How to be chief?!

[bluenebula83]

Hey guys I'm an intern. I was just curious...if I'm interested in becoming a chief one day I know you start applying your second year of residency. Do you just get chosen to become a chief or is it better to throw your name out there at your university? And if so, who would you talk to? Just curious. Thanks in advance!

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[indiamacbean]

perhaps a better question than How is Why. Is it the endless meetings, the interns complaining about their schedules, the administration pushing you to squeeze more work out of the residents? Pretty much everyone I know at many different hospitals and programs is REALLY glad when their chief year is over. Some people enjoy the teaching but my sense is you get to do less of this than you might like.

I will say the one exception to this is ACS at Hopkins. If you are crazy and like to work harder than a Hopkins intern than that seems like a really cool job.

As to How, be smart in morning report, teach your interns and med students, make friends with the PD and associate PD, let them know early on you would be interested. caveat emptor

 

[Instatewaiter]

perhaps a better question than How is Why. Is it the endless meetings, the interns complaining about their schedules, the administration pushing you to squeeze more work out of the residents? Pretty much everyone I know at many different hospitals and programs is REALLY glad when their chief year is over. Some people enjoy the teaching but my sense is you get to do less of this than you might like.

I will say the one exception to this is ACS at Hopkins. If you are crazy and like to work harder than a Hopkins intern than that seems like a really cool job.

As to How, be smart in morning report, teach your interns and med students, make friends with the PD and associate PD, let them know early on you would be interested. caveat emptor

Yeah, the ACS at hopkins IS the attending which is kinda cool... of course they do work harder than even the interns but it seemed very different than the administrative BS that chief year is everywhere else.

 

[DrWBD]

Do well on the in-training exam as an intern.

 

[bluenebula83]

Do well on the in-training exam as an intern.

It's interesting you say that because I heard many a people say outright that they will not use the scores from the in training exam to determine chief residency positions.

 

[AZhopeful]

At my school, I think the IM PDs use a combination of informal or formal surveying of the residents as to who they think would do well as chief, and a bunch of private haggling to convince people that they should be chiefs. There's a subset of people who stand out as chief candidates, and there's a sub-subset of people who can be sold on doing it.

 

[VJWDO]

It depends on your program. At my program you are asked to be chief based on your leadership qualities and knowledge base as well as your desire to teach. The biggest thing is to make friends and get along with everyone. The candidates for chief my year were basically picked off one by one because they were not well liked by some of the admin and even residents. They were great candidates with good scores and great teaching abilities but just could not get along well. Chief is basically about being the ultimate moderator. You are constantly in the middle of a **** storm and you need to be able to keep your head about you. If you are energetic, levelheaded and don't mind working hard then you are probably chief material. Of course you have to be near the top of your class as well when it comes to academics.

PLEASE PLEASE PLEASE Don't tell people you are going to or you want to be chief without them soliciting you. This just looks douchy!

Just my 2 cents😀

 

[DrWBD]

It's interesting you say that because I heard many a people say outright that they will not use the scores from the in training exam to determine chief residency positions.

Don't believe everything people tell you, especially in post-graduate medical education.

While it is plausible that it wouldn't be an absolute criteria (i.e. a candidate who scored in the 90th percentile on the ITE might not automatically lose out to another who scored in the 99th) I don't see how it wouldn't be considered at all. An academically weak resident, no matter how well he gets along with the housestaff, probably wouldn't make a good chief resident.

 

[C5toC9]

Does being a chief resident really provide much advantage for securing good fellowships? It's like a year's lost of attending salary if there is no benefit in the end.

 

[gutonc]

+169 on the "why" issue.

How is easy. Rock the wards, teach your students and interns well and do well on the ITE (no, it's not supposed to be used for this kind of thing, but the person who chooses the chiefs - the PD - is also the person who sees your ITE scores so it can't help to bomb the exam).

I'm not sure I will ever understand the "why" part though. I can only think of two good reasons to be a chief resident:
1. Your sole career goal is to be a PD.
2. You are promised (in writing) a cards or GI spot the following year if you take the beating that is the chief spot.

