Objectives
At the end of this chapter you will be able to:
- describe strategies to facilitate a program director’s transition out of the position
- describe key knowledge areas to ensure an effective handover to a new program director
- identify sources of support for the new program director
Case scenario
Dr. Lise Boucher was pretty excited as she set up pictures in her new office. Becoming a program director (PD) was a job she wasn’t quite sure that she was ready for, but she bravely took it on. She had always had an interest in medical education and had won the teacher of the year award for the past 2 years. The residents seem to really like her and confide in her regularly. She thought that she might apply for the site coordinator position when it became available but when she was encouraged to apply for this position, she jumped at it.
Just as she finished unpacking, Dr Sylvie Chan, the outgoing PD, stopped by to hand over. She showed Lisa the password for the computer where the resident files are kept and gave her a schedule of meetings and activities for the year. Lisa was a little shocked by the number of meetings outside the program but was excited to hear that everyone was very supportive. Especially the national PD group. Sylvie said that postgrad tends to help with the budget and let Lisa know that there were currently two learners in difficulty. She showed Lisa these specific learner files and explained their learner support plans. “It’s a lot to take in, I know!” she said with a laugh. “Not to worry. You got this! I’m so glad you are taking over from me. You’re great! I wasn’t sure who would want this job and I’m so happy you’re doing it. I’m heading off on my very well-deserved leave after the last eight years as PD!” Just before Sylvie left, she gave two more pieces of advice: (1) plan a big holiday after you are done being PD and (2) start finding your replacement now.
Sylvie left with a smile on her face. Lisa sat in the silence of her new office with a mix of emotions. Who knew drinking from a fire hydrant could be so quiet! She opened her computer and typed in “succession planning,” determined to do this right.
Introduction
Residency programs are complex, high-stakes, dynamic enterprises. Residents are full-time employees who are expected to both deliver service and learn. Programs and institutions have various reporting structures, budgetary demands and accreditation requirements. All of these elements operate in a national context of societal needs and educational frameworks. Ensuring that there are people with the appropriate skills and abilities to lead is critical to the success of any program. Despite this need, clear succession and handover plans are often lacking. As program director (PD) you have the ability to create, influence or advocate for systems and structures to ensure the security of your program and ease the transition to the next leadership. This includes thinking about effective succession planning, creating systems to curate and access program data centrally, and identifying future leaders and helping them develop.
Succession and replacement planning
Planning for the future is a program priority, not a PD priority. PDs may or may not have direct influence on the operations of the department but they are looked to as leaders and often seen as future departmental leaders. This means you have a voice!
| Key term | Definition |
|---|---|
| Succession planning | An organization-level proactive approach to deliberately ensure that the right skills and abilities are present at each level of the organization |
| Replacement planning | Identifying a person who can take over with minimal handover or support at short notice |
| Talent management | Identifying future leaders and helping them develop to be their best through mentoring and support structures |
Succession planning
Succession planning is a proactive process that an organization invests time and energy in to ensure that the right skills and abilities are present at each level. It is less about the attributes of a particular person and more about the needs of the position. Talent management, recruitment, mentoring and continual review of the skill requirements of the position in the dynamic environment are all important parts of an effective succession plan. One way to facilitate succession planning is to deliberately create positions that have overlapping responsibilities and key skills. Competence committee chairs may need to be able to lead, focus faculty members and keep abreast of national trends. Site coordinators meet with residents in difficulty and understand scheduling and the interface between academics and clinical responsibilities. Some programs have assistant PDs who get involved with curriculum mapping, national committees and some of the behind-the-scenes work. To facilitate faculty members’ development, individuals can be initially recruited to positions with a smaller scope of responsibility; this can be part of a deliberate talent management approach and can help to create a pool of future leaders. Businesses with robust succession planning strategies identify the skills required for each job, develop these skills broadly among their future leaders and constantly re-evaluate their plans to ensure success. Academic departments should think similarly. Recognizing that there is strength in diversity, care should be taken to select talented individuals from diverse backgrounds including but not limited to race, gender, gender identity, and sexual orientation.
Replacement planning
This is the “lottery ticket question.” Who would take over for the PD, or a person in another key position, if they unexpectedly were unable to do their job (e.g., if they won the lottery). People in key positions may need emergency backup for either the short or long term. Thought should be put into both scenarios. Appropriate replacement planning means having the name of a specific person who is ready to take over in an emergency. This person will need to have the requisite knowledge and experience as well as access to any confidential information needed for immediate decision-making.
Making the job amazing
Being a PD can be very rewarding and fulfilling, but it can also be exhausting, stressful and even a little scary at times. Remember, the face that you show to the world is the only one they see. If you focus on the amazing and positive aspects of the job, you will be seen as a role model to future leaders. If you regularly complain about the challenges, you may find that is all they hear. Focusing on the positive not only inspires others it can also inspire you too.
Handing over
You have had an amazing career as PD and it is time to hand the job over to the next generation. During this time there is a lot to consider. What needs to be handed over? How can you avoid bias? What needs to be talked about, and what just needs to be accessible? What is your role going to be in assisting the new PD? How much overlap should there be?
