Does being a chief resident matter in the long run?

[exsanguination]

We voted in our new chiefs this week and it got me thinking. How much does being chief matter in the long run? I've heard stories that range from, "it doesn't matter at all" to "it only helps with your first job" to "it put me on a fast track to becoming partner at my group."

I don't know if I have a chiefly bone in my body, and seeing how much extra work they take on leaves a sour taste in my mouth. However, if it makes that much of a difference for job placement, I can suck it up for a year and deal with it. Presumptuous, I know, because my co-residents would also have to vote me in, but I'm just trying to think ahead.

In case it matters, I'm a PGY1 going onto 2. Four year academic program. No plans on being an academic doc in the future, will probably do community practice. Definitely do not want to do a fellowship.

What do you guys think? Any experiences?

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[The White Coat Investor]

It matters more than I thought it did, but not that much. I'd vote "only helps with your first job." That said, that could be your only job if you're lucky. I doubt it would help you make partner faster/easier.

 

[RPedigo]

I would say being chief absolutely helped me with regard to applying for jobs -- the job I accepted probably would not have taken me otherwise. This goes doubly if you are interested in academics. However, it was a tremendous amount of work.

 

[Birdstrike]

I agree that it matters a little. It's like anything else in life where someone volunteers to do some extra work for the team for little or no extra material reward. It gives the impression there's a little bit of leadership quality there. But by no means is it a must, because we're all leaders in a sense, in that we've succeeded at this level and lead a healthcare team as physicians. So do it if you want, but don't feel obligated.

 

[WilcoWorld]

Sometimes it makes a difference, but usually it doesn't.

Like most things in life, it's worth doing if you want to do it for its own sake. Otherwise, it's not worth loosing sleep over (you already do enough of that).

I say this as a former chief resident.

 

[Groove]

It doesn't matter at all. Chiefs handle all the administrative responsibilities that the PD and assistant PDs don't want to be bothered with... It's an easily recognizable "sucker" role for anyone who's had administrative or management experience. It might benefit a few people who's been fairly sheltered in their job experiences but regardless... be extremely grateful for the guys and gals who step up to the plate to fill those shoes. Little thanks, lots of complaints, and lots of work outside the ED in their spare time... herding cats.

 

[BruceWilly]

*Whispers into George's ear* "George O'Malley... the chief's intern." *Hands George a stack of paperwork*

People will do anything for a title. This reminds me of the people who create interest groups just so they can put supreme commander on their email signature and/or car windshield.

 

[emergentmd]

Its prob worth it in 1 out of 10 jobs

 

[goodoldalky]

Might help you in your first job if it is academic. Maybe..

 

[DrQuinn]

I think it does matter if you're looking for a competetive job, but like Birdstrike says, a little. maybe a little more than a little.

Being a chief resident helps "self select" out certain types of people. Call them leaders. Suckers. Glutton for punishment. Higher achievers. Gunners. Whatever. It doesn't matter. Being a chief resident at a residency has to be approved by the PD. The PD always wants what is best for the residents and the program. So if you are a chief resident, this helps "self select" out a "higher quality" candidate.

Our group is 40 docs, and about 1/3 - 1/2 of our group are chief residents. It helps us separate some wheat from chaff, as we rarely hire and if we do hire we want only top quality peeps. That's not to say that NOT being a chief doesn't mean you're not a "top quality peep" but when you're trying to really figure out what kind of long term partners you want in a group this does help. I was chief way back in the day, but our absolute best and brightest and upper echelon resident was not chief, nor was he interested in it. So it isn't 1+1 = 2.

All Porsches are cars. Not all cars are Porsches.

 

[Birdstrike]

I think it does matter if you're looking for a competetive job, but like Birdstrike says, a little. maybe a little more than a little.

Being a chief resident helps "self select" out certain types of people. Call them leaders. Suckers. Glutton for punishment. Higher achievers. Gunners. Whatever. It doesn't matter. Being a chief resident at a residency has to be approved by the PD. The PD always wants what is best for the residents and the program. So if you are a chief resident, this helps "self select" out a "higher quality" candidate.