Other (bad) reasons people give for being a chief:
1. "I want to do academic general IM." Bogus...do a GIM fellowship. Sure, it's 2 years instead of 1, but you do less than 1/2 the work a chief does and get 40-60% of your time protected for "research" (read: skiing and going to the beach). You can also work the same number of hours as a Chief but by moonlighting and make nearly an attending's salary.
2. "Doing something for a year while I wait for my fellowship to start." Umm...I'm pretty sure that's why hospitalist jobs exist.
3. "Waiting for my spouse/partner to finish their residency/fellowship before moving." See #2.
4. "Not sure what I want to do after residency." I'm pretty sure "be everyone's biatch" isn't on the short list. Hello locums.

After all this, if you do wind up being a Chief resident, you need to know that there are really only 2 kinds...a-holes and tools. Be the former, or you risk being the latter which only makes the job that much harder.

 

[gutonc]

+169 on the "why" issue.

How is easy. Rock the wards, teach your students and interns well and do well on the ITE (no, it's not supposed to be used for this kind of thing, but the person who chooses the chiefs - the PD - is also the person who sees your ITE scores so it can't help to bomb the exam).

I'm not sure I will ever understand the "why" part though. I can only think of two good reasons to be a chief resident:
1. Your sole career goal is to be a PD.
2. You are promised (in writing) a cards or GI spot the following year if you take the beating that is the chief spot.

Other (bad) reasons people give for being a chief:
1. "I want to do academic general IM." Bogus...do a GIM fellowship. Sure, it's 2 years instead of 1, but you do less than 1/2 the work a chief does and get 40-60% of your time protected for "research" (read: skiing and going to the beach). You can also work the same number of hours as a Chief but by moonlighting and make nearly an attending's salary.
2. "Doing something for a year while I wait for my fellowship to start." Umm...I'm pretty sure that's why hospitalist jobs exist.
3. "Waiting for my spouse/partner to finish their residency/fellowship before moving." See #2.
4. "Not sure what I want to do after residency." I'm pretty sure "be everyone's biatch" isn't on the short list. Hello locums.

After all this, if you do wind up being a Chief resident, you need to know that there are really only 2 kinds...a-holes and tools. Be the former, or you risk being the latter which only makes the job that much harder.

 

[VJWDO]

+169 on the "why" issue.

How is easy. Rock the wards, teach your students and interns well and do well on the ITE (no, it's not supposed to be used for this kind of thing, but the person who chooses the chiefs - the PD - is also the person who sees your ITE scores so it can't help to bomb the exam).

I'm not sure I will ever understand the "why" part though. I can only think of two good reasons to be a chief resident:
1. Your sole career goal is to be a PD.
2. You are promised (in writing) a cards or GI spot the following year if you take the beating that is the chief spot.

Other (bad) reasons people give for being a chief:
1. "I want to do academic general IM." Bogus...do a GIM fellowship. Sure, it's 2 years instead of 1, but you do less than 1/2 the work a chief does and get 40-60% of your time protected for "research" (read: skiing and going to the beach). You can also work the same number of hours as a Chief but by moonlighting and make nearly an attending's salary.
2. "Doing something for a year while I wait for my fellowship to start." Umm...I'm pretty sure that's why hospitalist jobs exist.
3. "Waiting for my spouse/partner to finish their residency/fellowship before moving." See #2.
4. "Not sure what I want to do after residency." I'm pretty sure "be everyone's biatch" isn't on the short list. Hello locums.

After all this, if you do wind up being a Chief resident, you need to know that there are really only 2 kinds...a-holes and tools. Be the former, or you risk being the latter which only makes the job that much harder.

I disagree with the above.

Being chief does help you get a fellowship at least that is what I was told by all the PD's I interviewed with for fellowship.

It is an awesome experience for those of us that would like to get involved in administration. I know that most of you don't get people like me but yes I like being in administration and I am neither an a-hole or a tool. At least not all the time.

I really enjoy being an attending on the wards, getting involved in all the administrative operations of a residency program, and helping residents achieve their individual goals.

