Survey Of Program Directors Research Articles

Diversity Recruitment in CardiovascularSpecialties: Barriers and Opportunities in Postgraduate Training Programs.

Diversity in postgraduate training programs can be increased through program-based recruitment strategies. Prospective applicants often examine website content to determine if training programs are inclusive and offer a good fit. Poor overlap between program director recruitment goals and program website content as a barrier to recruiting a diverse physician workforce has not extensively been studied. The aim of this study was to characterize barriers to recruiting a diverse physician workforce in cardiovascular specialties in the United States. Cross-sectional survey of program directors and evaluation of website content for training programs in adult general cardiology, cardiothoracic surgery, vascular surgery, and adult cardiothoracic anesthesiology. A total of 68 surveys were completed (response rates of 10% to 13% across specialties), and 626 websites in cardiovascular specialties were analyzed. A majority (63%) of program directors prioritized increasing diversity, although 40% of these respondents did not have a plan or resources. Program culture was cited as a barrier to recruiting a diverse workforce. The median website score for inclusion and health equity content was 4.0 out of 18.0, with a health disparities curriculum offered in <10% of websites for most specialties. To advance diversity in cardiovascular specialties, training programs must have inclusive learning environments perceived by prospective applicants. Barriers to recruiting a diverse physician workforce may be decreased by addressing training program culture with an emphasis on modifying training program website content to attract more diverse applicant pools. Health disparities curricula are underutilized resources in cardiovascular specialties that may support recruitment of a more diverse physician workforce.

Skin of colour dermatology education in US primary care residency programmes: a nationwide cross-sectional survey of programme directors

Abstract Background Physicians-in-training report inadequate education in skin of colour (SOC) dermatology during residency. Although dermatology programmes have made progress in teaching SOC dermatology, the status of SOC dermatology education in primary care residency programmes remains unclear. Objectives To characterize SOC didactic and clinical training opportunities available to primary care residents, laying the groundwork for future curriculum development of SOC dermatology. Methods This cross-sectional study consisted of a nationwide 16-question survey disseminated by email between October 2022 and February 2023 to US primary care residency programmes identified using the Accreditation Council for Graduate Medical Education (ACGME) database. Results Of responding programmes (n = 49/1224, 4.0%), 29/49 offered SOC didactic training, most often through integration of content within general dermatology lectures (n = 29/49, 59.2%) and board review sessions (n = 13/49, 26.5%). Over half of programmes (n = 35/49, 71.4%) offered SOC clinical training through rotation in a general dermatology clinic (n = 33/49, 67.3%) and skin-related chief concerns in primary care clinics (n = 29/49, 59.2%). Programmes with directors indicating that they planned to incorporate SOC education into future curricula (n = 20/49, 40.8%) were more likely to already have SOC didactic and clinical training opportunities (P = 0.01 and P = 0.02, respectively). Regarding future directions, programme directors were most interested in integrating SOC topics within dermatology lectures (n = 31/49, 63.3%); identifying an expert (n = 31/49, 63.3%) and allocating lecture time (n = 10/49, 20.4%) were the most frequently cited barriers. Conclusions Some primary care programmes provide SOC dermatology didactic and clinical training opportunities, which are influenced by programme directors’ willingness to incorporate such training into curricula, and present opportunities for dermatologists to educate primary care residents.

High Conflict Divorce in Counselor Education: Investigating an Emergent Curricular Gap

High conflict divorce (HCD) is increasingly prevalent, profoundly impacting families, and placing a unique burden on mental health professionals. Despite the significant emotional, psychological, and legal challenges associated with HCD, many counselors report feeling unprepared to address these complex cases due to inadequate training during their graduate education. This study examines the extent to which CACREP-accredited counselor education programs in the United States incorporate HCD content into their curricula. A survey of program directors from Clinical Mental Health Counseling programs revealed that while topics related to family dynamics and conflict resolution are commonly addressed, HCD-specific training is less frequently covered. Key areas, such as litigation and courts and parental alienation and the reunification processes, are often neglected, limiting graduates’ ability to navigate the intricacies of HCD effectively. The findings suggest a need for specialized coursework and expanded training to better prepare counselors for the growing demand in this area. Addressing these gaps could enhance both counselor competency and the well-being of families navigating HCDs.