Our group is 40 docs, and about 1/3 - 1/2 of our group are chief residents. It helps us separate some wheat from chaff, as we rarely hire and if we do hire we want only top quality peeps. That's not to say that NOT being a chief doesn't mean you're not a "top quality peep" but when you're trying to really figure out what kind of long term partners you want in a group this does help. I was chief way back in the day, but our absolute best and brightest and upper echelon resident was not chief, nor was he interested in it. So it isn't 1+1 = 2.

All Porsches are cars. Not all cars are Porsches.

Isn't that interesting, that the chief isn't always (or often isn't) the smartest or best clinically? Not that you can't be the smartest, best doc and be "chief" or "director," but often it seems it's a totally different skill set, or more likely, personality trait. I would liken it more to the 4 wheel drive Sport Utility vehicle than a Porsche: not necessarily the purest, flashiest of its kind, but willing to do a little bit more of the heavy lifting and towing.

 

[emergentmd]

I think it does matter if you're looking for a competetive job, but like Birdstrike says, a little. maybe a little more than a little.

Being a chief resident helps "self select" out certain types of people. Call them leaders. Suckers. Glutton for punishment. Higher achievers. Gunners. Whatever. It doesn't matter. Being a chief resident at a residency has to be approved by the PD. The PD always wants what is best for the residents and the program. So if you are a chief resident, this helps "self select" out a "higher quality" candidate.

Our group is 40 docs, and about 1/3 - 1/2 of our group are chief residents. It helps us separate some wheat from chaff, as we rarely hire and if we do hire we want only top quality peeps. That's not to say that NOT being a chief doesn't mean you're not a "top quality peep" but when you're trying to really figure out what kind of long term partners you want in a group this does help. I was chief way back in the day, but our absolute best and brightest and upper echelon resident was not chief, nor was he interested in it. So it isn't 1+1 = 2.

All Porsches are cars. Not all cars are Porsches.

Dislaimer - I have never been chief resident. But I have been ED director, assistant director, part of the medical board, etc.

And I can tell with certainty that being Chief resident would have absolutely zero bearing on hiring for a community job. Being cheif resident has no correlation on if you can move the meat, if you are good to work with, if you are clinically a good doctor.

The Chiefs in my program, I would say 2 of the 3 were great docs. The 3rd was terrible and I would shoot myself if I had to work a shift with her and roundly thought of as the worse resident.

 

[EctopicFetus]

I also think it matters where you come from and the process. My residency it was chosen by the faculty. There is another residency where people choose to run and then get selected by some mix of fellow residents and faculty.

In the end I think it matters due to what Quinn said. That being said I think it has more to do with non clinical skills than clinical skills. IMO as someone who did hiring it matters more as it speaks to someone willing to be a good partner in a democratic group. I would estimate of the 40 docs about 1/2 were chiefs.. maybe a little more.

 

[DeadCactus]

Chiefs probably view it as a plus. People who weren't chiefs probably don't care. The net balance would then be a positive...

 

[Hercules]

In the end I think it matters due to what Quinn said. That being said I think it has more to do with non clinical skills than clinical skills. IMO as someone who did hiring it matters more as it speaks to someone willing to be a good partner in a democratic group. I would estimate of the 40 docs about 1/2 were chiefs.. maybe a little more.

I will disagree with emergentmd and third this. I'm a partner in a community SDG and it matters when we hire for all the reasons stated above. In a well run SDG I need you to do more than just show up and punch the clock. Chiefs in general tend to be people who have already demonstrated they will do more than just work their shifts. That said there are obviously tons of great doctors who were not chiefs, so it's not a requirement but it does help.

 

[Arcan57]

Part of the equation is going to be, are you trying to find a job in an area that can choose to be selective about the physicians it hires? Stable SDG in a nice places to live? Being chief, having your PD be buddies with the senior partners, being related by blood or marriage to a partner are all going to be major factors. CMG gig in area that either undesirable or in a place with rapid growth/reallocation of jobs (ie. Houston with the population boom in the suburbs and the explosion of FSEDs)? Then basically you're looking at whether you can be credentialed by the hospital (ie unrestricted state license and relatively clean criminal/malpractice hx). After that it comes down to some subjective assessment of how much work you're going to be in terms of generating med staff and patient complaints and your ability to move the meat in a manner that falls somewhere on the bell curve of the current providers.

