Program directorship is often framed as an administrative role or temporary leadership assignment. Less often is it examined as a structurally vulnerable position, balancing the needs of residents, faculty, institutions, and accreditation requirements.

In this episode of PDs@SEA, Dr. Marianne Chen and Dr. Bryan Mahoney reflect on the candid “Everything You Wanted to Know” session from the SAPM meeting, surfacing experiences program directors across the country rarely articulate publicly. The conversation opens with a striking finding: only a small minority of program directors anticipate staying in the role beyond six years, prompting discussion about burnout, identity, and the hidden labor of residency leadership.

The discussion explores how artificial intelligence is entering PD workflows, from letters of recommendation and promotion reviews to early scheduling experiments, alongside a clear-eyed assessment of where automation helps and where human judgment remains essential. Recruitment practices are also examined, including signaling, interview volume, second looks, and the tension between efficiency, equity, and applicant experience.

These themes are grounded in the daily realities of program leadership: evaluations, duty hours, follow-ups, and persistent administrative load. Practical strategies emerge around organization, delegation, habit formation, and boundary-setting, as well as how perspective shifts with experience.

The episode closes by asking whether the growing competitiveness of anesthesiology will translate into a sustainable pipeline of future leaders, and what institutions must do to support those entrusted with raising the next generation professionally.

Key Takeaways From This Episode

• Program director burnout is largely structural, driven by the role’s position between residents, faculty, institutions, and accreditation requirements.
• Short PD tenures signal sustainability challenges that cannot be solved through individual resilience alone.
• AI is beginning to reduce administrative burden for PDs, but only when paired with deliberate human oversight.
• Recruitment mechanisms such as signaling and second looks improve efficiency while introducing new equity tradeoffs.
• Administrative overload remains a central stressor and requires systems-level solutions, not incremental fixes.
• Sustainable PD leadership depends on habits, delegation, and boundaries rather than constant availability.
• Program directors shape the future of the specialty by “raising residents professionally,” extending their impact beyond individual programs.

Especially Useful For

Program directors, associate program directors, residency leadership teams, department chairs, and clinician-educators focused on the sustainability of graduate medical education leadership.

Related Episodes

• Why Residency Leadership Is Burning Out (And Why It Still Matters)
  A direct examination of PD burnout, structural pressures, and why sustaining leadership roles requires institutional support rather than individual endurance.
• Passing the Torch: How a Residency Survives (and Grows) Through Leadership Change
  Explores leadership transitions, continuity, and what departments can do to protect programs during periods of PD turnover.

This episode marks a major milestone for PDs @ SEA. We celebrate our tenth episode and welcome our new co-host, Dr. Marianne Chen, Residency Program Director at Stanford. Marianne joins host Dr. Bryan Mahoney to talk about leadership transitions, the realities of running a residency, and how signaling and recent ERAS changes are reshaping recruitment across anesthesiology.

Together, they compare early data, share how signaling is affecting the depth and fairness of application review, and reflect on the role of team-based recruitment. They also discuss the value and limits of the new applicant essay prompts and how programs interpret gold and silver tier signals differently.

This conversation offers practical insight for program directors, faculty, clerkship directors, and educators navigating this year’s recruitment season. It also highlights the shared commitment across programs to support trainees and build strong, inclusive learning environments.

This episode was recorded, produced, edited and published by Larry Chu, MD and the Stanford AIM lab.

In this episode of PDs at SEA, Dr. David Stahl reconnects with two former colleagues from The Ohio State University to reflect on what happens when leadership changes hands in a residency program. Dr. Amy Bauman, now the program director at OSU, and Dr. Jared Spear, outgoing chief resident, join the conversation to discuss the practical and emotional dimensions of program director transition from three different vantage points: the departing PD, the incoming PD, and the residents navigating the shift.

The discussion explores why program directors move on, how successors step into leadership roles they may or may not have felt ready for, and what residents experience when the person who recruited them is no longer the one leading the program. The conversation also addresses the realities of the job itself: the steady presence of daily fires to manage, the challenge of maintaining boundaries and perspective, and the ways in which mentorship, communication, and shared values carry programs through change.