Health Literacy Curricula in Pediatric Residency Programs: A National Survey.

Using health literacy informed communication strategies can mitigate health inequities. Despite the high prevalence of limited health literacy among parents and children, pediatricians infrequently use clear communication techniques and further education is imperative. There is minimal literature exploring health literacy curricula in pediatric residencies. We sought to evaluate health literacy education across pediatric residency programs. The Academic Pediatric Association's Health Literacy Special Interest Group performed a national, cross-sectional survey of pediatric associate program directors from July 2022 to September 2022. We asked about the presence of health literacy curricula, teaching strategies used, content highlighted, outcomes assessed, and barriers encountered. Among 55 associate program directors from programs diverse in setting, size, and geographic region who participated, most (84%) reported their residents would benefit from more health literacy training. Only 44% reported the presence of health literacy education, with minimal teaching of evidence-based principles, such as the universal precautions approach to clear communication. Health literacy is infrequently taught in pediatric residency programs and there is appreciable variability among existing curricula. There is need for greater dissemination of existing resources, as well as standardization of curricula and assessment tools to ensure pediatricians are well-versed in use of health literacy-informed communication techniques. [HLRP: Health Literacy Research and Practice. 2025;9(1):e3-e7.].

Editorial Comment on "Trends in Urology Residency Applications: Results From The Society of Academic Urologists Program Director Survey From 2022 to 2024".

Editorial Comment on "Trends in Urology Residency Applications: Results From The Society of Academic Urologists Program Director Survey From 2022 to 2024".

Reply to Editorial Comment on "Trends in Urology Residency Applications: Results from The Society of Academic Urologists Program Director Survey from 2022 to 2024".

Reply to Editorial Comment on "Trends in Urology Residency Applications: Results from The Society of Academic Urologists Program Director Survey from 2022 to 2024".

Teaching Climate and Health in Preventive Medicine Residency Programs: A Survey of Program Directors.

Background Climate change and related pollution and environmental damage are an urgent focus for public health physicians. Curricular content is increasing in medical schools, but to date, only pediatrics has published guidance for residency education. Objective To survey program directors of Accreditation Council for Graduate Medical Education preventive medicine specialties (public health and preventive medicine [PHPM], occupational and environmental medicine [OEM], and aerospace medicine [AM]) for current teaching on climate and health issues. Methods Links to an online 9-question confidential survey were sent to all program directors through Listservs January through March 2024. Questions were developed with guidance from a climate health expert. Responses were analyzed via summary statistics for continuous data, as well as Fisher's Exact, Kruskal-Wallis, and Wilcoxon pairwise comparison tests for nominal data. Results Thirty-five of 71 programs responded (49.3%), including 21 of 42 PHPM, 12 of 23 OEM, and 2 of 6 AM programs. Two (5.9%) reported having a formal curriculum for climate and health issues, and 2 (5.9%) reported not covering any included topics. Programs differed by topic emphasis with OEM and AM more likely to address fire, smoke, wind, and flooding effects. Lectures and local or state health department rotations were the most frequent teaching strategies. Of complete responders, 23 of 34 (67.6%) expressed interest in joining a workgroup to develop shared curricula. Conclusions This survey of preventive medicine residency programs found that most include climate and health topics, but only 2 have a formal curriculum, and 2 reported no topics included in the survey.

Climate Change Curricula in US Graduate Medical Education: A Scoping Review.