 

[exsanguination]

Thanks for the replies every one

Chiefs probably view it as a plus. People who weren't chiefs probably don't care. The net balance would then be a positive...

This is probably the crux of the matter.

Though it concerns me when there's two people who've posted that said half of their SDG is compromised of chief residents...

I really don't want to do all the work required of a chief. I agree with some of the posters above in that it attracts a certain type of person, rather than being a measure of a good doctor. I'm definitely not the gung-ho vocal gunner leader type. Probably more of the clock puncher and meat mover as some have described.

Oh well, guess I'll work for some underpaying CMG in BFE. Good thing I don't want a porsche 😉

 

[emergentmd]

I will disagree with emergentmd and third this. I'm a partner in a community SDG and it matters when we hire for all the reasons stated above. In a well run SDG I need you to do more than just show up and punch the clock. Chiefs in general tend to be people who have already demonstrated they will do more than just work their shifts. That said there are obviously tons of great doctors who were not chiefs, so it's not a requirement but it does help.

Our Partnered SDG in a highly sought of area that before 3 yrs ago, maybe hired 2-3 docs a year. I can tell you it didn't matter if you were Chief or not. All it matters is if one of the partners knew you. If a partner vouched for you, you would get an interview and likely hired over a Chief of a top ranked program.

We didn't advertise for positions. It was all word of mouth.

 

[Hercules]

Our Partnered SDG in a highly sought of area that before 3 yrs ago, maybe hired 2-3 docs a year. I can tell you it didn't matter if you were Chief or not. All it matters is if one of the partners knew you. If a partner vouched for you, you would get an interview and likely hired over a Chief of a top ranked program.

We didn't advertise for positions. It was all word of mouth.

To clarify, I didn't mean to disagree with your own personal experience-- it sounds like it didn't matter to your group. It does matter somewhat to some community groups though.

 

[deleted547339]

I certainly hope not.

 

[emergentmd]

To clarify, I didn't mean to disagree with your own personal experience-- it sounds like it didn't matter to your group. It does matter somewhat to some community groups though.

No problem. Currently, as there is such a shortage of ED docs, you just need a license and breath to be hired. For the more competitive jobs in nice Cities that have a "waiting lists" (Which I do not believe that there are many), its more who you know that if you are chief.

 

[Doctor J]

I'd also say that of the groups I've looked into, most would prefer a salty-sea-dog EM trained doc a few years out of residency over a wet-behind-the-ears newbie. If you're clinically solid and efficient and not a jerk, what does it matter if you scheduled the vacations for your co-residents?

Speaking broadly and offensively.

 

[Birdstrike]

I'd also say that of the groups I've looked into, most would prefer a salty-sea-dog EM trained doc a few years out of residency over a wet-behind-the-ears newbie. .

What if the salty old EM trained guy is so crispy-grizzled and burned out that smoke comes out of his ears when interrupted and has a gallows sense of humor so grim, even coroners and crime scene investigators have to excuse themselves when he walks in the room?

Still attractive?

 

[deleted547339]

What if the salty old EM trained guy is so crispy-grizzled and burned out that smoke comes out of his ears when interrupted and has a gallows sense of humor so grim, even coroners and crime scene investigators have to excuse themselves when he walks in the room?

Is there another kind?

 

[Doctor J]

🙂 I said 'a few years out', not 20.

 

[EM_Rebuilder]

I think being a chief helped establish my leadership foundation and I have been out just four years.

I don't think it helped me get my next 'job' out of residency, but those initial foundations (and taste of administration) led me to seek other leadership positions within that job and onto various positions in organized medicine.

All that combined led me to combine with a couple other EM physicians and we founded two free standing emergency rooms, the first opening the end of July.

Would this all have happened if I was never a chief? Maybe, but I actually doubt it.....