Majority Of Program Directors Research Articles

Fortifying the workforce: A national survey of hematology/oncology fellowship program directors and training fellows for community-based careers.

9028 Background: Most hematology/oncology (HO) care occurs in community settings. In a recent national survey of currently practicing community oncologists, we highlighted areas of unmet need regarding preparation for community-based (CB) careers during fellowship [Agrawal et al, JCO OP 2024]. Our study aims to explore attitudes of HO fellowship program directors (PDs) relating to CB HO training. Methods: We conducted a cross-sectional email survey of 185 HO fellowship PDs in the United States. The primary outcome was assessing PDs’ attitudes regarding inclusion of CB HO training during fellowship. Secondary outcomes included assessing whether programs currently have clinical and/or non-clinical training experiences specifically addressing skills relevant to community practice. Participants were also surveyed to assess PDs’ attitudes regarding what motivates fellows to choose careers in community practice. Demographics pertaining to program leadership and fellows were also obtained. Results: We received a total of 53 responses (29% response rate). The majority of respondents’ programs were in academic tertiary care hospitals (76%) with a plurality in the Northeast (32%), had a median of 5 trainees per class, and had roughly equal Male and Female (including transgender men and women) trainees (70%). The majority of PDs had been in clinical practice for ≥10 years (68%) and in their program leadership position for ≤10 years (83%). Almost all PDs (96%) reported having graduates who pursue careers in CB settings, with financial compensation cited most frequently in making this decision (98%). The majority of PDs (83%) agreed that training experiences in CB HO should be available for their trainees during fellowship. A multivariate regression analysis demonstrated that there were no significant factors associated with this outcome (p>.05). Training experiences relevant to community practice were not uniformly available amongst programs, with 74% of programs offering clinical experiences, but only 32% offering non-clinical experiences. The most cited clinical experience was the option to rotate in a CB setting (80%), and the most common non-clinical experience was exposure to training in quality improvement/patient safety (88%). Conclusions: While most HO training programs in the U.S. are embedded within academic centers, nearly all PDs indicated their programs train fellows who pursue careers in the community. PDs believe that experiences tailored to CB HO practice should be available to their fellows. Although many respondents’ programs offer CB clinical rotations, relevant extra-clinical skill development opportunities are lacking. Goal-concordant pathways for career development during HO fellowship can be optimized, particularly as they relate to training individuals for practice in CB settings, a growing need within the HO workforce.

Traditional versus virtual interviews: A perspective of paediatric dentistry program directors and residents.

COVID-19 pandemic restrictions necessitated changes in conduct of the interview process for the selection of candidates in paediatric dentistry residency programs. To examine the experiences and attitudes of paediatric dentistry program directors and residents regarding the virtual interview process during the 2020/2021 application cycle. A survey was sent to 82 directors and 416 postdoctoral members of the American Academy of Pediatric Dentistry with data collected from individuals interviewed during the 2020/2021 cycle. Response rates for directors and residents were 27% (N = 22/82) and 17% (N = 72/416), respectively. Seventy-three percent of directors (N = 16) believed that virtual interviews were not an adequate substitute for in-person interviews and made it difficult to present facilities, observe applicant interactions, and assess personality. Fifty-nine percent of the directors (N = 13) were not interested in using virtual interviews if restrictions were lifted. Residents reported that virtual interviews were accommodating but were unable to observe interpersonal interactions, assess the location and facilities, and understand the program culture. Sixty-one percent of residents (N = 44) prefer to interview in-person. The majority of program directors (73%) felt that virtual interviews could not substitute for in-person interviews and 59% would not be interested in using virtual interviews in the future. Residents (94%) reported inability to evaluate the location and facilities, and 61% prefer to interview in-person for future interviews.

Descriptive Analysis of Vitreoretinal Surgery Fellowship Program Directors.

Purpose: To evaluate the demographic, educational, and scholarly characteristics of Association of University Professors of Ophthalmology-accredited vitreoretinal surgery fellowship program directors in the United States and Canada. Methods: Demographic, educational, and scholarly profiles of identified program directors were collated from online public resources. Characteristics were compared by sex, program size, ranking, and affiliation. Results: Eighty-one program directors (mean age [±SD] 54.7 ± 11.0 years) from 78 fellowship programs were identified. The minority were women (14.8%), who were on average 6 years younger than their male counterparts (P = .07). The majority of program directors had an academic affiliation (90.1%), most commonly professor (54.8%). The mean h-index, 5-year h-index, and m-quotient were 20.9 ± 14.9, 5.9 ± 4.4, and 0.82 ± 0.42, respectively. Compared with their counterparts, program directors of both "top 10" and large programs published more manuscripts (P < .05), accrued more citations (P < .05), and had a higher h-index (P < .05). Fellowship programs with female program directors had a significantly larger proportion of female retina faculty (P = .002). Conclusions: The backgrounds of vitreoretinal surgery program directors are diverse. However, women remain underrepresented in this position, highlighting an area with the potential for greater equity in ophthalmology.

