Protected Time for Program Administration among Nephrology Program Leadership in the United States

Area of Science:

• Medical Education
• Nephrology Fellowship Training
• Graduate Medical Education Administration

Background:

• The Accreditation Council for Graduate Medical Education reduced minimum program director protected time for administration from 10 to 8 hours/week in 2022.
• No core faculty requirement was established alongside the reduction in protected time.

Purpose of the Study:

• To survey US adult nephrology program leaders regarding the impact of reduced protected administrative time and the absence of a core faculty requirement.
• To assess the sufficiency of protected time and estimate the time needed for program administration.
• To evaluate burnout levels among program directors, associate program directors (APDs), and core faculty.

Main Methods:

• An anonymous online survey was distributed to all US adult nephrology program directors in March 2023.
• Program directors forwarded surveys to their core faculty and APDs.
• Surveys collected data on protected time, sufficiency of time, estimated needs, and burnout using validated measures.

Main Results:

• 42% of programs with >6 fellows did not meet the reduced minimum protected time requirements.
• Only 37% of program directors felt their protected time was sufficient.
• APDs and core faculty reported low protected time (3±3 h/wk and 2±3 h/wk, respectively), with 42% of APDs and 50% of core faculty having none.
• High levels of emotional exhaustion were reported by 25% of program directors, 34% of APDs, and 21% of core faculty.

Conclusions:

• Program leaders estimate that minimum necessary program administration time exceeds current Accreditation Council for Graduate Medical Education requirements.
• Associate program directors and core faculty significantly contribute to nonclinical training activities.
• A substantial proportion of APDs (34%) and program directors (25%) exhibit a high likelihood of burnout.