Mind you I have been hired as junior faculty and get a substantial salary compared to most other chiefs across the country so that could be why I feel this way.

I think if you ask most of my residents they would not say I am an A-hole unless provoked and that I am definitely not a tool!

Just my 2 cents🙂

 

[DrWBD]

2. You are promised (in writing) a cards or GI spot the following year if you take the beating that is the chief spot.

Realistically, this is the "why" for probably 90% of chief residents.

Keep in mind that if you are an FMG or DO that wants to do a competitive fellowship, this is often the only way. Program directors know this very well.

 

[gutonc]

Realistically, this is the "why" for probably 90% of chief residents.

Keep in mind that if you are an FMG or DO that wants to do a competitive fellowship, this is often the only way. Program directors know this very well.

I'd say closer to 95% but I thought I'd throw another "good" reason in there just for completeness.

 

[chief6124]

Another good reason

1. I work 8-3pm 5 days a week

2. in the 1st 4 months i made and extra 40k on top of my chief salary with all my time moonlighting. I have paid off my car and credit cards. Also i bought a 2ct diamond and will get married this year( hard to do in first year of fellowship).

3. I go to vegas once a month.

Not bad to me!!

 

[ResidentMD]

Another good reason

1. I work 8-3pm 5 days a week

2. in the 1st 4 months i made and extra 40k on top of my chief salary with all my time moonlighting. I have paid off my car and credit cards. Also i bought a 2ct diamond and will get married this year( hard to do in first year of fellowship).

3. I go to vegas once a month.

Not bad to me!!

If you are a chief in the program at UNLV, it does not count

 

[bluenebula83]

Another good reason

1. I work 8-3pm 5 days a week

2. in the 1st 4 months i made and extra 40k on top of my chief salary with all my time moonlighting. I have paid off my car and credit cards. Also i bought a 2ct diamond and will get married this year( hard to do in first year of fellowship).

3. I go to vegas once a month.

Not bad to me!!

Hey this sounds pretty good to me! And it puts you in a good spot to grab a fellowship you want.

 

[Dr Ymous]

Another good reason

1. I work 8-3pm 5 days a week

2. in the 1st 4 months i made and extra 40k on top of my chief salary with all my time moonlighting. I have paid off my car and credit cards. Also i bought a 2ct diamond and will get married this year( hard to do in first year of fellowship).

3. I go to vegas once a month.

Not bad to me!!

nice

 

[Crazy Diamond]

Hey this sounds pretty good to me! And it puts you in a good spot to grab a fellowship you want.

oh boy !

 

[dragonfly99]

First, I don't see a good reason to do it unless they promise you a spot in the fellowship you want, and/or you want a career as a PD or other hospital administrator. You can make a lot more money as a hospitalist, and maybe advance your career more in your subspecialty field by doing dedicated research in your field. However, if they promise you a GI or cards or hem/onc spot, then by all means do it.

How the chiefs are picked is totally institution-dependent. At mine it was all done in secret by the dept chair, PD and probably a few other faculty. I believe it was done based on how smart someone seemed as an intern in morning report, probably the ITE exam, and how the person "came across" in terms of dress, etc. At some places, the residents and interns have some or even a lot of input, so making friends would then be important. At my institution the house staff had no input into this, or substantially none.

 

[Omar Mukhtiar]

At my programs, qualities required for being Chief were:

-Brown nose faculty, be a part of the "Group" 👎
-Snitch on your collegues, be an "Insider" 👎
-When Chief, willing to be unpopular with the residents, all requests for some sort of accommodation of schedule or vacation to be answered with a "NO" 👎

It was a pretty pathetic experience. Of course this was in community hospitals


Why do it?
Possibility of going on to a fellowship 👍

The rest is all bull. Why would someone waste 1 yr of their professional life & close to $180,000 in compensation (the difference in base pay for a hospitalist & a Chief-$220 to 250000 minus $50 to 80000). Hospitalists get leadership positions too. They too have "perks" like bonuses (Vs Moonlighting pay).

Why should the Chief's section on this forum be a "members only" club? What have they got to hide that others should not know??
Now you have 2 year to work on your "skills". Good luck.