The Reply

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Kane thoughtfully and correctly recognizes factors that contribute to program director satisfaction. The important landmark events in the lives and training of the young physicians in our programs triggered happy memories and general assent from all of us. In fact, the data we presented are concordant with Kane's statements. To understand the components of the Program Director Satisfaction Survey (PD-Sat) instrument, the reader is referred to Table 2 of our article,¹ where it is clear that the facets of “work with residents” and “work with colleagues” make up the near majority of total satisfaction compared with the other 5 facets combined. Furthermore, the essence of what Kane has identified, “work with residents,” was the only facet to demonstrate statistical stability in both the 1996 and 2005 administrations of the instrument, indicating that this is a particularly enduring component of program director satisfaction. Kane focused on the associations in Tables 3 and 4 of our article, which were found by assessing the link between scores on the PD-Sat instrument and the variables that were otherwise measured in the 2005 Association of Program Directors in Internal Medicine Program Director's Survey. We note in the results that the regression model identifying the 4 potentially modifiable, statistically independent, and significant factors associated with program director satisfaction accounted for only 14% of the total variance in PD-Sat scores. Clearly, there are other variables that account for program director satisfaction, and it is likely that many of them relate to the primary facet of “work with residents,” as Kane has suggested. We look forward to further studies of program director satisfaction that may test this and other hypotheses to further delineate the components of program director satisfaction so that we may all better mentor the next generation of program directors to provide the stability in leadership our residents deserve for the growth of their careers.

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1. Hinchey K, McDonald FS, Beasley BW. Sources of satisfaction for residency program directors: a second administration of the Program Director Satisfaction Survey. Am J Med. 2009;122:196–201
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