Program Signaling in Obstetrics and Gynecology Residency Applications.

The objectives of this study were to evaluate how obstetrics and gynecology residency program directors used applicant signaling and to understand how two tiers of signals influenced interviews, ranking, and matching into programs. A multimethod, deductive-sequential design was employed using a national survey of residency program directors and a convenience sampling of programs to study how obstetrics and gynecology program directors used program signals in the 2022-2023 residency-application cycle. A total of 80.5% (236/293) of program directors receiving the survey provided information about signaling, and 20 programs provided application outcome data for applicants who signaled them. The majority of program directors (86.9%) opted into signaling, 43.4% used signals as part of their initial screening, and 33.1% used it as a tiebreaker after reviewing applications, with 45.4% feeling it improved their ability to conduct a holistic review and 41.5% inviting applicants they may not have invited previously. Among programs providing applicant data, the influence of signals on the chances of an applicant being interviewed varied, but an overall strong positive effect of signaling was observed across the sample. The mean rank was 42 for gold signals, 45 for silver, and 38 for no signal (F(3)=5.97, P <.001). Signaling was widely used by programs and was an effective tool to allow applicants to communicate real interest in a program. Signaling was associated with an increased likelihood of an applicant's being interviewed but did not influence an applicant's position on the rank list.

Evaluating Inpatient Care Team Models in Hematology and Oncology Fellowship Programs in the United States

Introduction. In response to a growing and increasingly older population with complex medical needs, the hematology and oncology (HO) care system has integrated the hospitalist model into inpatient systems alongside HO trainees and faculty. The inclusive workforce is comprised of hospitalists and advanced practice providers (APPs) who co-manage patients with specialists or form separate non-trainee (NT) teams. Despite multiple advantages of the hospitalist model, the optimal care team structure and the impact on HO fellowship training have not been previously explored. We aimed to survey HO fellowship programs in the United States to identify the structure of inpatient HO staffing models implemented at their institution, and collect data on perceptions of the NT model within the fellowship programs. Methods. We constructed and distributed two national web-based surveys targeting all adult HO fellowship program directors (PDs) and fellows from Accreditation Council for Graduate Medical Education (ACGME)-accredited programs. The surveys were designed to assess various aspects of HO inpatient services, including team compositions, individual responsibilities, and availability of NT services. We also assessed the PDs' and fellows' perception on the impact of NT teams on their training and education. The surveys were emailed weekly between 6/20/23-7/29/23. Results.We identified 147 HO training programs.A total of 35 PDs and 101 fellows responded our survey (Table 1). The majority of PDs (83%) were from university training programs in the Midwest (43%) and Northeast (33%), with fellow class sizes of 6-12 (47%). Most (67%) programs had both trainee (T) and NT teams included in their inpatient medicine models (Figure 1). The most commonly reported NT team was the bone marrow transplant and cellular therapy service (BMT) (57%), supported primarily by APPs (55%). Only 33% of respondents reported a dedicated sickle cell disease (SCD) inpatient team within their institution. Hospitalists were included in the care model of the inpatient oncology (27%), inpatient malignant hematology (23%) and SCD (13%) teams. Most PDs agreed that the fellows are primarily responsible for most inpatient tasks and over 50% agreed that APPs are responsible for direct patient care, admissions and discharge planning. 83% of PDs reported that their program had an appropriate balance between inpatient and outpatient care. Half (50%) of PDs reported that fellows had a positive perception of NT teams at their institution, and 35% were neutral. The fellows who responded were predominantly second-year fellows (43%) in Northeastern (43%) university hospitals (92%) from programs with 6-12 fellows (63%). Most (71%) respondents had both T and NT teams included in their inpatient model. Inpatient malignant hematology (53%) and inpatient solid oncology (53%) teams were the most commonly reported NT teams, followed by BMT (40%) (Figure 1). Fellows reported their primary responsibilities to include procedures and tumor board discussions (94%), communication with outpatient teams (91%) and resident education and supervision (89%). APPs were primarily responsible for discharge planning (63%), admissions (59%) and direct patient care (58%). Most (85%) fellows agreed that their program had an appropriate balance between inpatient and outpatient care. Most fellows (69%) reported the impact of NT teams on fellows' inpatient and training experience to be neutral. Fellows from institutions without NT teams responded that the addition on NT team would have a positive impact in their training experience (69%). Most PDs and fellow respondents perceived a financial barrier to the implementation of NT teams at their institutions. Conclusions.Our findings highlight the existing heterogeneity in the distribution and composition of services among HO programs nationwide. PD respondents and fellows without NT teams perceived these teams as a beneficial addition to the program, in contrast to fellows in programs with existing NT teams who reported a neutral impact. Further investigation of the reasons for this discrepancy is essential to identify areas of improvement. Additional insights from the ongoing survey will be presented during the meeting.