Background Climate change threatens humanity's health and well-being. While climate change topics have been increasingly incorporated into undergraduate medical education, it is unclear to what extent they have been incorporated into graduate medical education (GME) curricula in the United States. Objective To examine how climate change has been incorporated into GME curricula in the United States. Methods We conducted a scoping review of published literature from January 2013 through November 2023. PubMed and Scopus were searched, with articles assessed by 3 reviewers in a blinded fashion. Resources were included if they described how climate change is incorporated into GME curricula in the United States, and if they discussed topics such as disaster medicine, mass casualty events, environmental medicine, public health, health policy, wilderness medicine, quality improvement, and sustainability. Articles were analyzed using descriptive numerical analysis and qualitative assessment to identify article characteristics and themes. Results The inclusion criteria generated 17 articles that examined climate change incorporation into GME curricula and curriculum interventions covering topics used for inclusion. The most common type of article (5 of 17, 29%) employed surveys of program directors on the inclusion of climate-related topics. Conclusions Published accounts of climate-related topics in US GME program curricula are few. More content is found in topics related to emergency medicine. Curricula frameworks have been proposed for pediatric and internal medicine residency programs, but we know little about their efficacy. Future scholarship should fill these gaps to educate learners to improve health care sustainability and resiliency.

Trends in Urology Residency Applications: Results from The Society of Academic Urologists Program Director Survey from 2022 to 2024.

To provide a cross-sectional view of the current opinions surrounding the urology match by analyzing data from the annual Society of Academic Urologists Program Director Surveys conducted between 2022 and 2024. Data collected through surveys distributed to all urology program directors consisting of questions covering program demographics, applicant selection criteria, preference signals, virtual interviews, and other relevant topics. 89, 90, and 89 program directors participated in the surveys for the years 2022, 2023, and 2024, respectively. The analysis revealed shifts in application review criteria, with increased emphasis on subinternship performance, letters of recommendation, and USMLE Step 2 Clinical Knowledge scores. Preference signals were widely adopted and viewed positively by program directors, with a majority supporting the continuation in a large-volume format. Virtual interviews were met with mixed sentiments, with concerns raised about their effectiveness in assessing candidates and replicating in-person experiences. However, they were recognized for their potential to level the playing field. This study underscores the evolving landscape of urology resident match. The adoption of virtual interviews, preference signals, and other changes co-occurring in medical education have altered the means through which applicants have been historically assessed. The findings highlight the need for ongoing feedback and transparency to ensure equitable practices for both applicants and residency programs.

Artificial intelligence-created personal statements compared with applicant-written personal statements: a survey of obstetric anesthesia fellowship program directors in the United States

BackgroundA personal statement is a common requirement in medical residency and fellowship applications. Generative artificial intelligence may be used to create a personal statement for these applications. MethodsTwo personal statements were created using OpenAI’s Chat Generative Pre-trained Transformer (ChatGPT) and two applicant-written statements were collected. A survey was sent to obstetric anesthesia fellowship program directors in the United States to assess the perceived readability, authenticity, and originality of the four personal statements. In addition, the survey assessed perceptions of applicants who use artificial intelligence to write a personal statement, including their integrity, work ethic, reliability, intelligence, and English proficiency. ResultsSurveyed fellowship directors could not accurately discern whether statements were applicant-written or artificial intelligence-generated. The artificial intelligence-generated personal statements were rated as more readable and original than the applicant-written statements. Most program directors were moderately or extremely concerned about the applicant’s integrity, work ethic, and reliability if they suspected the applicant utilized ChatGPT. ConclusionsProgram directors could not accurately discern if the statements were written by a person or artificial intelligence and would have concerns about an applicant suspected of using artificial intelligence. Medical training programs may benefit from outlining their expectations regarding applicants’ use of artificial intelligence.

