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

Introduction: Residency Program Director (PD) longevity has decreased over time,1 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: A survey-based cross-sectional study of OBGYN PDs conducted via electronic listserv 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 5 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 between December 2024 to March 2025 with 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. The majority were satisfied with relationships with faculty (73%), support from their departmental chair (77.9%) and designated institutional official (86.4%), but cited less satisfaction with work/life balance, and noted challenges including lack of time (91.5%), administrative burden (94.9%), and resident evaluations (91.5%). Likelihood of remaining PD was associated with higher levels of overall satisfaction (OR 2.19; 95% CI 1.15–4.15; p=0.016) and satisfaction with work/life balance as an independent factor (adjusted OR 7.45; 95% CI 2.17–25.63; p=0.001).