Interprofessional education in US radiologic technologist programs: Results of a national survey

BackgroundInterprofessional Education (IPE) prepares students to work in healthcare teams while promoting multidisciplinary learning. The Interprofessional Education Collaborative is a national organization committed to advancing interprofessional learning experiences and promoting team-based care. Previous studies of several allied health disciplines have explored faculty attitudes and beliefs about interprofessional education, but none have investigated program directors of radiologic sciences education programs. Because of their impact on radiologic sciences (technology) programs, it becomes necessary to analyze the attitudes and beliefs of program directors. To this end, this project investigated how program directors ranked the four IPE core competencies, how IPE is currently implemented in their program, and the differences between program directors who have implemented IPE in their curriculum and those that have not yet implemented IPE. MethodsAn online survey was distributed via email to 701 radiological science program directors of programs accredited by the JRCERT. The quantitative data was evaluated by crosstabulations, descriptive statistics, and Mann-Whitney U tests. ResultsWe found most program directors believe that IPE should not be a separate accreditation standard. The majority of program directors with over five years in academia had already implemented IPE in their curricula (n = 68, 91%). Program directors with 11–15 years in academia had the highest rate of IPE implementation (n = 22, 81.48%). Approximately half of the programs without IPE in their curriculum would like to see a greater emphasis on IPE in their programs (n = 36, 55.38%). Most program directors (n = 114, 80.90%) somewhat or strongly agreed that interprofessional education will increase the student's ability to understand problems. Less than half of respondents agreed that their program had the resources and personnel to teach IPE (n = 59, 43.3%). Program directors ranked the IPE competency Communication (n = 42, 32.60%) first, followed by Ethics (n = 39, 30.20%), Teams and Teamwork (n = 31, 24.00%), and Roles and Responsibilities (n = 17, 13.20%). ConclusionThere is strong support from program directors for IPE to be implemented within radiological sciences programs. Radiologic Technology program directors reported active collaborations with other health-care related programs, similar to collaborations noted in previous research studies. Many program directors that had not yet implemented IPE reported investigating ways to incorporate an IPE activity into their curricula. However, barriers that can affect IPE implementation have been identified.

How Did We Get Here and Where Are We Going? Career Trajectories of United States General Surgery Residency Program Directors

To develop the future of United States (US) surgical education leadership, surgical trainees and early career faculty who aspire to become program directors (PDs) must understand the potential career pathways and requisite skills and experience to become a general surgery residency PD. The objective of this study was to understand the demographics, career experiences, and professional satisfaction of US PDs in general surgery. An anonymous, cross-sectional survey utilizing a novel instrument. An electronic survey distributed to US general surgery PDs between June and November 2022 PARTICIPANTS: PDs of US general surgery residency programs. A list of the Accrediting Council for Graduate Medical Education (ACGME)-accredited general surgery PDs was created from the ACGME list from the 2022 to 23 academic year. The survey achieved a response rate of 46.2% (159/344). Only 32.1% of PDs identified as female and 67.3% identified as male with 1 respondent preferring not to identify their gender. PDs were White or Caucasian (68.6%), Asian (13.8%), and Black (3.7%); 4.4% were Hispanic or Latino. Only 83.7% of PDs completed fellowship training. PDs have been in the role for an average of 5.5 ± 4.9 years. The PDs were compensated for an average of 54.7% (±14.9% SD, 0%-100% range) of their time towards clinical duties. They were compensated on average for 35.7% (±12.6%, 0%-100%) of effort for residency-related administrative duties. Only 5% of PDs had obtained or were enrolled in an education-related degree. Only 55.4% of PDs had received formal surgical education training in teaching and assessment. 54.1% of PDs were interested in obtaining a more senior leadership position in the future. Most PDs (38.4%) expect to serve as PD for 5 to 8 years in total. Overall, the majority of PDs were very satisfied (29.6%) or satisfied (51.6%) professionally; similarly 28.9% were very satisfied and 48.4% satisfied personally. This study represents the most up-to-date characterization of the personal, academic, and career-related features of current surgical residency PDs across the US. PDs enjoy a high degree of professional and personal satisfaction and most aspire to increasing leadership within their organizations. Compared to prior data, PDs have become more diverse in terms of both gender and race over time. Opportunities exist for increased mentorship of aspiring and current PDs as well as increased training in teaching and assessment.

