11. Recommendation 6

Recommendation 6: In programs with 13 or more residents, the program director and/or associate program director require additional protected non-clinical time above their minimum FTEs dedicated to the administration of the program (see table).  The program director must assign this FTE to themselves or to the APDs to meet the minimum aggregate FTE.

Recommendation for Minimum Protected Non-Clinical Time for PD/APD
Number of Approved Resident Positions	Minimum PD FTE	Minimum number of APDs	Minimum protected APD FTE	Additional protected FTE*	Minimum aggregate of PD and APD FTE
less than 12	0.5	1	0.4	0	0.9
13-24	0.5	1	0.4	0.1	1.0
25-49	0.5	2	0.8	0.2	1.5
50 or more	0.5	3	1.2	0.3	2.0
*The program director must assign this FTE to themselves or to the APDs to meet the minimum aggregate FTE.

 Justification

The role of the APD is not as clearly defined as the program director. RPS recommends that APD and PD protected non-clinical time can be combined. This shared responsibility gives the program director the flexibility to share protected non-clinical time with APDs. The 2018 WWAMI networking data based on 26 FM residency programs data indicate that the median PD/APD FTE is 0.57. Administrative pressures contribute to the12-14% PD turnover per year in family medicine.⁷ The median tenure for internal medicine program directors is 4 years.⁸ The APD can share these responsibilities to help reduce PD burnout. The APD protected non-clinical time is important when the APD will function as the PD in their absence.