Vent/Rant about the Chief System

[drosophilamelanogaster]

Hi all,

I apologize for going into a bit of an upcoming rant in advance. I am curious to know if others feel the way that I do and have had similar issues. If you think I'm acting like a brat/child or have nothing nice to say, that's fine. I used to be in general surgery and I can handle criticism. It's an anonymous online message board and if you want to "call me out" or simply want to troll, well that's what people behind computer screens do, have at it.

I am in a small residency program (so as not to identify, I will say it is a ROAD program and leave it at that--radiology, ophthalmology, anesthesia, or dermatology) with a total of 10-15 residents. We have a third and fourth year acting as chiefs, who have been elected by the attendings and residents (there are 10-15 attendings as well, almost equal to the number of residents). They are elected at the end of their second year (running against their other classmates) and become a chief as a rising third year with the already-existing rising fourth year chief.

I have had a few issues with my specific chiefs, as well as the chiefing system in general and again, I'd like people's feedback -- has your experience been similar or do you have similar grievances (or maybe not)? This is mostly to vent, I am well aware that I am not going to change the world here.

With regard to the chief system, I really don't like the idea that two residents have been selected to basically be the boss. Hear me out. I know someone has to do the scheduling, handle vacation requests, etc, and that is not my issue. But at least at our program, every issue has to go through the chief, any complaints, any resident issues. If you go to the PD first, the chiefs get very upset--which kind of encapsulates the problem that I have with them. It is a "how dare you go over my head!" mentality. I feel like the power has gone to their head, i.e. why are you getting all in a tizzy because someone talked to the PD about an issue instead of coming to you first? They take themselves way too seriously. They would tell you they aren't power hungry and probably believe themselves, but there is no reason to be upset over something like that if you aren't, am I right? I don't know why I haven't mentioned this sooner, but my issue with it is, I don't like that two people have been anointed "in charge" and now have the authority to tell of the other residents what to do -- you aren't better than us, you aren't my boss, my attendings (who I work with directly daily) and in particular my program director are. I know, I probably sound like I have oppositional defiant disorder (hooray for me remembering what that is) but seriously, I've never had an issue with authority in my life. I was always respectful with my parents and bosses and I've held jobs in the legal and hospitality industries in the past. One of the points of resentment for me is that I am in my 4th year and I really don't like the concept of a 3rd year telling me what I can and can't do, when just a few months ago when I was a 3rd year resident and he/she was a 2nd year resident, I was considered a more senior resident, they were not a chief, and I was higher in the pecking order so to speak. Now he/she feels very large and in charge, empowered, and I think a major underlying issue is her/him feeling like the alpha dog while I feel that I'm a year older, been here a year longer, and I'm in the senior-most class and should be more alpha. But I digress. Trying to broaden the scope to a wider discussion, regardless of whose side your on, I just feel like this system breeds internal battles and somebody feeling like they can control everyone/everything, and people (in this case) are bound to resent that.

Now you might already be saying to yourself, hmm, I think maybe you have something interpersonal going on between you and a chief(s) and that's the issue at play here. Well, you wouldn't be entirely wrong, and I seek advice in this department as much as your insights. This new chief, the third year, is in charge of scheduling and constantly taking advantage of weaknesses in our system. We technically have a few research weeks that can be taken, but they are almost always used for studying for our boards. When he/she wants a day off, she/he just tells her partner in crime, the other chief, "I'm going to take a research day" with no intention of paying it back--he/she has even told me so, this is not speculation. He/she expects to have just as much time to study as the other residents who never took a research day/week, and he/she knows our program director doesn't want to babysit us and trusts the chiefs to manage the vacation time and scheduling. The latest issue we've run into is him/her giving himself/herself less call weeks and night float weeks than the other residents, even the more senior residents (such as myself a year ahead of him/her) when traditionally it has always been by class and if anyone has fewer weeks, it's always the 4th years. I just received a schedule where he/she has fewer weeks call than all of the senior residents when every year as a junior resident, I took the most call and the seniors had it best. I could go on and on with examples but simply put, this resident is out for himself/herself and is very self-serving when it comes to all of the chiefs duties. They have the authority/power and they are taking full advantage of it, in plain sight because the program director trusts us to govern ourselves. I don't want to be a tattle tale, but I don't see how he/she is going to lay off the throttle--they are getting away with more and more because they are unchecked, and simply put, I have had enough of it. I know rocking the boat is never necessarily the best option, but I also don't see it getting any better. I frankly have no trust in our chief(s) at this point because I know they put themselves first and rather than being impartial and a responsible chief, they are self-serving. I see right through all of the little days off here and there, the less call than everybody else, and the BSing through it if I call him/her out. They don't care who they screw over, as long as they get their way and "get out of" as much work as they can.