Advanced planning can help you to transfer your mountain of knowledge to the next PD more effectively.
Program data
Handing over program data involves more than just sharing the computer password. Most if not all program-level data are now housed electronically. If you keep a future transition in mind as you are making decisions today about how this information will be stored and accessed, you can make the life of the next PD much easier.
Emails and other communication data
Many programs are moving toward a “position” email account (e.g., PDPeds@sth.com) to allow curation of program-related communication and prevent work emails from being stored in personal accounts. This can help the next PD to easily access the “institutional memory” contained in emails. A word of caution for these accounts: keep them tidy and organized. Don’t keep anything that isn’t needed. Keep only the communications that are useful to the program. Confidential information needs to be thoughtfully curated to ensure that individuals’ privacy is respected. Remember as you store emails that you don’t know who will be reading them in the future.
Resident files, policies and processes
Often resident files and information on policies and processes are stored at a program or institutional level in a fashion that makes the documents accessible to people who have the appropriate privileges. Navigating who should have access can be challenging. Consider creating a map or how-to guide for the next generation of leaders in your program. Also, be clear about who is creating these systems and maintaining them: they need to be kept up to date. This includes making sure that unneeded or outdated versions are removed, as the next PD will not necessarily recognize which is the old version and which is the new one.
Relationships and connections
Residency programs exist in a network of relationships both locally and nationally. There may be programs that you rely on for support and key collaborators who have been helpful to you. When possible, plan on personally introducing the new PD to these programs and people. The history you have built as a PD can help warm the water for the next person. This will also help ensure that the new PD knows who to contact and that the programs and collaborators know to send their communications to the right person going forward.
History and wisdom
You have developed, or will develop, a world of expertise in regard to your program and your residents. This will be incredibly valuable to the next PD. Here are a few places that you can share that wisdom deliberately. Be mindful of how you frame these issues. Framing them in a positive way will always serve the next PD, the program and the learners best.
Resident performance
Unless your program is very large, you will probably know your residents better than anyone else. Share insights that will help your successor to better support the learners, while respecting the residents’ privacy.
Key program issues
Will your residents do 24-hour call? Will final-year residents have protected time for research? Have your residents reported any incidents of racism, harassment, or discrimination? What were the outcomes? You will make many decisions over your tenure. Some of these may be contentious. It may be worth explaining to the next PD your rationale for some of your key decisions so that your successor understands the context and the associated issues. They may disagree with some of your decisions, but at least they will understand why you made them. To refresh your memory, consider reviewing the minutes of your residency program committee’s meetings as well as program policies.
Wellness tips
Did you struggle? Probably. Most PDs struggle at some point. It is OK and probably helpful to normalize that and share with the next PD what wellness strategies you found helpful. How did you protect your time? Where did you fail and how did you grow? How did you maintain healthy boundaries, to balance being accessible to the learners and protecting your personal life? These tips may very well be the most helpful thing you can pass along to the next PD. They can also open the door for the next person to be open and ask for help when they may be struggling.
Ongoing supports
There are many different resources that a new PD can lean on for support. Creating a list of these resources and sharing it may be very valuable to your successor. Some potential resources include the following:
Local program support
Administrative assistants, residency program committee members, chairs, postgraduate medical education (PGME) offices and the previous PD all can provide unique lenses on the program.
External support
National specialty committee leaders and other program directors have a vast collective experience and are usually keen to help in any way they can. PDs can also consider engaging an executive coach who can act as a confidential thinking partner when difficult decisions have to be made.
Faculty development resources
Programs like the Royal College’s Workshop for New Program Directors provide a crash course on the roles of a PD. There are several online resources that are broadly accessible on the websites of the Royal College, other programs and other colleges. PGME offices often have access to resources for new PDs and are invested in their success.
Equity, Diversity, and Inclusion resources
Share a list with your successor.
A word about walking away
You may find, as many others have found, that being PD becomes part of your identity. You want your program to be successful forever! You can be a valuable resource to the future leaders of your program. However, your presence may also unintentionally limit their ability to lead. Work with the next PD to find a space that enables you to help them, but remember that you are not leading any longer. You stewarded the program as far as you could. It is time to hand it over.
Further reading
- Shekshnina S, Osnes G. Why the best CEOS are already thinking about their exits. Harvard Business Review Oct 2019 Available from: https://hbr.org/2019/10/why-the-best-ceos-are-already-thinking-about-their-exits?autocomplete=true
- Luby V and Stevenson JE. 7 Tenets of a Good CEO Succession Process. Harvard Business Review. Dec 2016. Available from: https://hbr.org/2016/12/7-tenets-of-a-good-ceo-succession-process
References
- Rothwell WJ. Replacement planning: a starting point for succession planning and talent management. Int J Train Dev. 2011;15(1):8799.
- Conger JA and Fulmer RM. Developing your leadership pipeline. Harvard Business Review Dec 2003.