Wow. Serious cynicism.
However, I like the Sith Lord analogy. You become an apprentice to a master. Your strength and knowledge of the force grows. The master imparts wisdom, but not too much to ensure dominence. Finally, your power grows to the point that you feel ready to be PD. The RRC rules are very clear that "There can only be a single program director in charge of the program". Hence, you challenge the current PD to a force of wills / might, and if you defeat them you become the new PD. And find a new apprentice.
Reality:
Many PD's, especially those at quality programs, do the job because they LIKE it. Imagine that? I disagree (a bit) with DF99's comment that people become PD's to climb the academic ladder. Problem is that from PD, there is no obvious next step to go to -- you don't usually become chair, or department head, etc. You can become DIO but that's not seen as a "big" position.
If you get into academic medicine, you need to decide how you want to earn your academic time. Although it is now becomig possible to be a pure clinician at an academic center (esp in GIM or Hospitalist), it's a pretty miserable experience IMHO -- workhours and workload have increased and pay is far below non-academic settings. Hence, you want to find some way to fund 30+% of your time.
You can do research, or administration. In the Admin category, there's the residency program, student program (assuming there's a medical school), or other funded pathways -- like working in IT/EMR, or in QI, etc. Most of these other pathways require some additional training or background.
So, running the residency program is a great way to fund 50-70% of your salary.
You would start by contacting the current PD and seeing if there is anything you can do. Come to morning report, get involved with a project to improve the program. If you show interest, you're likely to be offered an Associate PD position. Very small programs won;t have Assoc PD's. You could also be a site director (if you were at a different site like a VA), or help organize the clinic, etc. Get involved with resident recruiting, remediation, and the admin meetings.
Once a change in PD's is planned, good programs will provide some overlap to ensure a smooth transition,
I cannot stress how helpful mentoring is in this process. It is not a good job to "figure out as you go".
