Respondents Versus Nonrespondents and the Total Population of TY Programs
More than half of the responding TY programs were based at university-affiliated community hospitals, 25% at community hospitals, and approximately 10% each at university hospital and military hospital programs. The median program size was 10 residents. Twelve programs reported training the minimum number of 4 residents per year, and 9 programs trained 20 or more residents per year. The median length TY programs had existed was 28 years, with this number biased by the initial accreditation year of 1983. Only 7 responding programs were started within the past 5 years. The ACGME data showed that more than 20 programs closed during that same 5-year period.14,15
The TY programs are required to have at least 2 sponsoring ACGME-accredited residency programs. The most common program sponsors were internal medicine (88%), general surgery (42%), family medicine (25%), emergency medicine (24%), and pediatrics (18%). Only 5% of the surveyed programs did not list either internal medicine or general surgery as a sponsoring program.
Most TY programs were located at institutions that sponsor a small number of other graduate medical education programs. The median number of other accredited residency programs was 5, and the median number of accredited fellowship programs was 2. Several community hospital–sponsored programs indicated that they had no accredited residency or fellowship programs at their institutions but were affiliated with institutions conducting 2 or more ACGME-accredited residency programs that served as sponsors for their TY programs.
Program Director Characteristics
The survey sample consisted of 69 men (70%) and 29 women (30%). The respondents' mean job tenure was 7.7 years. Forty percent also served as a program director or associate program director for another residency or fellowship program at their institution ().
Transitional-Year Program Director Characteristics
Program Director Satisfaction
Survey respondents spent a median of 20% of their time fulfilling TYPD duties, but there was wide variation from a low of 10% to a high of 90%. Time spent as TYPD tended to vary based on program size, other medical education responsibilities, and institutional setting. More than 70% of TYPDs were satisfied with the time allotted to fulfill his or her duties. However, 19% of those surveyed were neutral, and approximately 9% were dissatisfied with the amount of time allotted for completion of TYPD duties ().
Percentage of Responses to Satisfaction Questions by Transitional-Year Program Directors
Forty-nine percent of TYPDs intended to serve less than 5 additional years in the program (). The most common reasons provided by TYPDs for leaving their positions were career advancement and pursuit of other professional interests, with 2 respondents stating that their program was closing at the end of the 2010–2011 academic year ().
How Long Do You Plan to Continue Serving as Program Director?
If You Plan to Quit Serving as Program Director, What are the Principal Reasons?
Important Factors to Strengthen TY Programs
There were 101 meaningful responses provided by TYPDs on ways to strengthen TY programs. The most common responses included strengthening the curriculum and broadening electives (25%), improving institutional support and funding (15%), and assistance meeting the new ACGME duty hour and supervision requirements (10%) (). The need to improve institutional support included those advocating for more TYPD protected time and those indicating the need for a dedicated program coordinator. Other responses included the need to improve or expand relations with sponsoring residency programs, to establish strong affiliations with nearby university programs, to receive assistance with medical student recruitment, and to receive assistance with recruitment and training of faculty to teach residents.
What Factors Are Important to Strengthening Transitional-Year (TY) Residency Programs for the Future?
Finally, the growing number of specialty residency programs deciding to capture the first postgraduate year as part of its categorical program was a concern for current TYPDs. Several respondents cited the need to more aggressively advocate for the value of the broad educational experience provided by TY training.