Survey of Informed Consent Procedures in Urology: Disclosing Resident Participation to Patients.

AbstractThe American Urological Association (AUA) and American College of Surgeons (ACS) codes of professionalism require surgeons to disclose the specific roles and responsibilities of trainees to patients during the informed consent process. The objective of this study is to analyze how these requirements are met by urology training programs. An anonymous electronic survey was distributed to the program directors (PDs) of the 143 Accreditation Council for Graduate Medical Education urology residency programs in the United States in 2021. Information was collected regarding program demographics, aspects of the program's consent process, and the disclosure to patients of the role and participation of residents in their surgery. There were 49 responses to the survey (34.3% response rate). Nearly 70 percent of PDs reported that attending physicians lead the consent process. The topics covered during consent discussion include possible complications (25%), expected recovery time (23%), length of the surgery (22%), the people involved (18%), and their specific roles (7%). Many PDs do not explicitly discuss trainee involvement (48.8%) or when a resident is to perform the majority of the case (87.8%). The majority of PDs (78.8%) communicate medical student involvement, but 73.2 percent reported having a patient decline participation of a trainee after describing their role. Despite the AUA and ACS codes of professionalism, many urologists do not disclose resident involvement in surgery to patients. Further discussions are needed to explore how to better balance resident education and patient autonomy.

Applicant and Program Director Perceptions Regarding Virtual Interviewing and Signaling [ID: 1373344

INTRODUCTION: In 2020, obstetrics and gynecology residency programs switched to a virtual interview format because of the COVID-19 pandemic. Most programs have continued to conduct virtual interviews. In 2022, program signaling was introduced to allow candidates applying to obstetrics and gynecology residencies to indicate interest in specific programs. The objective of this study is to survey medical student residency applicants and program directors about their perceptions of the process. METHODS: Education for All (EFA) developed a validated survey assessing student and residency program director perceptions. This survey was distributed online to all residency applicants and program directors who registered for the 2022 EFA Residency Fair. RESULTS: Five hundred six obstetrics and gynecology residency applicants and 33 program directors responded. 37% applicants indicated that virtual interviews would probably provide enough information to create a rank list, but 36% were not sure. 37% of students and 50% of residency programs indicated the process should continue to be virtual. Ninety-one percent of students indicated they would “definitely” use signaling, and 66% of program directors said signaling “might or might not” improve the application process. In a free-text section, many applicants expressed concern with the virtual interview process. CONCLUSION: Fifty percent of residency programs and the majority of residency applicants are unsure if interviews should continue to be virtual. Nearly all candidates planned to use program signaling, but the majority of program directors were unsure if this would improve the application process. Further study is necessary to determine whether program signaling and virtual interviews should be continued in the future.

Evaluating the gender of vascular surgery residency program directors in the United States