Sorry, this is a bit of a winding rant from someone who is tired physically and tired of this system in more ways than one. Feel free to share your own stories, feedback, advice, or what have you. It sickens me to think that this chief is so highly regarded by the attendings because he/she has projects going on and is a brown-noser.

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[GoSpursGo]

It sounds like the issue isn't with the system, but with the fact that the third year is an ass. This wouldn't be a problem if he wasn't abusing his power, but he is, and chances are that trying to change that would result in more trouble than it's worth.

As you know, some people in medicine are jerks, and sometimes you wind up having one who gets to tell you what to do. Just suck it up and get through this final year.

 

[AMEHigh]

We had a problem with our chief. It was very annoying and rant inducing and it eventually lead to scheduling being transferred out of their hands once the attendings received enough complaints and figured out what was going on. So yeah it happens. Sounds like you have a crappy chief, unfortunately it happens.

 

[gutonc]

The system is typical.

The chief(s) is/are a dou**bag. (TL;DR...I can't tell how many people you hate in this program, but it's at least one and I can't be bothered to figure out if it's more than that)

Head down, chin up.

Remember that they can't stop the clock.

 

[Dr.LeoSpaceman]

I just received a schedule where he/she has fewer weeks call than all of the senior residents when every year as a junior resident, I took the most call and the seniors had it best. I could go on and on with examples but simply put, this resident is out for himself/herself and is very self-serving when it comes to all of the chiefs duties.

What everyone else said. This is prima facie evidence for being a terrible chief.

When scheduling, I went out of my way to make sure I was taking as many (or more) calls/crappy shifts than everyone else.

 

[DarkHorizon]

They have no power over you, i am surprised they would even consider giving a younger resident the power to dictate your call schedule. I would straight up confront this resident and ask them what’s up. In every part of my training, call schedule is always made on the basis of seniority. Most senior residents got first dibs, then mid levels and then juniors. No way would I let a younger resident boss me around like that, I would get confrontational right way, in a private conversation. They should give you the courtesy of being a senior resident and hence picking your call days/weekends.

 

[Dave1980]

Well the OAD specialities are all 3 years long. So clearly you are in a radiology program.

 

[drosophilamelanogaster]

They have no power over you, i am surprised they would even consider giving a younger resident the power to dictate your call schedule. I would straight up confront this resident and ask them what’s up. In every part of my training, call schedule is always made on the basis of seniority. Most senior residents got first dibs, then mid levels and then juniors. No way would I let a younger resident boss me around like that, I would get confrontational right way, in a private conversation. They should give you the courtesy of being a senior resident and hence picking your call days/weekends.

Unfortunately, the way this happens is, because there's a third year chief (new chief) and a fourth year chief (who was chief as a third year also), the fourth year sticks scheduling duties on the third year because it's a pain in the rectum and it's effectively dumped onto them. So it has become an annual duty for the new chief to be the scheduler.

Well the OAD specialities are all 3 years long. So clearly you are in a radiology program.

Very observant, and you are indeed correct. But aside from providing context, it really isn't particularly relevant to the 99% of the content post. I'm impressed with your detective work, but it's hardly important.

 

[guytakingboards]

I was in a program like that; actually two: both residency and fellowship.

In the former case, the chiefs that came after me were very similar to your description and my friends two years behind were very annoyed by it. In the latter case, I had a chief fellow who always managed to schedule himself for academic days on mondays or fridays, on a nearly weekly basis.

In either case, the non-chiefs (/victims) spent a lot of time bitching/complaining and generally being unhappy. They'd pore over the schedules for any inequities and raise a stink to anyone who'd listen. People got tired of hearing the same rants daily.

Not saying there's a right or wrong way to go but you have two options.
1) Chill out, roll with it and focus on fellowship/learning/outside life.
2) Go to war.

Both options have their pluses and minuses. I will say, somewhat from experience, you will likely have a hard time finding someone who cares as much about that stuff as you do.

 

[drosophilamelanogaster]

What everyone else said. This is prima facie evidence for being a terrible chief.

When scheduling, I went out of my way to make sure I was taking as many (or more) calls/crappy shifts than everyone else.