2024 ACLP Recommendations for Training Residents in Consultation-Liaison Psychiatry

Despite rapid shifts in consultation-liaison psychiatry (CLP) training in residency, including increasing general residency training requirements from the Accreditation Council for Graduate Medical Education, greater utilization of advanced practice providers, and effects of the coronavirus-2019 pandemic, the Academy of Consultation-Liaison Psychiatry has not updated recommendations for residency training in CLP since 2014. A national survey of residency program directors in 2021 suggested many changes to the structure of CLP rotations at individual programs over the past decade. These recommendations are intended to guide residency program directors toward optimizing CLP training for all residents, including those who will eventually pursue CLP fellowship. We convened a workgroup of 8 Academy of Consultation-Liaison Psychiatry members holding leadership positions in residency and fellowship education on local and national levels. The project was approved by the Academy of Consultation-Liaison Psychiatry Executive Council and conducted via a three-stage iterative process. Consensus was reached on 34 recommendations across four domains, including structural issues, faculty supervision, formal curriculum and evaluations, and elective experiences. Residents must spend sufficient time on CLP rotations to achieve relevant milestones. Given that consultants are expected to offer unique insight, the ideal placement of core CLP rotations comes at a time in residency where residents are able to provide expert opinion and lead teams. Faculty expertise in CLP and availability to provide direct supervision and oversight to trainees are essential. A separate and formal CLP didactic curriculum should exist, and elective opportunities should be offered to supplement training. Establishing a strong CLP foundation for all residents is essential for ensuring competency in providing psychiatric care for medically complex patients and collaborating with our colleagues in other specialties, as well as fostering trainee interest in pursuing a career in CLP.

Variations in Trauma Education Practices Across Emergency Medicine Residencies: Insights from a National Survey of Program Directors.

Care of the acutely injured trauma patient is integral to the practice of emergency medicine. It is currently unknown how most emergency medicine residencies structure their residents' trauma experience and little guidance for competency assessment is provided by the Residency Review Committee. Our study aimed to determine current emergency medicine residency practices in trauma resuscitation. We conducted a cross-sectional survey of members of the Council of Residency Directors in Emergency Medicine (CORD) listserv in April 2023. Frequency with percentage of item responses is reported and differences across trauma levels assessed via Fisher's exact test (α = 0.05). Fifty-seven program directors responded to the survey (21.9%), the majority of whom operate at Level I facilities. Significantly more Level II/ III centers send residents to other sites for trauma experience compared to Level I (p = 0.000). Residents participate in all key procedures (eg, airway management, central venous access) when managing traumas except thoracotomy where participation was notably lower and statistically different across levels (p = 0.000). Lastly, program directors were very confident their residents can lead traumas independently and few acknowledged citations for deficiency in trauma training. Trauma training and confirmation of competency is critical among EM residents who may serve as the sole lead in rural emergency departments. This study demonstrates that there is considerable variability in how residency programs structure trauma education, particularly with regards to the exposure to invasive procedures and the opportunity to lead trauma resuscitations. As the American Board of Emergency Medicine has introduced requirements for program directors to attest specifically to the competence of residents to lead trauma resuscitations, standardized and validated tools should be adopted to support this attestation and ensure competence regardless of the program hospital's trauma level.

Patient safety and quality improvement education in dermatology residency programs: a nationwide survey of program directors.

Patient Safety and Quality Improvement (PSQI) are key components of graduate medical training, as detailed by the Accreditation Council for Graduate Medical Education (ACGME), with specific requirements that residents participate in experiential learning in PSQI during residency training. This study aimed to analyze the breadth of available and required PSQI educational experiences across dermatology residency programs in the United States. The objective of this study was to characterize the scope of PSQI educational experiences across dermatology residency programs. We electronically surveyed program directors of all ACGME-accredited dermatology residency programs from September 2023 to March 2024. Responses to the survey were anonymously collected with Research Electronic Data Capture (REDCap). Of the 145 dermatology programs surveyed, 37 program directors responded (25.5%). 89.2% of programs reported requiring residents to participate in PSQI educational experiences, with the most common being participation in a resident-led QI project (70.3%), which was also the most commonly available experience (91.2%). The least common required experience was observed simulated patient safety events and analyses. 83.8% of programs reported formal mechanisms to assess residents' competency in QI. This study highlights variation in PSQI experiences within dermatology residency programs across the United States. More than 10% of surveyed programs reported no required QI experiences during residency training despite ACGME program requirements. Additional gaps include variation in assessment of resident PSQI competencies. This study provides insight on the current landscape of PSQI education across dermatology residency programs and identifies opportunities to strengthen dermatology programs' PSQI educational offerings.

Characterizing Collegiate Recovery Programs in the US and Canada: A Survey of Program Directors.

