What is it like to be chief resident in anesthesia?

[brotherbloat]

Hi there,

Just wondered from chief residents what it's like to be chief. Would you do it again? Is it worth all the administrative stuff you have to do? How does it help, if at all, in your job search? Just wondering.

Thanks,

BB

[Capsaicin]

Great question. Something I've been thinking about as well on the interview trail. Oh yeah, I guess I'd better match first though.

Also for any chiefs, who picks the chiefs at your program and how does the process work?

--Cap

[UTSouthwestern]

Interesting question that I haven't seen posted before. Guess I can reveal this information now that I am five months away from finishing.

Chief resident:

Job description: Leader, innovator, scheduler, full time pinch hitter, administrative assistant, human juggling act, counselor, mother/father, brother/sister, bastard/bitc*, and enforcer.

Benefits: Nice ribbon on your resume. Jobs come looking for you. Almost automatic interview when they know you are chief. Automatic fellowship placement if you go that route. Faculty appointment if you so desire.

Detractors: Time, TIME, T I M E. You spend at least 2-3 hours each day answering pages and e-mails, putting out small fires, hunting down wayward residents, sitting on important but numerous committee meetings, planning schedules two months in advance, planning out the yearly schedule at the beginning of the year which you will then change at least three dozen times due to maternity/paternity leave, poor resident performance, family tragedies, personality conflicts, etc. Someone doesn't show up for any reason then you are there to take their place. Educational planning meetings, residency review committees, multispecialty chief residents' conferences, residents' meetings, etc. are all part of your year. You spend more time being chief than reading for the most part and if you are married with kids, you aren't going to be a very good spouse/parent for that year.

Many of you have asked me how and why I respond so quickly to questions and the answer is easy: I am always on the computer checking e-mail and charting out schedules for multiple clinical sites at nine different hospitals.

The job hunt becomes a lot easier, however, and I had people contacting me as well as myself initiating contact. California, Arizona, Washington state, Oregon, and Texas were my acceptable destinations and I interviewed at more than a dozen sites including some who had previously published that they were not hiring this year. One friend of mine is still not talking to me after she found out I interviewed and was offered by a group that she had been trying to get into since before she started residency. Some groups even stated flatly to me that they only hire chief residents for their groups (a little pompous and shortsighted in my opinion, but whatever floats your boat).

So does it help? Definitely. Should you campaign to get the position? Hell no. Every resident should work with the diligence and enthusiasm that would make them candidates for the position, but what will separate you from the pack is your willingness to go the extra mile and help your fellow residents and program whenever there is a need and even when there isn't a need. Recognition comes through merit and service, not backstabbing, politicking, or machinations. I have seen a couple of people in other residencies do the latter and claim the position but all that does is create a chief resident without the ability or backing of the residents to lead.

I always wanted to help and do extra work because I loved the extra opportunities to gain experience and even just watch other people in action to learn their secrets. You can also separate yourself from the pack by being lazy, showing up late, not being prepared, and having a me first/the world is against me attitude. YOU CANNOT JUST TURN OFF LAZINESS AND SUDDENLY BECOME AN ACHIEVER. You slack off early in your residency and not only does it become hard to deviate from your wayward path, but it is also hard to shake off the label of lazy/stupid/dangerous resident.

For our institution, the residents and faculty each vote and the top two vote getters become chief, although the chairman holds veto power if he feels a candidate isn't academically well positioned to handle the spot or for any reason he feels a person should be disqualified from holding the position.

Would I do it again?


Yes I would. It's been the most taxing year of my life trying to be a full time spouse, father, chief, clinical resident, and job seeker, but if this experience coupled with an already deep educational residency hasn't prepared me for what lies ahead, I don't know what else could.

[MAC10]

Is it an extra year?

[UTSouthwestern]

Originally Posted by MAC10

Is it an extra year?

No. No one would take it unless it was integrated with a fellowship year.

[Epidoodle]

Great post UTSW. One of the best I've read in a long time. It should be required reading for every applicant and current resident.

[UTSouthwestern]

Originally Posted by Epidoodle

Great post UTSW. One of the best I've read in a long time. It should be required reading for every applicant and current resident.

I firmly believe what I have typed and I believe that it is a mindset that will make you a leader and make you someone that everyone can trust to do what is right. I am also just grateful that I found my way into anesthesiology after going through serious doubts and reservations in my mind in my IM residency.

One other benefit of being chief: You get to plan out your own schedule and know with certainty that your schedule won't change. I feel sorry for the residents in my program who have had to have their schedules changed by me to cover for absent residents for various reasons. Thankfully, almost all of them have kept their chin up and I can honestly say that I think that the entire CA-1 class has placed itself in position to be chief. I would love to still be around to vote on that class as I don't think we could go wrong with just about any member of that class.

[Tollway]

Originally Posted by UTSouthwestern

Thankfully, almost all of them have kept their chin up and I can honestly say that I think that the entire CA-1 class has placed itself in position to be chief. I would love to still be around to vote on that class as I don't think we could go wrong with just about any member of that class.

I know several people in that CA-1 class who I wouldn't trust with a family member (I did my internship at Baylor-Dallas with them).........

[Capsaicin]

Originally Posted by Tollway

I know several people in that CA-1 class who I wouldn't trust with a family member (I did my internship at Baylor-Dallas with them).........

That's OK, I would trust about 3/4 of my med school class with a family member...there is such a thing as knowing too much about someone.

[UTSouthwestern]

Originally Posted by Tollway

I know several people in that CA-1 class who I wouldn't trust with a family member (I did my internship at Baylor-Dallas with them).........

Interesting. Considering what your Baylor Dallas faculty said about you I would be interested in which ones you are talking about. A statement like the above isn't something I would throw around so easily considering the connations it can have and considering some of those residents vouched for you when you applied here. PM me.

[Tollway]

Originally Posted by UTSouthwestern

Interesting. Considering what your Baylor Dallas faculty said about you I would be interested in which ones you are talking about. A statement like the above isn't something I would throw around so easily considering the connations it can have and considering some of those residents vouched for you when you applied here. PM me.

I was joking UT. No harm done. I meant to put a winky smiley. Sorry

[UTSouthwestern]

Originally Posted by Tollway

I was joking UT. No harm done. I meant to put a winky smiley. Sorry

No problem, Tollway.

[patelakshar]

.

[Skip Intro]

Originally Posted by patelakshar

when you say that chief is a fellowship year does that mean:

intern (1) + residency (3) + chief (1)
OR
intern (1) + residency (2) + chief & y3 residency (1)

For gas, I think it's the latter (i.e., 4 years total, with the chief year also being CA-3/PGY-4). In some other programs, like IM or peds (etc.), your chief year is an extra year (i.e., PGY-4 in an otherwise 3-year program), but this isn't always the case either.

-Skip

[UTSouthwestern]

Originally Posted by patelakshar

when you say that chief is a fellowship year does that mean:

intern (1) + residency (3) + chief (1)
OR
intern (1) + residency (2) + chief & y3 residency (1)

Actually, I said that only if the chief year was integrated with a fellowship would most residents be willing to stay an extra year. In other words, the chief resident year is not an extra year currently and is performed in your CA-3 year.