Protocol for the Spring 2025 CERA Program Director Survey

The Council of Academic Family Medicine Educational Research Alliance (CERA) is a collaboration of family medicine education organizations that aims to advance family medicine educational research.¹ CERA regularly surveys department chairs, clerkship directors, residency program directors, and members of academic family medicine organizations. Members of each organization associated with the Council of Academic Family Medicine (CAFM) are eligible to submit proposals to contribute questions to these targeted surveys. CAFM organizations include the Society of Teachers of Family Medicine (STFM), the North American Primary Care Research Group (NAPCRG), the Association of Departments of Family Medicine (ADFM), and the Association of Family Medicine Residency Directors (AFMRD).

CERA subjects proposals to a competitive, peer-reviewed acceptance process. Authors of accepted module proposals are assigned mentors from CERA, identified as experienced researchers with prior CERA involvement. The CERA mentors assist with question revision of the proposed survey, data analysis, and dissemination through presentations or publications. CERA administers the Institutional Review Board (IRB) approval process (through the American Academy of Family Physicians), manages survey distribution to targeted audiences, and conducts data collection.² This article describes the methodology and demographic results of the spring 2025 CERA Program Director Survey.

CERA administered the omnibus survey from April 22 to May 23, 2025. The survey included five modules selected from 18 submitted proposals (Table 1) and recurring standardized demographic questions. The methodology of a previous CERA Residency Program Director Surveys has previously been described in detail.¹ The Residency Program Director Survey is conducted twice a year, in the spring and fall. The CERA Residency Program Director Survey Director reviewed all questions to ensure alignment with the subproject aims, clarity, and existing evidence of reliability and validity. A group of family medicine educators not included in the target sample pretested the questions. The research team revised questions for flow, timing, and readability based on the pretesting results. The American Academy of Family Physicians IRB approved the project in March 2025.

The sampling frame for the survey included all directors of Accreditation Council for Graduate Medical Education (ACGME)-accredited United States family medicine residency programs as identified by the AFMRD. CERA delivered email invitations to participate through the online program SurveyMonkey (Symphony Technology Group, Menlo Park, CA). Nonrespondents received up to four weekly follow-up emails and a final reminder 1 day before the survey closed. AFMRD provided summary demographic data for the full sample of potential respondents to enable statistical comparison with actual survey respondents.

We calculated descriptive statistics, including frequencies and percentages, for the following demographic variables: education/training/degrees, gender, race/ethnicity, and self-identification as underrepresented in medicine. For education, the survey limited response options to “MD” or “DO,” and AFMRD combined these degrees into one category, thus, we could not perform comparative analysis for this variable. For the remaining variables, we used χ² tests to compare the potential versus actual respondents, excluding the options of “No Response” and “Choose not to disclose” categories. We set the significance threshold of 0.05 for all two-sided tests. All analyses used Stata SE18 software (STATA Corp, College Station, TX).

The initial pool of potential respondents included 799 residency program directors. Of these, 15 emails were undeliverable. The survey began with a qualifying question to exclude programs that had not yet graduated a resident class. After excluding 58 residency program directors, the potential respondent sample included 726 program directors. A total of 389 responses were received, including the 58 disqualifying respondents. Ten residency program directors answered only the qualifying question; they were removed and treated as nonrespondents. The final sample included 321 completed responses, yielding a response rate of 44.2% (321/726; Table 2).

No significant differences were found in gender, race/ethnicity, or self-identification as underrepresented in medicine between the potential survey respondents and the actual survey respondents (Table 2). After survey administration, CERA provided each module team with the deidentified data specific to their survey module.

The spring 2025 CERA Program Director Survey had an acceptable response rate. We found no significant demographic differences between actual and potential survey respondents.