ObjectiveWomen in vascular surgery, especially those in leadership positions, are historically sparse but have the potential to make significant contributions to diversifying the future cohort of vascular surgeons. We aimed to analyze the current demographics of integrated vascular surgery residency (0+5) and fellowship (5+2) program directors (PDs) in the United States. MethodsA cross-sectional study of all active Accreditation Council for Graduate Medical Education-accredited 0+5 and 5+2 programs was performed. Program and PD data were obtained in February 2023 using publicly accessible sources. Program accreditation date, affiliation type, female faculty, and female trainees were collected. PD data included medical degree, training pathway, country of training, gender (male vs female), current age, appointment age, duration between training and appointment, research output, and H-index. ResultsSeventy-four 0+5 programs and 117 5+2 programs were included. Most programs were university-affiliated (164/191; 86%). Seventy-six percent (146/191) of PDs were identified as male, with the remaining 24% female. The mean age was 52 ± 7 years, and the age at PD appointment was 46 ± 7 years. The time between training completion and PD appointment was 11 ± 7 years, and the mean term length was 4 ± 3.5 years. Female PDs were younger overall (49 ± 6 vs 53 ± 7 years; P = .04) and at age of appointment (41 ± 5 vs 48 ± 7 years; P = .03). There was a trend of female PDs having longer term lengths compared with male PDs (6 ± 4 vs 4 ± 3 years; P = .08). Forty percent of residents were female, and 26% of full-time faculty were female. 5+2 female PDs were in programs with more female faculty (P = .001). Female department leaders had double the number of female PDs compared with male department leaders. Male PDs had a higher mean number of publications and Hirsch index compared with female PDs. However, these differences were not statistically significant when adjusting for age and age at position appointment. ConclusionsMost 0+5 and 5+2 PDs were men, and the overwhelming majority of department or division leaders in vascular surgery were male. Although the majority of PDs were male, female PDs were appointed earlier in their career. The current state of diversity in vascular surgery leadership has improved over the past decade; however, there still needs to be more female vascular surgeons, especially in leadership positions. Continuing institutional and societal efforts to recruit female trainees and promote women to leadership is essential to improve the diversification of vascular surgeons.

LGBTQ+ Training in United States Radiation Oncology Residency Programs

<h3>Purpose/Objective(s)</h3> The LGBTQ community is an understudied and medically underserved population who experience increased cancer risk and worse cancer outcomes. Negative provider interactions, including discrimination and lack of knowledge regarding LGBTQ-specific health issues are cited by patients as barriers to care, including in radiation oncology (RO). Notably, little is known regarding LGBTQ knowledge and attitudes among RO residents (ROR) or LGBTQ-specific training in RO residency training programs. Thus, we sought to assess the extent of current LGBTQ-specific training in U.S. RO residency programs. <h3>Materials/Methods</h3> Two published surveys of LGBTQ-education in residency were adapted to RO. The first assessed LGBTQ education from the perspective of program directors (PD) and associate PDs (APD), while the second survey was to RORs. The surveys were sent to all ACGME-accredited U.S. RO residency PD, APD, and program coordinators (PC), with the ROR survey being disseminated by the respective PCs. Each survey consisted of subsections of attitudes and knowledge in the care of LGBTQ patients, RO program characteristics, program inclusion of LGBTQ-specific education, and individual demographics. <h3>Results</h3> There were 69 responses (29 PD, APD and 40 ROR). The majority of respondents (PD, APD/ROR) identified as white (79%/58%), non-Hispanic (76%/72%), male (55%/55%), and heterosexual (86%/78%). The majority of PD, APDs did not receive LGBTQ education in medical school (60%) or residency training (96%), while the majority of residents (68%) did receive LGBTQ training in medical school; yet, both groups felt this training was insufficient to care for LGBTQ patients during residency (76%/68%). Overall, respondents felt comfortable treating LGB (90%/85%) and T (79%/62.5%) patients. However, the majority did not feel confident in their knowledge for LGB (52%/62.5%) or T (79%/85%) health needs. The majority of respondents' programs have never had a didactic session on LGBTQ health (78%/80%) resulting in 61%/61% of respondents feeling their program inadequately prepares residents to work confidently with LGBTQ patients. However, the majority felt their program is receptive to incorporating LGBTQ health content into their curriculum (75%/75%) and expressed a personal interest in such education (97%/80%). Additional data will be available by time of conference. <h3>Conclusion</h3> We found an increase of LGTBQ education in medical schools between PD, APD and ROR, suggestive of a recent improvement in LGBTQ content; yet most residency programs still lacked any LGBTQ-specific education. While the majority felt comfortable treating LGBTQ patients, they simultaneously lacked confidence in knowledge regarding LGBTQ health needs; yet, possessed desire for additional education and belief that such trainings should require. Conclusion is that residencies need to do a better job incorporating LGBTQ health content into their curricula, which is supported by interest from ROR and program leadership.

