Chief Resident Stipend

[fuzzypants17]

Hey guys and gals,

My current program does not give a stipend for administrative duties and I know some programs do. I am in negotiations with the department and needed information on how much other programs give. If you could please tell me how much and from which program (so I can say it is not geographically influenced)?

Thanks,

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[mlw03]

at a midwest program, each chief received about $1000 extra for the academic year while serving as co-chiefs.

if your program doesn't want to pay you, and you don't want to do it, just say no. adam smith in action - if they desire your services badly enough, they'll pay for it.

 

[gutonc]

OK...that's completely insane. I don't remember the exact number off the top of my head (and it's changed since I did actually know it), but the program here (West Coast) pays in the $10-15K/chief range. In addition to administrative duties they generally have their own clinic 1x/wk, attend during resident clinic 1x/wk and attend on the wards 4 weeks/yr.

For my duties as chief fellow (and medical although not administrative director of a moonlighting service), I get $6K/year. Doing it for free or $1K a year is either the dumbest or most insulting thing I've ever heard of. Maybe both.

 

[mlw03]

settle down there, hoss. i'm a pathologist from a program with 15 residents (total, not per year). not the same situation as chief for an IM program with 150 residents. we made the rotation and call schedules, dealt with stuff as it occurred throughout the year, and acted as a liason between residents and program directors. it was a good experience, and something i can put on my CV the rest of my career. so don't insult my choice by calling it insane, dumb, or insulting.

OK...that's completely insane. I don't remember the exact number off the top of my head (and it's changed since I did actually know it), but the program here (West Coast) pays in the $10-15K/chief range. In addition to administrative duties they generally have their own clinic 1x/wk, attend during resident clinic 1x/wk and attend on the wards 4 weeks/yr.

For my duties as chief fellow (and medical although not administrative director of a moonlighting service), I get $6K/year. Doing it for free or $1K a year is either the dumbest or most insulting thing I've ever heard of. Maybe both.

 

[gutonc]

settle down there, hoss. i'm a pathologist from a program with 15 residents (total, not per year). not the same situation as chief for an IM program with 150 residents. we made the rotation and call schedules, dealt with stuff as it occurred throughout the year, and acted as a liason between residents and program directors. it was a good experience, and something i can put on my CV the rest of my career. so don't insult my choice by calling it insane, dumb, or insulting.

To be fair, I was assuming the OP was talking about a large residency program (although s/he didn't say that...it was strictly an assumption).

And I'm a chief for 12 other people with the job exactly as you describe it. The $6K I get is about half what the job is worth in annoyance factor alone.

 

[Sneezing]

Being Chief:
3 headaches a week
20 extra emails a week
2 extra meetings a week
1 sad sob story a month
Mountains of paper work
0.0 dollars in extra pay

Putting Chief resident on your resume for life: (supposed to be) Priceless!

 

[mlw03]

Adam Smith, people. Don't want to do the job for the pay/conditions offered? Just say no. This ain't that complicated.

 

[dpmd]

I am at a program with only 2 residents per year. We get paid a little extra each year we complete, but there isn't a big jump for our final year (and we are both called chiefs). Maybe I am not understanding the way other programs do it, but completing the final year isn't an option and the administrative/academic tasks that come along with it are not negotiable (although I guess no one has ever actually put it to the test by just not making a schedule or whatever). Maybe because it is a surgery program or because we are small, but I wouldn't want the secretary or program coordinator to take over the tasks anyway because it wouldn't work out as well (as evidenced by the way conferences used to be assigned until I took it over-with people scheduled who were actually on away rotations or on vacation)

 

[Law2Doc]

I am at a program with only 2 residents per year. We get paid a little extra each year we complete, but there isn't a big jump for our final year (and we are both called chiefs). Maybe I am not understanding the way other programs do it, but completing the final year isn't an option and the administrative/academic tasks that come along with it are not negotiable (although I guess no one has ever actually put it to the test by just not making a schedule or whatever). Maybe because it is a surgery program or because we are small, but I wouldn't want the secretary or program coordinator to take over the tasks anyway because it wouldn't work out as well (as evidenced by the way conferences used to be assigned until I took it over-with people scheduled who were actually on away rotations or on vacation)

This is really common with small programs with only two residents per year. When they reach their last year of residency, they are automatically chief residents. In bigger programs with 8+ residents per year, two get elected chief, and get saddled with a lot of administrative obligations others in their year don't get. There's usually a bit more money, but usually not a ton more. I don't think the $15k gutonc quoted is common at all. Mostly you do the job for resume purposes when seeking fellowship.

