Best chief you ever had?

[infantum23]

I'm starting my chief duties in a month here and looking for ideas.
Anyone have teaching strategies or activities or methods that their chiefs used that you appreciated or found helpful?
Just looking for tips, I want to help my interns and juniors out as much as I can.

---

Members don't see this ad.

 

[schussboarder]

Best teaching rounds I had (surgery residency):
During rounds, each patient we had, the chief would ask a question about the patients diagnosis/pathology. He would initially ask ask an open ended question and then if no one knew the answer he would start giving small details about the the correct answer. He would then stop and assign someone (med student/intern/2nd year) to present the rest of the details regarding the diagnosis/pathology at some point during the rest of the day.
I liked this because.. 1) The chief started talking about the diagnosis/pathology which showed he knew what he was talking about and wasn't FOS, 2) It allowed us juniors to read up on a topic during the day in between cases so that we were competent enough to present it to a group. 3) By presenting it, we fully understood what we were talking about at that point. 4) Since multiple people were presenting a short 5 min topic during the day we learned a decent amount

The key thing though was that the chief was actually competent and knew what he was talking about. We've had other chiefs who have tried to do this but it didnt work because no one took their medical knowledge seriously

 

[Law2Doc]

The key to being a good chief is instilling team loyalty. Establishing loyalty and chain of command are paramount to being a good chief. The rest is kind of secondary. (there's a thread on here which is a perfect example of a chief seemingly not doing this, where interns are comfortable assigning the chief duties). My best chief had high expectations of his charges but was always ready to jump on the grenade. If an intern inadvertently ordered a study or consult an attending didn't want, or otherwise missed the ball, the chief was quick to jump in and tell the attending "I told him to do that", "It was my fault, I should have done X", etc., take the hit from the attending and then privately scold the intern. There was never any question who was in charge -- the chief answered to the attendings and we answered to him. Teaching is less about strategy and needn't be done in a Formal setting (in fact many argue that didactics are the least useful teaching format); there will be things you just know because you have more years on the job. Teach what you know, whenever it's opportune, and read up on what you don't.

 

[WingedOx]

Two big philosophies, one I did from the start, one I learned the hard way.

1. Just remember that ultimately if you need your residents to get something done and they're not doing it, it's your responsibility to figure out why that is and give them the ability to do it. It's not simply "them failing to do it" if you're in a leadership position.

2. If you share roles with another chief, divvy up responsibilities and stick to that division. It creates a major headache when two people have different opinions on how things need to get done, and this prevents toes getting stepped on.

 

[cabinbuilder]

1. Make sure the call schedule is fair an equal: Everyone for each year has the same amount of days. Everyone gets a holiday call. Make sure that is fair too.
Have to be the bad guy sometimes. I had my muslim intern covering Christmas. She was pregnant and went into early labor and on bedrest so could not cover. I had 4 people on medicine who had to round that day anyway so I had to announce that each of the 4 had to cover call on Christamas - 6 hours blocks that they decided amongst themselves according to family plans. They grumbled but it got done and nobody missed out on family plans.

2. In my residency the people post call on Tues, Wed, Thurs had to present morning report. Make sure you don't have the same 3 people always doing morning report. It should be equal.

3. Try to honor vacation requests. Have them tell you before the schedule comes out.

4. Know that the sign of a great chief is being willing to put out fires and helping the interns. I slept with my phone and was always available for a crisis during solo call, etc. If I needed to come in an help an intern on their call shift for an hour - I did. You want things to be smooth and not have little things get to the PD. You are the buffer between the two.

 

[Apollyon]

2. If you share roles with another chief, divvy up responsibilities and stick to that division. It creates a major headache when two people have different opinions on how things need to get done, and this prevents toes getting stepped on.

It's like the assistant principles in big schools - "buses, butts, and books" - one is in charge of transportation, another is the disciplinarian, and the third is in charge of books. The roles are clear and unambiguous.

 

[galactus]

Know how to delegate, and if needed be, REGULATE