Managing Resident Mental Health: Prevention is Better than Cure

There is a high prevalance of burnout and mental health illness among trainees. Through structured meetings, Program Directors (PDs) have an opportunity to screen and aid residents that may be affected by mental health concerns. However, barriers to this process exist. This study sought to evaluate the perspectives of PDs regarding mental health screening for trainees. A 13-item survey-based study. Electronic distribution of the survey was performed via three individualized requests sent via e-mail to PDs. PDs of 5 ACGME specialties, including Internal Medicine, Pediatrics, Emergency Medicine, General Surgery, and Psychiatry were invited to participate. In total, 595 PDs responded to the survey (response rate = 40.0%) In general, PDs expressed dissatisfaction with the management of burnout and mental health. Most PDs supported periodic screening of residents for burnout (87.0%) and mental health (73.9%). For a resident that could screen positive for mental illness, most PDs were concerned about the possibility of harm to a patient (70.7%) and implications for future licensing (65.7%). Only 30.2% of PDs currently use some form of standardized screening to identify residents struggling with mental health and burnout concerns. The majority of PDs across 5 ACGME specialties support the use of periodic screening of residents for burnout and mental health. However, concerns exist regarding such screening such as the implications for future licensing. Additional work needs to be done to address PD concerns and destigmatizate mental health wellbeing and care among trainees.

Otolaryngology Residency Match During the COVID-19 Pandemic.

ObjectiveTo review changes made by otolaryngology residency program directors (PDs) during the 2020-2021 National Resident Matching Program (NRMP) match cycle and describe their attitudes toward the 2021-2022 match cycle.MethodsCross-sectional study using an anonymous 31-item online survey in Research Electronic Data Capture (REDCap) with questions regarding the 2020-2021 NRMP match. This survey was distributed to 125 PDs from Accreditation Council for Graduate Medical Education (ACGME)-accredited otolaryngology residency programs.ResultsThirty-three PDs responded (26.4%). Of the PDs, 78.8% had an online info-session prior to the start of the cycle, and 30.3% reported that an increased number of applicants contacted them compared to the prior cycle. There were no changes made in Step 1 criteria (72.7%), and 81.8% reported no changes in interview selection. Of the PDs, 54.5% reported interviewing more candidates. Respondents reported a decreased cancellation rate (66.7%) and cost of recruiting (87.9%); 87.9% said that they did not change the way they developed their rank order list (ROL), and 84.8% reported matching at their usual level compared to prior years. Of the respondents, 42.4% reported making a change that was an overall improvement for their program. Of the PDs, 34.4% were unsure whether they would sustain virtual interviews in 2021-2022, 25% stated that they would not incorporate virtual interviews, and 40.7% stated that they would incorporate a virtual interview in some part of the cycle.ConclusionOtolaryngology PDs approached virtual interviewing in different ways. Despite the changes made, applicants can find comfort in knowing that match outcomes were perceived as typical by a majority of PDs.

Resident Mental Health and Burnout: Current Practices and Perspectives of Urology Program Directors

ObjectiveTo understand perspectives of urology program directors (PDs) regarding the management and screening of resident mental health and burnout. MethodsAfter piloting and survey validation, an IRB-exempt 14 question survey was distributed to PDs of all 145 ACGME accredited urology residency programs. Statistical significance was determined using an alpha value of 0.05 and response plurality was determined by non-overlapping 95% confidence intervals. ResultsA total of 72 PDs completed the survey (response rate = 49.6%). The majority of PDs (59.7%) do not use standardized screening for resident burnout or mental health. A statistically significant proportion of PDs agreed to implementing periodic mental health (75.0%, 95% CI [65.0%-75.0%]) and burnout (87.6%, 95% CI [79.9%-95.1%]) screening. Female PDs were more likely to agree to implementing mental health screening compared to male PDs (female=94.4% vs male=68.5%; P =.03). If mental health screening was implemented and a resident tested positive, PDs were most concerned about harm to a patient (72.2%, 95% CI [61.9-82.6]) and implications of a positive screen on future licensing and practice (55.6%, 95% CI [44.1-67.0]). ConclusionAlthough the majority of urology PDs believe residents should be periodically screened for burnout and mental health, most do not currently screen their trainees. If mental health screening was implemented, PDs expressed concern about patient harm and challenges associated with future licensing. Our survey results suggest opportunities for improving management of resident burnout and mental health.