 

[Winged Scapula]

This is really common with small programs with only two residents per year. When they reach their last year of residency, they are automatically chief residents. In bigger programs with 8+ residents per year, two get elected chief, and get saddled with a lot of administrative obligations others in their year don't get. There's usually a bit more money, but usually not a ton more. I don't think the $15k gutonc quoted is common at all. Mostly you do the job for resume purposes when seeking fellowship.

Actually in surgery programs, regardless of the size, all final year residents are called Chief residents. One or two may be "chosen" (read: forced) to be administrative Chief. As dpmd noted, the Chief year in Surgery it not an option or "extra" year and it is not done of fellowship resume purposes. There is no prestige in being a Surgical Administrative Chief.

As for money, our Admin Chief got $10K extra salary and an extra week in vacation. Its highly variable depending on the program.

 

[michaelrack]

In some IM programs, the chief resident is a junior faculty position and done the year after completing residency. At my residency program, the IM chief resident had the academic rank of "Instructor", right below asst prof

 

[Law2Doc]

In some IM programs, the chief resident is a junior faculty position and done the year after completing residency. At my residency program, the IM chief resident had the academic rank of "Instructor", right below asst prof

Yeah I think a lot of the confusion stems from whether the chief resident (1) is an additional year, (2) is just extra administrative duties imposed on one or two senior residents out of many, after an election, or (3) something imposed on every resident in their final year of a program simply by virtue of being in their final year. All these models exist, and likely result in different $ implications.

 

[Socrates25]

At my institution, its an extra 17k per year. Its an extra year added on to the end of residency. You have to get "selected" for it.

For that 17k you have to do a ton of administrative stuff (program takes 17 residents per year), do 4 weeks of wards per year, and 8-12 hours of clinical duties (clinic, ER) per week.

 

[Smurfette]

My program only gave an extra $1000 a year for the two admin chiefs, and it wasn't worth the hassle of trying to coordinate 50-60 people's schedules and change things to accommodate unforeseen events and deal with the fallout and ramification of those changes.

 

[Acherona]

Being an IM chief resident is totally different than most other specialties. It's an entire extra year which you could potentially use to get a real job somewhere and make a six figure salary, or do a fellowship and advance your career. They better offer more $$ than the base pgy4. Not comparable to just having some extra annoying admin duties tagged on to your last year of residency which you have to complete anyway.

 

[Groove]

I don't think there are any financial incentives at my institution within our residency program, merely psychological ones.

Personally, I don't consider the potential headaches to be worth the advantages, but that's after a previous career where I was involved in management and administration duties along with my regular job. Ultimately, being a "chief" during your last year is an offloading of administrative duties and responsibilities, most that are unpleasant or burdensome, from faculty to senior resident(s). It's fairly transparent and obvious to anyone looking on, but again... there are some advantages such as... it looks good on your resume, is probably good experience for someone that lacks any management/administrative experience, is a leadership role, can have an element of impact on the program and is ultimately appreciated by the faculty (and residents) for your service.

Our chiefs get less shifts, but I'm sure the extra responsibilities they do outside of work can get tiresome. I don't envy them, but I will say that a good chief or set of chiefs can make many things much easier and having a good spokesperson or representative for the residents can make a big difference sometimes.

IM is completely different. I don't see how you guys do an extra year. I have the ultimate respect for any resident that stays on an extra year to be a "chief", regardless of pay and responsibilities. I'm not entirely certain what the advantages are, but I can't say that I would ever do that unless they were significant. I'm sure it must open up some otherwise closed doors and opportunities.

 

[michaelrack]

I don't think there are any financial incentives at my institution within our residency program, merely psychological ones.

