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The Great Reshuffle in GME: Program Administrators Have More Options

Updated: May 10, 2023

In the niche world of graduate medical education (GME), training programs are experiencing the effects of the ‘Great Reshuffle’, alongside other sectors. The recent buzz around this term, also known as the ‘Great Resignation’, coined by Anthony Klotz, an associate professor of management at Texas A&M University in early 2021[1], describes a prediction for a sustained workplace shift – not just voluntary resignations from jobs, but also a change in the relationship with work forever[2].

GME Administrators at all career levels – Education Directors, Managers, Coordinators, and other GME staff – are on the move, changing positions, institutions, and even careers. The pandemic has prompted Program Administrators to reassess their priorities – and ask for greater flexibility, improved benefits, and a better work/life balance. Many have gone on to seek new opportunities that better suit their needs. Others are leaving the workforce altogether.

The talent shortage is causing workforce gaps across the country and a strain on GME program operations. There are several factors to consider when strategizing the best ways to deliver program support, recruit and retain top talent, and optimize staffing to maximize impact on training programs.

Redefine Program Support Institutions are experiencing high Program Administrator turnover and budget constraints hindering new hires, while new accreditation requirements are being rolled out by the Accreditation Council for Graduate Medical Education (ACGME). Effective July 1, 2022, the ACGME Specialty-Specific Program Requirements: Program Coordinator Dedicated Time states the Program Administrator must be provided with a minimum dedicated time and support specified by specialty for the administration of training programs[3]. The calculation of FTE is important in human capital management, especially when decisions relating to the Program Administrator staffing complement are needed. These new requirements are sure to impact the bottom line. Fortunately, there is still time to act; ACGME will not be issuing citations for minimum FTE requirements until July 1, 2023. Table 1 provides an example of how the required staffing changes impact the appropriate FTE coverage for cardiology fellowship subspecialties. Where previously 1.0 FTE may have been managing multiple fellowships, the newly mandated Minimum FTE Required Administrator Support is 1.5 FTE + 1.02 Aggregate FTE for a total of 2.52 FTE. This is an increase of 1.52 FTE of support that the sponsoring institution must obtain to remain in compliance with ACGME standards. Table 1. Hypothetical Scenario showing the impact of FTE changes for a Cardiology department with multiple subspecialty training programs.

Recruit and Retain Top Talent As institutional leadership (Designated Institutional Officials, Program Directors, and Hospital Executives) review their human resource policies, staffing requirements and needs, and employee offerings, they should reflect on the following priorities to assist with hiring and retention[4]:

  • Offer flexible work environments and support

  • Provide professional development opportunities

  • Emphasize mental health and wellness

  • Train managers to lead hybrid and remote teams

  • Prioritize diversity, equity, and inclusion

Typically, institutions rely on their own human resources process for recruiting talent; however, it is often the case that the specific attributes of the best candidate for GME roles are missed. As we move forward, beyond this workplace shift, we must employ all techniques to find and retain competent Program Administrators. In addition to formal qualifications and previous direct experience, we should also look at skills-based, assessing candidates on their skill set and future potential. Staffing to Maximize Impact The talent shortage is becoming a priority area of concern among GME training programs and Germane Solutions is working to help solve the issue. With increasing oversight in the administration of GME, finding and retaining qualified Program Administrators is becoming increasingly challenging. Germane Solutions can help fill in the gaps in program administrative duties. We are experts in GME and are equipped to provide continuous programmatic support, ensuring each teaching site maintains successful operations and accreditation standards. Germane Solutions can help in the following ways:

  • Provide interim Institutional and Program administrative services, with GME expert oversight

  • Advise on best practices to optimize program administration and operations

  • Reduce the administrative burden for staff across the organization

  • Train and mentor newly hired program administrators to develop their expertise and administrative skillset as quickly as possible

We are committed to helping solve the ‘Great Reshuffle’ dilemma. This time brings tremendous opportunities for institutions to innovate their educational programs while providing satisfying working environments for their Program Administrators.


Works Cited

[1] Kellett, A. (2022, February 11). The Texas A&M Professor Who Predicted ‘The Great Resignation’. Retrieved from Texas A&M Today: [2] Olivier Sabella. (2021, December 19). The Great Reshuffle: 10 workforce trends that will shape 2022. Retrieved from LinkedIn: [3] Common Program Requirements. (n.d.). Retrieved from ACGME: [4] Michelle Fox. (2022, February 4). The Great Reshuffle: Companies are reinventing rules as employees seek remote work, flexible hours, and life beyond work. Retrieved from CNBC:


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