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. 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. 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. 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.

Client and program-level factors associated with planned use of medications for opioid use disorder in specialty substance use treatment programs: Evidence from linked administrative data and survey data

BackgroundMost patients in specialty drug treatment programs that are not federally licensed Opioid Treatment Programs (OTPs) programs do not receive medications for opioid use disorder (MOUD). MethodsWe linked results from a survey of non-OTP treatment program directors in New Jersey (n = 81) to statewide administrative records of admissions for opioid use to those programs between July 2021–June 2022. Using multi-level regression, we examined the association of three types of factors with planned MOUD use: program survey responses, client-level factors, and program-level client characteristic mix. ResultsOf 9583 opioid treatment admissions in non-OTP settings, 41 % included treatment plans involving MOUD. Programs where directors reported staff concerns about buprenorphine's efficacy or diversion had a lower proportion of clients with planned MOUD, as did programs reporting too little physical space to prescribe. Being self-referred to treatment, unemployed and not looking for work, aged 30–49, heroin use (vs. prescription opioid use), and stimulant use in addition to opioids, were positively associated with planned MOUD; while non-Medicaid insurance, and Black and Hispanic race/ethnicity, were negatively associated with planned MOUD. Clients were more likely to have planned MOUD if their programs had a higher proportion of clients aged 30 or older, heroin as primary “drug of abuse,” stimulant use, and not working but actively looking for work. ConclusionFindings suggest addressing program staff attitudes toward buprenorphine could help increase planned MOUD. There is also a need to improve access for clients with non-Medicaid insurance, address within-program race and ethnic disparities, and address employment-related barriers to medication.

AAPM BTSC Report 377.B: Physicist brachytherapy training in 2022 - A survey of therapeutic medical physics residents.

A survey of medical physics residency program directors was conducted in Spring 2021 to examine the current state of brachytherapy (BT) training during residency. In this related work, a subsequent survey of therapeutic medical physics residents in 2022 was conducted to assess the confidence and experience of the trainees. Concerns for access to high-quality and diverse training in BT have escalated in importance due to recent declines in BT utilization. A survey consisting of 26 questions was designed by a working unit of the Brachytherapy Subcommittee of the American Association of Physicists in Medicine (AAPM) and approved for distribution by the Executive Committee of the AAPM. The survey was distributed to current trainees and recent graduates of the Commission on Accreditation of Medical Physics Education Programs accredited therapeutic medical physics residency programs by the AAPM. The participant response was anonymously recorded in an online platform and subsequently analyzed using spreadsheet software. The survey was distributed to 796 current medical physics residents or recent graduates over the course of 6weeks in February and March of 2022. The survey received 736 views and a total of 182 responses were collected, with 165 respondents completing the survey in full. Among those responses, 110 had completed their residency training, with program start dates ranging from calendar years 2015 to 2021. Individual responses from the survey takers (including partial survey submissions) were evaluated and analyzed to compile results. Medical physics residents reported the highest levels of confidence and caseload for gynecological BT procedures when compared with other surveyed treatment techniques. This indicates opportunities to improve training and increase access to clinical caseload are needed in order to improve competency and confidence. Time constraints (clinical and rotation-based) were indicated as impediments to BT proficiency. Medical physics residents reported enthusiasm for additional training opportunities in BT, and it is evident that additional structure and programs are required to ensure adequate access to BT training during residency.

Burnout among Postgraduate Healthcare Trainees at a Tertiary Healthcare Center in Saudi Arabia.