Personally, I don't consider the potential headaches to be worth the advantages............it must open up some otherwise closed doors and opportunities.

I would think the advantage of getting your own private forum on SDN makes the sacrifices of being a chief well worth it to most chief residents

 

[Groove]

I would think the advantage of getting your own private forum on SDN makes the sacrifices of being a chief well worth it to most chief residents

damn...completely forgot about that one...should have been at the top of my list of advantages

 

[LucidSplash]

As for money, our Admin Chief got $10K extra salary and an extra week in vacation. Its highly variable depending on the program.

And in some places, where the extra salary/stipend is at the discretion of the GME office, some programs get the extra stipend and other don't. We recently discovered that all programs at my institution are given extra $ for a chief stipend... except surgery. Even my PD didn't know. Still haven't heard a good explanation for this.

 

[EM_Rebuilder]

I got a Ham at Christmas.... at least it was Honey Baked....

 

[mlw03]

I got a Ham at Christmas.... at least it was Honey Baked....

that wouldn't be much use to those of us who keep kosher (or halal).

 

[Socrates25]

And in some places, where the extra salary/stipend is at the discretion of the GME office, some programs get the extra stipend and other don't. We recently discovered that all programs at my institution are given extra $ for a chief stipend... except surgery. Even my PD didn't know. Still haven't heard a good explanation for this.

The most likely explanation is that the only programs taht get extra stipends are those that require an extra year in order to be chief.

 

[fuzzypants17]

Does anyone have a list or know of a list with the general surgery programs and how much is given as a chief stipend for administrative duties?

 

[Roguelyn]

FM program with 18 residents, co-chiefs get $1000 each. It's not an extra year. No one ever wants to do it and PD has to beg and plead to get someone. This year he's threatening to assign a different person for 2 months at a time (thus making us all do it) with no stipend for anyone if no one will step up and volunteer. The chiefs have to attend a couple of 7a meetings each week, a couple of hospital committees each month, organize all the new intern training/orientation, plan schedules, vacations and CME, arrange for guest speakers, and, in theory, act as liaison between residents and attendings. It's also expected that they tattle on the residents to the PD. They also sit in on disciplinary meetings for residents. Anytime the program needs volunteers for various things around town - med student seminars, first aid, BP screenings - and can't get any, the chiefs have to go.

 

[mlw03]

FM program with 18 residents, co-chiefs get $1000 each. It's not an extra year. No one ever wants to do it and PD has to beg and plead to get someone. This year he's threatening to assign a different person for 2 months at a time (thus making us all do it) with no stipend for anyone if no one will step up and volunteer. The chiefs have to attend a couple of 7a meetings each week, a couple of hospital committees each month, organize all the new intern training/orientation, plan schedules, vacations and CME, arrange for guest speakers, and, in theory, act as liaison between residents and attendings. It's also expected that they tattle on the residents to the PD. They also sit in on disciplinary meetings for residents. Anytime the program needs volunteers for various things around town - med student seminars, first aid, BP screenings - and can't get any, the chiefs have to go.

Sounds like a fantastic opportunity. No wonder no one wants to do it for an extra $80/month. And by the time you're a chief you probably already have your fellowship lined up anyway, so who cares?

 

[blue2000]

Big west coast general surgery program (I think a total of 80 residents including prelims) the R5s got (I believe) an extra 150/month to be "chief residents." The most painful part was making the monster call schedule for four sites for an entire year, including outside rotators from other programs. We usually tried to do it in a single afternoon til late at night. Also we dealt with the inevitable fallout of the call schedule, as well as all the other scheduling issues that came up (one rotation call schedule had to be completely redone in October after an outside program pulled their resident due to their own staffing issues). You also dealt with the inevitable complaints about the call schedule, as well as making sure conferences were assigned correctly, etc etc etc. All of the chiefs shared the burden though.

 

[Oxer45]

Hey guys and gals,

My current program does not give a stipend for administrative duties and I know some programs do. I am in negotiations with the department and needed information on how much other programs give. If you could please tell me how much and from which program (so I can say it is not geographically influenced)?