Perspectives of Residency Applicants and Program Directors on the Role of Social Media in the 2021 Urology Residency Match

ObjectivesTo perform a survey assessing the use of, attitudes towards, and perceived utility of social media (SoMe) in the 2021 urology residency match. MethodsWe distributed surveys to urology residency applicants and program directors (PDs) via the Urology Match 2021 Google Spreadsheet and email. The survey collected demographic information as well as SoMe activity, perceived pressure to use SoMe, match results, and attitudes regarding the utility of SoMe in the match process. ResultsA total of 108/528 (20%) applicants registered for the 2021 match and 61/142 (43%) PDs completed the survey. More applicants than PDs felt that SoMe helped them gain better insight into residency programs or applicants, respectively. Fewer applicants than PDs felt that SoMe activity provided a benefit to them in the match process. No significant relationship was found between SoMe viewing frequency, posting frequency, or tweetorial use with match outcomes. The majority of PDs believed that SoMe played a more important role in the 2021 match process than previous years while 15% and 12% reported that an applicant's SoMe activity helped or hurt the chances of matching to their program respectively. ConclusionsSoMe, particularly Twitter, was widely used in the 2021 match by both applicants and PDs. A majority of applicants and PDs believed that SoMe use aided them in some way in the match process, yet there was no relationship between the volume or type of applicant SoMe activity and match outcomes.

A Novel Ambulatory Curriculum for Pulmonary and Critical Care Fellowship Training.

Background: Dedicated ambulatory training during pulmonary and critical care medicine (PCCM) fellowships is often limited. A novel 2-year longitudinal outpatient pulmonary fellowship curriculum was previously developed, piloted, and studied. The exportability and potential impact of this ambulatory curriculum on PCCM fellowship training nationally is not known.Objective: We aim to understand the current state of ambulatory training in PCCM fellowships and the impact of a standardized outpatient curriculum on fellows’ ambulatory knowledge and competency.Methods: Nineteen programs participated in the study from 2017 to 2019. Six programs received the first year of content, seven programs received the entire 2-year curriculum, and seven programs served as a control. Fellows, faculty, and program directors (PDs) completed a series of surveys assessing satisfaction with ambulatory education and the curriculum. Fellows completed a series of medical knowledge inventories, and programs submitted in-training exam scores.Results: A total of 221 fellows (39%) and 17 PDs (89%) completed the precurriculum surveys, and 38 (12%) fellows and 10 (53%) PDs completed postcurriculum surveys. Before curriculum implementation, only 34.4% of fellows rated the quality of their ambulatory education as good or outstanding compared with 57.9% at the end of the study. Eighty-five percent of faculty and 89% of PDs rated the curriculum as good or excellent. Faculty believed that the teaching scripts were easy to use (78.4%), were factually accurate (86.3%), and provided high-yield information (82.1%). The majority of PDs indicated that the curriculum positively impacted patient care (78%) and fulfilled an unmet educational need (100%), and most planned to continue the curriculum after the study (78%). Feedback surrounded the need for updated content based on recently published guidelines and studies.Conclusion: The curriculum is a standardized and feasible way to address a previously unmet need in PCCM fellowship education. PDs rated the curriculum highly and most plan to continue it in the future. Our limited data set suggests that the curriculum was well received by fellows and faculty and positively impacted perceptions of ambulatory education and preparedness for independent practice. Future study with a larger sample of fellows is needed to better understand the generalizability of these findings.

The impact of coronavirus 2019 on general surgery residency: A national survey of program directors

BackgroundCoronavirus disease 2019 (COVID-19) has had a widespread impact on graduate medical education. This survey aims to assess how general surgery residency programs adapted to the initial wave of the COVID-19 pandemic in the United States (US). Materials and methodsGeneral surgery program directors (PDs) in the US were invited to partake in a 16-question survey between April 17 and May 1, 2020. The survey included questions about basic program information, clinical practice changes, changes to education structure, surgery resident clinical duties, and perceived impact on resident operative experience and future career choices. ResultsForty-eight PDs completed the survey in the designated two-week period. Almost all (44/48, 91.7%) programs changed their didactic education to an online video conference-based format. Thirteen programs (27.1%) decreased the amount/frequency of formal education, and 13 (27.1%) reported canceling didactic education for some period of time. The majority of PDs (26/48, 54.2%) felt these changes had no impact on resident didactic participation, 14 (29.2%) reported an increase in participation, and 8 (16.7%) reported decreased participation. Ten programs (20.8%) redeployed residents to non-surgical services at the time of this survey, 30 (62.5%) have not redeployed residents but plan to if needed, and 8 (16.7%) did not have any plans to redeploy residents. ConclusionsThe outbreak of COVID-19 has required general surgery residency PDs to change numerous aspects of resident education and clinical roles. Future inquiry is needed to assess if these changes lead to appreciable differences in resident preparedness and career selection.