The aim of this study was to investigate the level of burnout among postgraduate healthcare trainees at a tertiary care center in Riyadh, Saudi Arabia, and assess the need to establish a well-being program. This cross-sectional study was conducted between December 2021 and January 2022 and used two validated questionnaires: the Copenhagen Burnout Inventory (CBI) for assessing burnout among postgraduate healthcare trainees, and a questionnaire for assessing program directors' opinion on the need for a well-being program. A total of 386 trainees and 85 program directors completed the questionnaire. In both groups, the majority of the respondents were male (trainees: 53.9%; program directors: 61.2%). A total of 226 trainees (58.5%) scored above the CBI burnout cut-off score, with the median score being highest in the personal domain (62.5,IQR: 45.8-75). In the univariate analysis, the mean burnout score was higher among trainees who were married (P = 0.036), had children (P = <0.001), and were seniors (P = 0.028), whereas in the multivariate analysis, the only significant predictor of burnout was having 1-2 children (P = 0.023) or 3-4 children (P = 0.013). In the program directors survey, 90.6% agreed that improving physicians' well-being would directly rectify patients' overall well-being, but only 28.2% stated that it is currently incorporated in the curriculum. This study found that a large proportion of postgraduate healthcare trainees experience burnout, particularly in the personal domain. Although program directors supported the concept of trainees' well-being, its incorporation into the curriculum was lacking, suggesting the necessity of establishing a well-being program.

Mapping out Remediation: An Actionable Roadmap to Support Trainees Through Remediation

What’s NewThis qualitative analysis offers an actionable, stepwise approach to remediation. IntroductionThe goal of graduate medical education is for trainees to develop the competence needed to practice independently; however, some residents struggle to achieve competency and require remediation. Evidence around how to best facilitate remediation is lacking. The objective of this study was to understand best practices for remediation in pediatrics. MethodA national web-based survey of pediatric residency program directors (PDs) on remediation practices was performed. The survey included 3 open-ended questions about PDs’ experiences with remediation. Self-reported barriers to and strategies for remediation were systematically analyzed using inductive thematic analysis to develop a theory of effective remediation in pediatric residency training. ResultsA total of 99 out of 195 (50.8%) program directors responded. Two main themes emerged: developing a personalized plan that ensures competency attainment and fostering psychological safety. Twelve categories outline actionable steps that PDs can take to make the remediation process successful. DiscussionBuilt from insight from pediatric PDs, we propose a conceptual model for effective remediation that accounts for competency attainment while safeguarding the emotional health of the resident. The conceptual model breaks the remediation process down into four phases: identification of the learner who struggles, planning the remediation process, implementation of the plan, and assessing the outcome of the process.

Nephrology Program Director and Fellow Home Hemodialysis (HHD) Curriculum Survey

Nephrology Program Director and Fellow Home Hemodialysis (HHD) Curriculum Survey

Digital technology implementation in prosthodontics postgraduate programs in Saudi Arabia: a multi-institutional survey of program directors

ObjectiveTo assess the current status of digital technology (DT) implementation in prosthodontics post-graduate (PG) programs in Saudi Arabian dental institutions.MethodologyA 19-item survey was created using Google forms and the link was emailed to the 29 prosthodontics PG program directors (advanced clinical training and joint program) in Saudi Arabia. The questionnaire contained five Sect. 1) didactic training and DT usage in PG preclinical, clinical and laboratory training, 2) incorporation of DT in PG program, 3) utilization of DT and the types of cases treated by PG students during their course, 4) information on the faculties involved in prosthodontics PG education, and 5) potential challenges encountered and program directors’ satisfaction of the PG program. Descriptive statistics was used to present the frequencies and proportions, and Chi square inferential test was used to compare the participants’ response based on the type of PG programs (α = 0.05).ResultsOnly 28 program directors responded to the survey, yielding a 95.5% response rate. Among the program directors, 24 (85.7%) and 4 (14.3%) directors supervised the advanced clinical training and joint programs, respectively. Among the DT, CAD/CAM was the most used technology (50–80%), followed by intra-oral scanning (28–96%). Digital technology implementation was largely limited by lack of resources or equipment (67%), cost (53%) and scarcity of PG teaching staff (46%). A significant difference was observed between the programs regarding the mandatory use of DT for their cases (p = 0.03).ConclusionsThis multi-institutional survey of program directors revealed that DT is continuously implemented in the last few years. Saudi dental institutions must prioritize implementing and utilizing DT in PG training to graduate competent prosthodontists in this fast-paced digital era. While DT is pivotal in dental education, its implementation is limited in many institutions due to resources or equipment, cost, and lack of trained faculty.