Thanks,

Unless it helps with fellowships, why would anyone want to be a chief resident (or administrative chief for surgery) ? In residencies where the final yr residents can moonlight, you'll probably make more moonlighting.

 

[LucidSplash]

In my surgery program, there is no choice. All our final-year residents are chiefs and each is assigned an admin chief duty. One is responsible for making sure everyone gets their weekly caselogs done and submitted for M&M, one runs our basic science conference, one is responsible for running grand rounds/recruiting speakers, and one does the schedule (both the block rotation schedule for the year and the monthly call schedule). No extra stipend. Just part of being a chief.

 

[Arcan57]

Unless it helps with fellowships, why would anyone want to be a chief resident (or administrative chief for surgery) ? In residencies where the final yr residents can moonlight, you'll probably make more moonlighting.

It all depends on what kind of career you're looking into. Being chief may open doors in academia (not just fellowships), some people (especially IM) aren't sure what to do after residency and use the time treading water to decide. Also, if you decided on your fellowship late then you'll have an extra year where you need to do something and at least you won't have to move if you stay on as chief. For most people that aren't looking for enhanced fellowship opportunities, the payoff isn't even vaguely worth the work.

And finally, some people do it out of loyalty or a sense of obligation to the program (9 of 11 residents applied for chief my year)

 

[NotAProgDirector]

Some of the confusion is that the term "chief" means different things in different programs.

In most surgical residencies, chiefs are residents in their final year. All final year residents are chiefs.

In some fields (especially FM), chiefs are selected from residents in their final year (PGY-3). They are in charge of schedules, and other administrative work.

In IM, chiefs are usually an extra year position (i.e. PGY-4). Being selected chief is seen as an honor, usually involves an appointment at the medical school, and involves a mixture of administrative, teaching, and academic time.

 

[Winged Scapula]

And in surgery, we (some programs) have an Administrative Chief who is selected/forced from the Chief/final year residents to do call schedules, settle petty arguments, etc.

 

[IlDestriero]

In anesthesia it's not an extra year position. Zero extra pay, zero extra vacation, many extra meetings emails and headaches. I do think it opens doors for job/fellowship interviews, especially early in your career. After a few years of experience and board certification it likely has little to no value.
If you're adding a year to your "training" with the significant administrative responsibility and some faculty level responsibility, I would want somewhere halfway between resident and Jr faculty salary (way more than $5 or $10k extra). If you're losing a year of faculty/pp pay, unless you're trying to score a very competitive fellowship, it's probably not worth it.

 

[Socrates25]

In my surgery program, there is no choice. All our final-year residents are chiefs and each is assigned an admin chief duty. One is responsible for making sure everyone gets their weekly caselogs done and submitted for M&M, one runs our basic science conference, one is responsible for running grand rounds/recruiting speakers, and one does the schedule (both the block rotation schedule for the year and the monthly call schedule). No extra stipend. Just part of being a chief.

One of those is not like the others. Whoever gets the schedule duty got shafted.

 

[LucidSplash]

One of those is not like the others. Whoever gets the schedule duty got shafted.

This is generally the perception. However, I think some responsibilities are better suited to different personality types. Having assisted the scheduling chief quite a bit this year (and having a professional background in crazy spreadsheet logic puzzle type things) I can say I will much prefer to be assigned the scheduling duties rather than the "recruit/schedule grand rounds speakers" or any of the other positions.

Additionally, better to spread things out rather than have ALL those responsibilities on ONE person - so if you're doing the scheduling, at least you're not doing the schedule AND everything else.

 

[Socrates25]

This is generally the perception. However, I think some responsibilities are better suited to different personality types. Having assisted the scheduling chief quite a bit this year (and having a professional background in crazy spreadsheet logic puzzle type things) I can say I will much prefer to be assigned the scheduling duties rather than the "recruit/schedule grand rounds speakers" or any of the other positions.

Additionally, better to spread things out rather than have ALL those responsibilities on ONE person - so if you're doing the scheduling, at least you're not doing the schedule AND everything else.

I agree with you about splitting of duties. Since I'm the chief at my place (and we have a separate stand-alone year for it instead of being part of your final year of residency) I have to do most of the things you mentioned.

