Resident Expectations, Program Alignment, and Program Director Longevity in Obstetrics and Gynecology Residency Programs

<ns5:p> Introduction Residency Program Director (PD) longevity has decreased over time, <ns5:sup>1</ns5:sup> with many specialties citing tenure in this leadership role of 5 years or less. Burnout, lack of support, and challenges with work/life balance may be causal factors. Our aim was to examine the current tenure of PDs in this field and identify factors supportive of longevity versus challenges that may contribute to turn-over. Methods We conducted a survey-based cross-sectional study of current and former OBGYN PDs between December 2024 and March 2025. The electronic survey included demographics, questions on overall satisfaction in the role, factors lending support, and those posing challenges. Descriptive analyses summarized participant characteristics and key findings. The primary outcome analyzed was certainty of remaining in the PD role for the next five years. Associations with increasing certainty of retention were examined using ordinal logistic regression with a proportional-odds model and logit link. Results A total of 59 responses were collected, including 50 (84.7%) as current PDs representing 20.7% of programs. Only 20% of respondents believed they would remain PD within the next 5 years. Most respondents reported satisfaction with relationships with faculty (93.2%) and support from their departmental chair (77.9%) and designated institutional official (86.4%). However, they reported less satisfaction with work/life balance, and noted challenges including lack of time (91.5%), administrative burden (94.9%), and resident evaluations (91.5%). Greater likelihood of remaining PD was associated with higher levels of overall satisfaction (OR 2.19; 95% CI 1.15–4.15; p = 0.016); satisfaction with work/life balance emerged as the strongest independent predictor of retention (adjusted OR 7.45; 95% CI 2.17–25.63; p = 0.001). Discussion While current average PD tenure in OBGYN is similar to other specialties, anticipated future retention appears lower. While PDs feel supported by faculty and institutional leadership, challenges related to work/life balance, administrative burden, and resident feedback and evaluation may contribute to a shortened tenure of PDs. </ns5:p>