Despite the inherent uncertainty of leadership turnover, the episode emphasizes continuity of culture, trust, and purpose. It offers reassurance to applicants and residents alike that transitions are common, that strong programs remain strong, and that the work of training physicians continues to be deeply meaningful.

This episode was originally published September 15, 2025 on YouTube

In this conversation, Dr. Brian Mahoney sits down to speak directly to the concerns and confusion many applicants experience during the residency match process. The discussion focuses on how the signaling system is evolving, practical strategies for allocating gold and silver signals, and why signaling should be based on thoughtful alignment rather than a sense of safety or prestige.

The episode also addresses a topic that creates anxiety every year: how to prepare for residency interviews and how much communication before and after interviews really matters. Dr. Mahoney offers clear guidance on when letters of interest or intent are appropriate, how to convey genuine enthusiasm without appearing performative, and why interview day is best understood as a search for a mutual fit rather than a test.

The conversation closes with advice for students who may not have strong local mentorship or a home anesthesia program, along with reflections on the value and limitations of networking at national meetings such as the ASA annual conference. Throughout, the emphasis remains steady: applicants should rank programs in the true order of their preference, trust the match algorithm, and focus on presenting themselves with sincerity, preparation, and humility.

This episode was originally published June 20, 2024 on YouTube

In this episode of PDs @ SEA, we sit down with student doctor and ASA Medical Student Component Senior Advisor, Tiffy Kung, to review the most commonly asked questions from medical students preparing to apply into anesthesiology. Together, we unpack how students are thinking about away rotations, signaling strategies, letters of recommendation, research identity, and how to assess program culture.

For program directors, this conversation provides a clear window into applicant mindset, sources of anxiety, and misconceptions that persist despite advising efforts. We discuss how to communicate expectations transparently, where signals are shifting applicant decision-making, and how to help students find programs where they will thrive.

This episode was originally published June 20, 2024 on YouTube

In this episode of PDs @ SEA, we sit down at the end of the interview season to compare what program directors actually experienced under the expanded signaling system. With both programs having wrapped interviews and finalized rank lists before second looks, the conversation turns to how gold and silver signals shaped who was reviewed, who was invited, and how programs interpreted applicant interest.

We discuss how much signals narrowed the screening workload, whether geographic preference added any additional value, why an applicant email means something very different now, and how some strong candidates may have unintentionally misplayed their signaling strategy. We also examine the return of in-person second looks, how programs are structuring them to avoid pressure or advantage, and whether away rotations are quietly becoming more important again as dean’s letters and application narratives become less informative.

This is a direct, grounded debrief for program leadership and advisors who want to better guide applicants next cycle, and for applicants who want to understand the real implications of how signals are being read on the program side.

This episode was originally published on January 17, 2024 on YouTube

In this episode of PDs @ SEA, newly appointed residency program director Dr. Erik Romanelli sits down with his mentor’s mentor, Dr. Adam Levine of Mount Sinai, who has led his residency program for nearly three decades. The conversation traces how a PD grows into the role, why the work matters beyond administration, and what sustains a career in residency leadership over time.

Dr. Levine reflects on the lessons that shaped him, the value of assuming nothing, and the core belief that program directors are first and foremost educators and advocates. The discussion touches on resident culture, recruitment in the virtual era, the balance between clinical presence and administrative leadership, and the importance of building an environment where people want to stay, train, and later return as colleagues.

This is a candid, generous exchange between two program directors at different stages of their journey. For anyone considering stepping into residency leadership, or reflecting on what it means to shape a training culture, this episode offers perspective, grounding, and a reminder of why the work is worth doing.

This episode was originally published January 17, 2024 on YouTube

In this conversation, Dr. Bryan Mahoney speaks with Dr. Stacy Fairbanks about her journey through anesthesiology training, medical education leadership, and her recent transition out of the residency program director role. Dr. Fairbanks reflects on what made the work meaningful, the challenges of balancing multiple stakeholders, the evolving pressures of training in a post-COVID clinical environment, and how residency culture shapes both learning and wellbeing. She speaks candidly about burnout in the PD role, the emotional weight of mentoring residents through triumphs and struggle, and what she wishes new program directors would know before they begin. This episode offers a grounded, honest look at the realities of training the next generation of anesthesiologists and what it takes to sustain the people who lead that work.

This Episode was Originally Published December 7, 2023 on YouTube