment, and alignment with intended goals of the guidelines. Methods Anonymous survey links were posted to an internal medicine discussion forum prior to the guidelines in spring 2017 and twice following the guidelines in fall 2018 and winter 2019. Two-sample tests of proportions were used to compare respondent characteristics with known survey population data. Pre- and post-survey comparisons were assessed for statistical significance with Pearson chi-squared statistic. Results The response rate varied from 30% to 35% for each survey period. Medical knowledge, patient care, interpersonal and communication skills, professionalism, and scholarly activity were reported frequently (>96%) at baseline. Inclusion of residency program characteristics, systems-based practice, practice-based learning and improvement, and skills sought to master increased over the study period. Conclusions The new guidelines improved uniform reporting of all core competency data. Overall, the gains were modest, as many pre-survey respondents reported high rates of including components within the guidelines.

Introduction: Prospective urology applicants in Saudi Arabia must go through a rigorous matching process. Defining which aspects of an applicant's portfolio or interview will get them matched is difficult. Our objective is to provide information on which aspects of an application are the most important. Subjects and Methods: In this cross-sectional study, an electronic survey was sent out to all urology program directors (PD). The survey included 27 items from an application that were rated by the respondent using a 5-point Likert scale. Results: Twenty-three urology PD completed the survey (79.3% response rate). Most of the PD subspecialized in endourology and minimally invasive surgery. The three most important aspects as perceived by all responding PD were as follows: performance during rotation at the respondent's centre, publications in urology, and the total number of electives in urology. The three least important factors were as follows: presentations in fields other than urology, recommendation letters from nonurologists, and quality reference letters from nonurologists. Conclusion: Performance during rotations has been shown in our and other studies to be one of the most important factors in an application. Surveying PD on what they value the most in an applicant, provides valuable information and more transparency regarding the match processes. We also recommend that our colleagues from different specialties conduct similar studies.

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. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has had a wide-reaching impact. Graduate medical education of orthopedic surgeons was not spared from the jarring changes. Purpose: We sought to survey fellowship program directors in the field of orthopedic surgery about how the COVID-19 pandemic affected the education of the 2019 to 2020 and 2020 to 2021 fellowship classes and the future of their programs. Methods: In October 2020, an 18-item survey was distributed by an official of the American Academy of Orthopedic Surgeons (AAOS) to the specialty societies that govern fellowship training. Each specialty society then distributed the survey to its respective program directors. A reminder email was sent during the enrollment period. Each respondent was able to complete the survey once. Survey questions were grouped into 3 sections: general information about the fellowship training programs, the impact of COVID-19 on the 2019 to 2020 fellowship class, and the future impact of COVID-19 on the fellowship training programs. Results: Of the 564 accredited orthopedic surgery fellowship programs in the United States, 190 directors responded. Of these, 73.59% reported COVID-19 had a negative impact on the 2019 to 2020 fellowship class. A normal distribution of responses was found regarding didactic and academic learning, research, and mentorship opportunities. A majority of respondents said they believe that there will be no negative impact on patient care the fellows provide in the years to come. Conclusion: Orthopedic surgery fellowship program directors acknowledged that while there were negative effects to training in the pandemic, they did not think these would negatively affect patient care provided by 2019 to 2020 fellows in the short and medium term. They also reported positive outcomes from the experience of the pandemic, including new ways to educate fellows. [ABSTRACT FROM AUTHOR]