Program and candidate experience with virtual interviews for the 2020 Complex General Surgical Oncology interview season during the COVID pandemic

BackgroundThe COVID crisis hit during the interview season for the Complex General Surgical Oncology (CGSO) fellowship. With minimal time to adapt, all programs transitioned to virtual interviews. Here we describe the experience of both program directors (PDs) and candidates with virtual interviews, and provide guidelines for implementation based on the results. MethodsSurveys regarding interview day specifics and perceptions were created for CGSO fellowship PDs and candidates. They were distributed at the conclusion of the season, prior to match. ResultsThirty (94%) PDs and 64 (79%) candidates responded. Eighty-three% of PDs and 79% of candidates agreed or strongly agreed that they felt comfortable creating a rank list. If given the choice, 60% of PDs and 45% of candidates would choose virtual interviews over in-person interviews. The majority of candidates found PD overviews, fellows only sessions and pre-interview materials helpful. ConclusionOverall, the majority of PDs and candidates felt comfortable creating a rank list; however, more PDs preferred virtual interviews for the future. Our results also confirm key components of a virtual interview day.

Pass/Fail USMLE Step 1 Scoring—A Radiology Program Director Survey

Rationale and ObjectivesIn February 2020, administrators for the US medical licensing examination (USMLE) announced that Step 1 reporting would change to pass/fail in hopes of reducing the overemphasis of USMLE performance on the residency selection system and improving medical student well-being. Our objective was to determine the perspectives of diagnostic radiology (DR), interventional radiology (IR), and nuclear medicine (NM) program directors (PDs) regarding pass/fail USMLE Step 1 scoring.Materials and MethodsA survey composed of thirteen questions on a three-point Likert scale, five demographic questions, and a free-text question was distributed to 179 DR, 84 IR, and 34 NM PDs from ACGME-accredited residency programs.ResultsIn total, 140 unique responses were obtained (response rate = 47.1%). The PD respondents had a male predominance of 79.1%, average age of 46 ± 7.2 years, and average tenure of 5.9 ± 5.2 years. A majority of PDs (69.6%) disagreed that the change is a good idea, and a minority (21.6%) believe the change will improve medical student well-being. Further, 90.7% of PDs believe a pass/fail format will make it more difficult to objectively compare applicants and most will place more emphasis on USMLE Step 2 scores and medical school reputation (89.3% and 72.7%, respectively).ConclusionThe lasting impact of pass/fail Step 1 scoring are uncertain and many radiology PDs do not support this change. While the central motivations to reduce the overemphasis on USMLE Step 1 performance and improve medical student well-being are admirable, it remains to be seen if pass/fail scoring will accomplish these goals.

Beyond Medical Knowledge and Patient Care: A Program Director's Perspective for the Role of General Surgery Subinternships

Established primary goals of general surgery subinternships are improvement in patient care and medical knowledge. However, the secondary gains such as obtaining recommendation letters and forming relationships are apparent but poorly defined. We sought the opinion of general surgery program directors (PDs) on the secondary purposes of subinternships. Our aim is to aide mentors and students to optimize the subinternship experience relative to the residency application process. A survey was administered in July 2019. This questionnaire consisted of 11 items and was broken down into 3 sections: demographics, PD perspective on the secondary goals of a general surgery subinternship, and the role of general surgery subinternships on the students' residency application. An online, national survey through the Association for Program Directors listserv. United States general surgery PDs affiliated with the Association for Program Directors listserv. Sixty-one PDs completed the survey from 42 (69%) academic and 14 (23%) community programs. The majority of PDs (n = 33, 54%) reported that assessment of a subintern's suitability for their residency was the most important secondary purpose. Furthermore, PDs (n = 24, 39%) valued a letter of recommendation from faculty the student worked with during a subinternship as the most important criteria in the interview selection process. Away rotations were perceived as of equal value to subinternships completed at the student's home institution. Overall, PD opinions were similar at academic and community programs. Our study suggests subinternships significantly impact a student's application to general surgery residency, clarifying a secondary role for these rotations. Subinternships are important for PDs to assess a student for ranking at their program. All students should pursue a letter of recommendation from subinternship faculty, when possible, as they can heavily influence the interview selection process. Away rotations should only be recommended for those students who need to strengthen their application.