Faculty speakers for grand rounds/noon conference lectures can be tricky, but at least the program director will generally have clout to encourage participation by the faculty so that its not that hard to find willing people. If there's an open slot that I cant get anybody to fill, she will make phone calls to get somebody to do it (which isnt needed that often thankfully).

Scheduling residents on the other hand is by far the least favorite thing to do in my job. They bitch and moan because they dont get all 10 of the special requests they put in for the month, or they scour the schedule and gripe because they are on-call for one more time that month than somebody else. Dealing with the faculty and scheduling them is easier by comparison. When I went to chief resident conference (national gathering of chiefs in my specialty) the wide consensus was that scheduling sucks because some residents (not all, but a significant number) feel entitled to a custom-made schedule.

A big benefit of being chief that hasnt been mentioned yet is that you really get to know faculty well. Just about every chief will have the opportunity to work closely with the department chair and there are opportunities to get involved in administration. I've had multiple meetings with our hospital leadership including the upper echelons of management and CEO that never would have occurred without the chief role. You can establish life-long networking connections that extend far beyond your residency years -- they can go to bat for you to make phone calls to fellowship directors or potential jobs.

Overall I think it is worth it 90% of the time -- its just the 10% of the time I do resident scheduling is when I think otherwise.

 

[LucidSplash]

Scheduling residents on the other hand is by far the least favorite thing to do in my job. They bitch and moan because they dont get all 10 of the special requests they put in for the month, or they scour the schedule and gripe because they are on-call for one more time that month than somebody else. Dealing with the faculty and scheduling them is easier by comparison. When I went to chief resident conference (national gathering of chiefs in my specialty) the wide consensus was that scheduling sucks because some residents (not all, but a significant number) feel entitled to a custom-made schedule.

I agree that the situation you describe sounds really terrible. However, we've circumvented the level of attitude you describe in a number of ways:

1) We're surgery and I think perhaps there's just generally a different attitude about the schedule in general. The party-line here is that you work when the schedule says you work, period, and everyone accepts this without much grumbling.

2) We limit the number of "special request" weekends off per year to 3-4, depending on the preferences of the scheduling chief. Better save those requests for the things that really matter.

3) There are several rotations in which we simply don't have the man-power to allow vacations. Therefore, vacations may not be requested when one is on trauma, critical care, peds surg, or night float.

3) We don't allow vacation requests from our off-service rotators. At my institution, all the FM interns do a couple months of general surgery at some point and the EM folks rotate on trauma and critical care. We don't consider the Ortho interns off-service as they rotate with us for most of the year. The EM folks are ok and understand the "no vacation on trauma/critical care" rule, but for awhile the FM peeps decided they'd lessen the perceived pain of having to be on surgery by scheduling their vacations on their Surgery months. As we have one FM person per month, this amounted to the equivalent of one particular resident taking a week of vacation every month. It strained our call schedule for everyone else, so we just started saying NO.

4) Vacation requests are generally expected to be made at least 1 month in advance, if not earlier. No vacations are permitted in June or July.

I definitely see that the scheduling duties can be the biggest PITA of all admin responsibilities if you are the type of person who is a real people pleaser and wants to make everyone happy and feels a lot of anxiety if people disagree with your decisions about the schedule. I certainly like to make people happy and did what I could while assisting the chief this year with the schedule, but in the end, I'm ok with being seen as a cold-heartless beach if necessary to make sure the call-schedule is covered without having to do calculus to make it happen.

 

[IlDestriero]

Faculty speakers for grand rounds/noon conference lectures can be tricky, but at least the program director will generally have clout to encourage participation by the faculty so that its not that hard to find willing people. If there's an open slot that I cant get anybody to fill, she will make phone calls to get somebody to do it (which isnt needed that often thankfully).

If you're someplace fun I'll come give your residents a lecture on the current research on anesthetics and developing pediatric brain, how about an update on the current recommendations for screening and sleep studies prior to T&As for OSA kids and its anesthetic implications. Though you probably have your own faculty anesthesiologists to present these things.

Cheers!