The following is a summary of “Nephrology Program Director Protected Time for Program Administration in the United States” published in the December 2022 issue of CJASN by  M. Yuan et, al.

Program directors were mandated to have 10-20 hours of scheduled time per week for program administration by the Accreditation Council for Graduate Medical Education (ACGME) (including didactic teaching). As of July 2022, this requirement was lowered for all internal medicine subspecialties based on program size, with the majority of nephrology programs needing only 8 h/wk. Researchers surveyed all 151 directors of US adult nephrology programs listed on the ACGME Public List of Programs 2021-2022 to learn more about their work schedules, including the amount of protected time they receive, whether or not they feel it is necessary, and how their time is allocated. 

Between March 31 and April 30, 2022, researchers fielded anonymous responses to a 20-question online survey. The study could only be described as descriptive. The proportion of those who responded was 66%. (99 of 151). Similar to other programs across the country, the majority (59%) of these fellowships had fewer than seven approved positions and were spread out geographically. Median protected time was 10 hours per week (interquartile range, 5-10), with 8 hours per week (interquartile range, 5-10) for those with fewer than 7 positions. Directors of programs, even those with fewer than 7 positions, reported needing a median of 12 hours per week (interquartile range, 10-16) more than they were allotted. 

Among program administrators who spent less than 10 hours per week on program management, 62% also provided direct patient care for more than 20 hours. Nearly 40% of teachers did not have any dedicated time for teaching. The most time-consuming activity was searching for new fellows (68%), whereas the most satisfying activity was teaching in a formal setting (80%).  Roughly 50% of nephrology programs were found to be out of compliance was the most satisfying activityACGME-mandated 10-hours-per-week minimum protected time for the 2021-2022 academic year. Director of programs reported spending a median of 12 hours per week on program administration.