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Abstract: TH-PO014

Nephrology Program Director Protected Time for Program Administration: A National Survey

Session Information

  • Educational Research
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Educational Research

  • 900 Educational Research


  • Yuan, Christina M., Walter Reed National Military Medical Center, Bethesda, Maryland, United States
  • Young, Brian Y., University of California Davis Health System, Sacramento, California, United States
  • Watson, Maura A., Walter Reed National Military Medical Center, Bethesda, Maryland, United States
  • Sussman, Amy Nicole, Banner University Medical Center Tucson, Tucson, Arizona, United States

In July 2019, the Accreditation Council for Graduate Medical Education (ACGME) reduced protected time for training program administration from 20 to 10-20 hours/week for nephrology program directors (PDs). No minimum time was specified for core faculty, where it had been 10 hours/week. In July 2022, it will be reduced to 8 hours/week for the majority of PDs. Program administration is defined as “non-clinical teaching and administration”.


Anonymous survey of all US adult nephrology PDs, administered from 3/31-4/30/2022, regarding protected time received for program administration, how much they think necessary, and division of their professional time overall. The 20-question, anonymous, on-line survey link was delivered by email to 151 PDs (ACGME Public List of Nephrology Specialty Programs 2021-22).


Response rate was 66% (99/151). Geographic distribution and approved clinical fellow positions were similar to the entire population. Median approved clinical fellow positions was 6 (IQR 4,8); 59% had <7 approved positions. Median protected time was 10 hours/week (IQR 5,10), but only 8 hours/week (IQR 5,10) for those with <7 positions. Overall, PDs estimated they required a median 12 hours/week (IQR 10,16) protected time to effectively administer their programs, as did those with <7 approved positions (12 hours/week (IQR 10,15). PDs reported core clinical faculty receive a median 2 hours/week (IQR 0,5); 39% of PDs reported 0 hours. Of PDs devoting <10 hours/week to program administration (median 8 hours/week (IQR 4,10) protected time), 62% provided >20 hours of direct patient care.


Approximately half of US nephrology programs are not in compliance with the ACGME-stipulated 10 hour/week minimum protected time for PDs. The majority estimate at least 12 hours/week are needed to effectively educate fellows and manage their programs. In view of our results and historically low board examination pass rates, the ACGME should track effects and reassess the 2022 decrease in PD protected time, as it does not align with PD-reported needs for education and administration.
Disclaimer: The views expressed in this abstract are those of the authors and do not necessarily reflect the official policy the Department of Defense or the U.S. government.