Benefits of a Chief Year

[WestcoastMedicine]

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I was talking with a fellow resident about this today and wanted other perspectives. I did read the thread on it from 2007, didn't know if any other opinions were out there.

Pros
1. Looks good for fellowship applications. I am not sure how good it looks. I feel it probably wont make a difference for job applications though. I would be very surprised if they would hire one candidate over another with equal qualifications simply because 15 years ago they did a chief residency year.

2. Gives you another year to figure out what you want to do if you are unsure.

Cons
1. It is a nightmare scheduling and dealing with everyone's problems in the program.
2. Financially it is not worth it. At my program we are not allowed to moonlight, even as a chief. The chief gets 3 or 4 thousand more than a third year resident for salary. This is another year before you are making an attending salary. Additionally, its only year your loans are not being paid back at the full monthly rate if you are doing income based repayment. As a result the interest accruing is likely more than your monthly payments putting you further into debt. So financially, not worth it.


Any other thoughts. I am thinking of doing PICU, which, based onthe NRMP data from last year there are 0.8 applicants per position, but I obviously would want to go to the best program possible. Thanks

 

[oldbearprofessor]

I was talking with a fellow resident about this today and wanted other perspectives. I did read the thread on it from 2007, didn't know if any other opinions were out there.

Pros
1. Looks good for fellowship applications. I am not sure how good it looks. I feel it probably wont make a difference for job applications though. I would be very surprised if they would hire one candidate over another with equal qualifications simply because 15 years ago they did a chief residency year.

2. Gives you another year to figure out what you want to do if you are unsure.

Cons
1. It is a nightmare scheduling and dealing with everyone's problems in the program.
2. Financially it is not worth it. At my program we are not allowed to moonlight, even as a chief. The chief gets 3 or 4 thousand more than a third year resident for salary. This is another year before you are making an attending salary. Additionally, its only year your loans are not being paid back at the full monthly rate if you are doing income based repayment. As a result the interest accruing is likely more than your monthly payments putting you further into debt. So financially, not worth it.


Any other thoughts. I am thinking of doing PICU, which, based onthe NRMP data from last year there are 0.8 applicants per position, but I obviously would want to go to the best program possible. Thanks

Nothing has changed my opinion, held firmly for over 20 years since I was NOT asked to be chief (obligatory CME disclaimer) that a chief year is not worth it. It benefits the hospital/department much more than the individual in all but a few cases. There are better ways to spend a year if you can't decide what to do, but at this point, it's time to learn to make the big decisions without a gap year (excluding baby raising or health needs, or waiting for a spouse to finish issues). There are several former chiefs on this forum that will argue the opposite side and hopefully will cuz this forum is a bit slow waiting on interview season for residencies. There is absolutely no need to do a chief year to get a good PICU/NICU position although of course, it won't hurt.

 

[blanche]

I've noticed a lot of chiefs start families/have another kid (if female) during that year. Not sure if that is a reason or a result, but just my anectdotal observations...might make sense b/c if you were to start a new job instead after your PGY3 year, would you be eligible for FMLA after only working a few months (ie, to take maternity..)?

 

[BigRedBeta]

I'm with OBP on this one...especially if you're not allowed to moonlight. Moonlighting is the only, only, only benefit I've ever been able to identify.

 

[DoctorWannaBe]

What if you want to work in academics as a outpatient pediatrician or hospitalist? Several of the chiefs from my program have done a chief year because they think it will help them get a job at a teaching hospital.

I would like the option of working at a teaching hospital, but there's no way I'm doing an extra year as a chief. It's time to start paying off loans!

 

[michigangirl]

Hi there-- like OBP I need to disclaim that I wasn't asked to be chief, but in hindsight, I am so glad I wasn't. it enabled me to move on to pursue my actualy career interest and get that much closer to being an attending and a real salary. Granted I'm in a five year fellowship program so the sooner the better for finishing up. What I noticed is that the chiefs are generally not utilized for their talents, which is being intelligent, dynamic physicians and teachers. If your interest is administrative snafus and scheduling, it's a great role. Depends on the program I suppose. The chiefs who were selected from my year both made the most of it and came up with great teaching programs and got to attend on the floors. One of them did get pregnant and had a baby that year, so there are pros. But if you know exactly what you want to do with your career-- fellowship or otherwise, I say dive right in-- unless you think your chief year will offer you a unique opportunity to hone your teaching, leadership and clinical skills and not just be an administrative expert.

 

[twilightdoc]

It seems that "chief years" vary dramatically with the program. At my institution, the chief residents play a major role in teaching residents and medical students, and are regarded as faculty and treated with great respect. It is an honor to be asked to stay on as one of the chief residents. I can't remember any of our former chiefs (and we have several currently on our faculty) who have expressed significant regrets for having done it, and all say that they learned a tremendous amount during that year.

 

[oldbearprofessor]

At my institution, the chief residents play a major role in teaching residents and medical students, and are regarded as faculty and treated with great respect.

Out of curiosity, are they paid as faculty? Do they have a formal faculty appointment (e.g. Instructor in Pediatrics)? If so, then I would certainly agree that for some people, this would be a reasonable thing to do. This would be uncommon though.

 

[twilightdoc]

Out of curiosity, are they paid as faculty? Do they have a formal faculty appointment (e.g. Instructor in Pediatrics)? If so, then I would certainly agree that for some people, this would be a reasonable thing to do. This would be uncommon though.

The position at my institution is a bit of a hybrid. Pay is better than for a 4th year resident or other 4th year trainee, not as good as for most starting full time faculty. Their fringe benefits are actually better than those of the faculty, however. The best analogy would probably be a one-year inpatient general pediatrics fellowship (with better pay). Most of the chiefs end up either in community practice or in an academic department as a general pediatrician, but some have gone on to do full Peds specialty fellowships after their chief year. I can't recall ever hearing the former chiefs express regret for having done the chief year. But all departments are different, and the experience at other programs may not be as rewarding.

 

[Dr Poe]

When I was asked to become a chief resident I was quite surprised and was extremely honored. At my previous institution it was considered the highest praise to be offered the position. I know people hate the fact that you have to deal with schedules and other issues but I really liked playing administrator 😳 and I may move into that position much further along in my career if possible. I also enjoyed the teaching/mentor aspect to the interns and junior residents. I think some of the skills I learned as chief definitely helped me deal with the stress of my first fellowship year.
My advice: I don't think it is really that important to be a chief resident to get into a good fellowship. If you enjoy teaching and mentoring go for it. You will be stressed as a chief but it helps a lot during your fellowship. But don't do it for the money😉