Program director longevity in emergency medicine residencies: A 40-year analysis

Area of Science:

• Medical Education
• Emergency Medicine
• Graduate Medical Education

Background:

• The role of the Program Director (PD) is crucial for the success and quality of emergency medicine residency programs.
• Understanding trends in PD tenure is important for program stability and continuity of leadership.

Purpose of the Study:

• To analyze trends in the length of service for emergency medicine residency program directors over the last 40 years.
• To identify factors, including PD start year, geographic region, and program accreditation year, that influence PD duration of service.

Main Methods:

• Retrospective analysis of program data from the American Medical Association (AMA) Graduate Medical Education Directory and Emergency Medicine Residents' Association (EMRA) Match database.
• Calculation of descriptive statistics and use of linear regression to assess predictors of PD duration of service.

Main Results:

• Data from 783 unique PDs (1983-2023) revealed a mean ± SD duration of service of 6.19 ± 4.72 years.
• PD service duration has decreased significantly in recent decades, from 6.49 years in the 1980s to 2 years in the 2020s.
• Both PD start year (p=0.002) and program initial accreditation year (p=0.001) were significant predictors of service duration, while region was not (p=0.225).

Conclusions:

• The duration of service for emergency medicine residency program directors is declining.
• PD start year and program initial accreditation year are significant factors influencing how long a PD serves.
• Further investigation is required to understand this trend and develop strategies to enhance PD longevity.