selection criteria for chief residents?

[walkermd]

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What criteria does your program use for selecting chief residents? My program just had our chiefs announced for next year and the selection was not quite what a lot of the residents expected, so it got me thinking.... I assume some degree of clinical competence is taken into consideration, but other than that, is it leadership? Publication record and expected academic excellence? Interest in teaching and mentoring interns & junior? Something else?

Curious how it works at your programs. Thanks!

 

[WilcoWorld]

Different places have different criteria, of course. However, I think that clinical competence should be more of a binary factor - as in, if you're competent then you're eligible, if you're incompetent then you're ineligible. Once that is decided, then the best leaders & teachers among the eligible should become chiefs.

As an aside, I know that not becoming chief can be damaging to an ego, but the truth is that very few employers care much about it.

 

[Greenbbs]

I was chief in my program. It's not that much glory for an ass-ton of extra work (scheduling, administrative crap, etc). We had our program inspection during my chief year. Made my life hell.

 

[deuist]

I was chief in my program. It's not that much glory for an ass-ton of extra work (scheduling, administrative crap, etc). We had our program inspection during my chief year. Made my life hell.

There was a paper published last year mentioning the same. Lots of work for little glory, although respondents did think that the year was beneficial.

 

[deleted109597]

The ability to "toe the line" comes to mind.

 

[leorl]

I was chief in my program. It's not that much glory for an ass-ton of extra work (scheduling, administrative crap, etc). We had our program inspection during my chief year. Made my life hell.

Is totally making my life hell! Although now that we're coming to the end of the year it's getting better (or I'm just caring less 🙂 ) . But there have been plenty of days where ranting has been continuous.

 

[xaelia]

The pattern we've witnessed at our program is that chiefs are chosen in a fashion to appease the faculty primarily to be non-controversial, the least irregular, and most pliable.

And our windows into the process have been that resident input is a lesser element.

 

[leorl]

that is a shame...

 

[lucky_deadman]

I was chief in my program. It's not that much glory for an ass-ton of extra work (scheduling, administrative crap, etc). Made my life hell.

Ditto!

 

[Painter1]

i think a factor i have seen play a big role in a candidate for chief (from my exprience) is initiative. i've seen a few residents become chiefs who were mediocre clinically and academically however they were always involved one way or the other prior to being chiefs in the residency (e.g. volunteering to take interviewees for tours, going to all outside conferences etc). there was one in particulary who was pretty sharp politically and in fact it felt like she was running for congress for a way, brownosing the appropriate faculty and residents. bottomline, you don't need to be the most competent clinician or score the highest on the inservice to become chief. at least at the program i was at.

 

[walkermd]

i think a factor i have seen play a big role in a candidate for chief (from my exprience) is initiative. i've seen a few residents become chiefs who were mediocre clinically and academically however they were always involved one way or the other prior to being chiefs in the residency (e.g. volunteering to take interviewees for tours, going to all outside conferences etc). there was one in particulary who was pretty sharp politically and in fact it felt like she was running for congress for a way, brownosing the appropriate faculty and residents. bottomline, you don't need to be the most competent clinician or score the highest on the inservice to become chief. at least at the program i was at.

I get the sense that this describes my program too. It's a shame though, isn't it? I would have thought that a main duty of being chief is to be a role model for the interns/juniors and to be a source of support for other residents. It just seems a shame that a main duty seems to be to become a part of the administration rather than as an advocate for residents.

 

[xaelia]

I would have thought that a main duty of being chief is to be a role model for the interns/juniors and to be a source of support for other residents.

One of our chiefs this past year quit the program during intern year to switch to PM&R.

He switched back to EM a month later.

Role model.

 

[roja]

It is incredibly program dependent, as well as roles.

In residency: all residents voted. most popular 3 were selected, with veto power by residency leadership. (not invoked.) one year, I think they had faculty vote as well.

Now: residents were asked who they would like, and also specifically was there anyone they didn't want (but had to give clear reason). Then faculty were asked the same. The education leadership then took all the information and made a decision. This was then taken to chair for final approval.

There are often things program directors know that the rest of the department doesn't (good standing etc) and this might play into.

Other places base it on votes. Others just have PD select. Probably lots of others.

Our chiefs do not do scheduling.

 

[VO2]

Is there generally an initial solicitation of interest for chief positions before the voting/polling process? My perception is that interest in chief positions can be pretty hit and miss.

 

[leorl]

yeah, there is usually an intent letter submitted, at least at our program. There are sadly some people who would be good chiefs but who are just not interested in adding it to their workload (the wise decision probably!)

Yeah, I echo the poster who said that chiefs are usually the ones who have been proactive. At my facility we have residents and faculty vote too, and top choices get it (but can be revoked if something is particularly problematic). This is so that as much as possible, residents chosen are ones who can represent the residents and be a go-to person for residents if issues arise. Unfortunately with that, there are definitely some people who have been selected who don't really do very much work. There are also those who try to manipulate (brown-nosing, sucking up, etc.) their way into chief positions but the good thing about having a residency/faculty vote is that hopefully some people can see right through them and not allow themselves to be represented by said person.

Anyway, in my opinion, being chief doesn't really mean that much, just some extra work and being "in the know" for things involving the residency.

 

[EM_Rebuilder]

I agree, selection is so program dependent.

The most important part is being a good clinician while being succesful and balancing with duties outside of the clinical shift.

If you cannot do the above, I would not be a chief as you have more to work on before finishing residency. I think this needs attained before you make the personal decision to go for it.

Our program looked at faculty votes, resident votes, prior chief recs, clinical skills, outside of shifts particpiation, desire/application letter, personality, and in-service scores....in no particular order with the final decision coming from the PDs.

I would do the job again; but I will also say that it probably had zero influence on my job search. The places I interviewed where most impressed with the fact that I had been moonlighting over a year and was coming from a four year program. Being a chief resident was not even mentioned. I am certain there has been some personal proffesional development that I maybe do not 'feel' or note.

 

[leorl]

I personally don't feel i've attained any "professional development." Many people before they went to med school or while in med school were captains of their sports teams, held leadership roles in various groups and I think that same kind of knowledge was attained prior to starting residency. At least for me where being captain of my sports team was seriously like running a business, so for me, being chief is actually a lesser job than when I was a crew captain.

 

[walkermd]

I would do the job again; but I will also say that it probably had zero influence on my job search. The places I interviewed where most impressed with the fact that I had been moonlighting over a year and was coming from a four year program. Being a chief resident was not even mentioned. I am certain there has been some personal proffesional development that I maybe do not 'feel' or note.

Interesting. Do you think being chief resident gives you a leg up for academic jobs, at least? Like a stamp of approval of some kind? Or does it not even matter for academics?

 

[leorl]

I don't think it gives you a leg up, really. During my fellowship applications, it got commented on. But say if a chief is going up against a non-chief who comes to a fellowship with already approved NIH funding, guess who gets the spot? Not the chief. It's a nice gesture and responsibility from a residency program, but it will not make or break your career.