Chief

[dochuffman]

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Does anyone know how much being a chief resident, at a University based IM program, helps with obtaining a cards fellowship?

 

[ry812]

it is something that will set you apart from other applicants. you have to realize how competetive it is, and being a cheif resident will set you apart from other applicants and get you through at least the first few applicant screenings.

 

[tibor75]

Doubt it.

At one interview I went to the Chief of Cards was a big basic science guy and he basically said that doing a chief year was a waste of time.

It probably is. Basically baby sitting a bunch of residents on a resident's salary.

The problem with determining if it helps is that the chiefs usually are made up of the best residents. So, I'm sure Chiefs do well in cards matches. But they probably would have done well anyway. If you can do it and get some good research experience at teh same time, it's probably great.

But when I was a resident, our chief was denied a fellowship spot at our own program. Pretty embarrassing.

I really can't imagine a PD saying, "Well both these guys are great, but this one was a Chief for a year, so let's rank him over this guy"

 

[cardsfellow2007]

Does anyone know how much being a chief resident, at a University based IM program, helps with obtaining a cards fellowship?

If you are a poor applicant from an academic standpoint, are coming from a community program, or don't have any research take the chief spot.

This year the two rising chiefs applying for cards at our program only have 6 or 7 interviews offers. Other applicants with good research credentials have >20 from our same program! In fact all of the other applicants have more interviews then them! (This may partially be because they applied to more programs : 50+ opposed to 30+). If the chiefs don't match (like the two who applied for GI last year), they will have wasted two years of their lives as they will have to find something to do for one year after being chief! Does it help then? It depends on the applicant. If you are a strong applicant don't do a chief year as you will likely get a cards spot during one of the two application cycles you could be applying in. If you do a chief year don't expect it to carry you; no cards spot is guaranteed.

PD's recognize that some of the chief residents nationwide are the most popular residents and may not necessarily make the best fellows if the rest of their application doesn't support them. They have to ask themselves: At 2am do I want to get a page from a very popular fellow asking how to take care of a patient that they should now how to deal with on their own or do I want to sleep through the night? That being said, if a chief was coming from a second tier program with an otherwise stellar application, they may have a shot at a top tier program.

 

[bamboo]

I've noticed that the chiefs at the top-10 programs I've spoken with on the interview trail seem to be heading towards prestigious fellowships or coming back after having spent a year of fellowship to be a chief...and obviously not all of them are in cards. How does the chief year work at the top progams? Some seem to have a chief year directly after residency, others seem to have a chief year after one year of fellowship. And how does one distinguish herself to be selected as a chief?

 

[NDESTRUKT]

Good question, I was wondering the same. How do you get "graded" during residency and how do you get selected to chief? I'm assuming there's some politics involved (which is the normal human thing to do anyways)...so any insight residents?

JP

 

[tibor75]

It can't be that hard. I don't think you have to rely on "grades."

I knew pretty much 6 months into internship who the best interns were, and my program had about 40 per class. I'm sure the attendings know as well and talk amongst themselves who they think the best residents are and who have the best interpersonal skills. they nominate a few, interview them, and then figure out who wants the job. Sure politics is involved, but it's not rocket science.

 

[Renovar]

At my program (a top university program), residents who does a chief year are pretty much guaranteed a fellowship spot of any specialty at my institution's hospital. Its an unspoken "rule" of sorts, as a courtesy for their extra year of service. Most of the chiefs who done a chief year here have take this route. Chiefs who doesn't take this route usually end up at other good programs for fellowships of their choice.

Granted, not only do CR's have to not be good residents, they have to be personable, able to deal with the administration well. My gestalt feeling of how they choose (at least at my institution) is not based on your grades, your research, your inservice score, etc. It has to do with who the chairman/PD/high level administration feel like they can work with the best, and who they want as the face of the department, the program, and the institution. At my institution, CR's not only have to deal with constantly bitching residents, attendings and administration, but also have to give introduction to medical grand rounds, lead medical student in physical diagnosis rounds/lectures, and serve a lot of the department's PR function, among other things.

As far as fellowships concerned, I tend to agree that CR's tend to do well, and have a higher probability of matching in any particular fellowship prgram compared to an average resident coming out of that particular program given same credentials. But as above stated, CRs tend to be solid residents to start with (from skill/knowledge/score/pubs standpoint), and may do just as well if they dont do a CR year. But again, this may all be institution-dependent.

 

[irlandesa]

respectfully disagree with the statement about CR's being picked because they are the best residents. Among last year's seniors, the PD's are rumored to have gone way down the rank list to get chiefs in place b/c no one wanted to do it. And in my class, the people who were picked included one girl who was totally freaked out her whole first month @ UMASS (note that she went to UMASS for med school for 4 years, and already had a ward rotation at another affiliate) and the Sub-I and I got stuck with late admits as a result, and a guy who has routinely forgotten to sign out his patients to the incoming resident at the end of the block and ends up asking people to cover for him at the last moment. I think they are good people, but would not say they are the strongest residents in our class. I am not either, I will admit, and did not wish to be chief. We have an unspoken rule that the chiefs should represent the resident population each year, meaning that if possible, 2 US MD's +, 1 IMG, and 1 DO are selected. There is usually no preference given to CR's for Cards or GI fellowships here, unless they went to UMASS.

No sour grapes here, just a different perspective from what others have mentioned.

 

[bamboo]

Perhaps the difference lies in the fact that the chief spots at top-tiered programs (e.g. like the "top 10" ish programs in the country) are coveted because more residents are interested in academics/teaching. I can definitely see how residents in community or other university-based IM programs who are interested in private practice may not want to spend a year doing something that will not enhance their career in any way, and get paid less while doing it. But I am specifically interested in how the chief year works in some of the top-tiered institutions. Any comments?

 

[tibor75]

Perhaps the difference lies in the fact that the chief spots at top-tiered programs (e.g. like the "top 10" ish programs in the country) are coveted because more residents are interested in academics/teaching. I can definitely see how residents in community or other university-based IM programs who are interested in private practice may not want to spend a year doing something that will not enhance their career in any way, and get paid less while doing it. But I am specifically interested in how the chief year works in some of the top-tiered institutions. Any comments?

I seriously doubt doing a chief year boosts your credentials. Especially when you go into fellowship. Remember, that you apply for fellowship 1 1/2 years before you leave your program. So the fellowship programs know you are going to be a chief and that helps, but they have no idea how good of a job you do because they already agreed to take you at that point.

Like I said earlier, chiefs at academic programs are made up of the "better" residents. But I doubt that turning down the chief year puts you at any disadvantage. Frankly, the earlier you get out of training, the better.