Transitions into GME Program Leadership Roles in Neonatal-Perinatal Medicine: Opportunities for Improvement

Introduction: Graduate Medical Education (GME) leadership can be a rewarding and valuable career path. Strong, skilled leadership is critical to the success of any training program. Despite this, there are few requirements and minimal guidance to prepare for GME leadership roles. Aims: Identify pathways into Neonatal-Perinatal Medicine (NPM) GME leadership roles and describe the needs of incoming program leaders. Methods: The Organization of Neonatal-Perinatal Training Program Directors (ONTPD) distributed an annual anonymous survey to all NPM programs in September 2024. Quantitative questions utilized descriptive statistics. For free text responses, thematic qualitative analysis was utilized to summarize the findings. Coding discrepancies were reconciled amongst the 3 independent reviewers. Results: Leadership from 87 out of 105 (83%) of NPM programs responded. The majority of respondents were the program director (PD) 88%, with 65% of PDs having previously served as an Associate PD (APD), with a median of 2 years in the APD role (Table 1). Of program leaders, only half (55%) planned to have a career in GME, with a wide variety of situations leading to the leadership role (Figure 1). Leaders first joined GME leadership a median of 4 years after completing fellowship. Most program leaders had support for transitioning into the role (91%) including: mentoring from other PD/APDs (44%), meetings to review program tasks and timelines (43%), program coordinator assisted in preparing (41%), and previous program leader stayed in another program role (40%). Figure 2 showcases program leadership’s overall satisfaction or dissatisfaction with important elements of the transition. Thematic analysis identified 6 major themes as most helpful in preparing for a role in fellowship program leadership: mentorship, resources, support, experience, planned transition, and national conferences. Local mentorship, resources, and outgoing program director support were most commonly described and national resources and mentorship through ONTPD were frequently cited. Conclusion: NPM program leaders need mentorship, resources, and support both locally and nationally. We identified areas of opportunity to optimize planned transitions for new leaders. We encourage division leaders to define roles, provide appropriate protected time for leadership in GME, and allocate divisional support and resources. These results reiterate the importance of national collaboration as a tool for new and successful GME leaders.