Basically, this resident came into residency guns blazing with a whole agenda in mind to advance himself/herself and propel them into a top flight fellowship and opportunities. Which hey, more power to you, I wish I had that kind of initiative. I do my job, am collegial, dabble in a few extracurricular activities but not the class president-prom king-QB of the football-captain america type. I'm more of a "glue guy" who brings a lot of flavor to the program and is socially active but not gung ho about turning every waking second into a CV boosting opportunity. This chief is hyper competitive and has run/won seats on national resident committees, done lots of research, and buttered up every influencer in the field that he/she wishes to go into in fellowship. Good for them, it has worked like a charm and they are in a great position. The only thing is, they aren't the Mr/Miss Congeniality type where they are beloved by all and just the All American person nobody could say a bad thing about. They are more like the go-getter who has a plan in mind and if anyone stands in the way, they better watch out. Like I said, hypercompetitive and always trying to outdo everyone else, and it's their way or the highway. Kobe Bryant said he was going to outwork everybody to be the best, so I respect the grind, but I don't respect the way they go about it because it's now permeating the chief power position. The attendings think this chief is a rockstar/allstar because of the innumerable accolades and stuff they've done, but that my way or the highway approach doesn't jibe well with me when they are a third year and I'm a fourth year. And based on the description above, you can imagine how he/she carries him/herself when I "call them out" on their shenanigans and trying to get out of stuff. More likely than not, they want to work less weekends so while I'm performing clinical duties for patients all weekend, they can be at home working on publications and case-in-point articles to keep the neverending beefing up of the CV going. It's all about "what will this do for me" to this person, and it's always about getting ahead.

 

[drosophilamelanogaster]

I was in a program like that; actually two: both residency and fellowship.

In the former case, the chiefs that came after me were very similar to your description and my friends two years behind were very annoyed by it. In the latter case, I had a chief fellow who always managed to schedule himself for academic days on mondays or fridays, on a nearly weekly basis.

In either case, the non-chiefs (/victims) spent a lot of time bitching/complaining and generally being unhappy. They'd pore over the schedules for any inequities and raise a stink to anyone who'd listen. People got tired of hearing the same rants daily.

Not saying there's a right or wrong way to go but you have two options.
1) Chill out, roll with it and focus on fellowship/learning/outside life.
2) Go to war.

Both options have their pluses and minuses. I will say, somewhat from experience, you will likely have a hard time finding someone who cares as much about that stuff as you do.

Very insightful post and I appreciate your experience and taking the time to read. Thank you for this.

 

[TraumaLlamaMD]

Are you close with the fourth year chief? If you’re going to complain to anybody I’d start there.

In terms of the chiefs getting annoyed when you go to the PD instead of them, I can tell you that my PD expected us (all PGY5s are chiefs in surgery) to handle the bulk of issues from the juniors, from scheduling issues to interpersonal drama. If juniors started taking these issues directly to the PD, we would get a reminder or request to please handle this stuff ourselves. Obviously the PD can step in for crises, or issues that involve the chiefs themselves, but for the most part we handled the issues because it was expected of us.

 

[DocVapor]

It's still early into their 3rd year and "chief" status. Now's the time to nip it in the bud, especially if it's that obvious what they're doing.

The whole point of running everything through your chiefs is to prevent chaotic messages going to/coming from the attendings, not to give them the power to pick and choose what gets addressed in the program. I may be wrong but hopefully, the 4th year chief is better and if you go to them repeatedly then hopefully they'll put a stop to this behavior. If not, then it's appropriate to go over their heads. If enough of your co-residents do that then they can't ignore it, and the attendings will get annoyed enough that things might change.

Edit: In our program (which was also like this one where the residents policed themselves) the mantra was always to go to attendings with solutions, not problems. If you do end up going above both chiefs, then make sure you've got enough support from your co-residents and have a workable solution in hand.

 

[Dave1980]

Very observant, and you are indeed correct. But aside from providing context, it really isn't particularly relevant to the 99% of the content post. I'm impressed with your detective work, but it's hardly important.

It wasn't detective work. I knew those specialities weren't 4 years. I thought I'd comment because you were being silly. Also I think you need to chill out and stop caring about the 3rd year.

 

[guytakingboards]

Basically, this resident came into residency guns blazing with a whole agenda in mind to advance himself/herself and propel them into a top flight fellowship and opportunities. Which hey, more power to you, I wish I had that kind of initiative. I do my job, am collegial, dabble in a few extracurricular activities but not the class president-prom king-QB of the football-captain america type. I'm more of a "glue guy" who brings a lot of flavor to the program and is socially active but not gung ho about turning every waking second into a CV boosting opportunity. This chief is hyper competitive and has run/won seats on national resident committees, done lots of research, and buttered up every influencer in the field that he/she wishes to go into in fellowship. Good for them, it has worked like a charm and they are in a great position. The only thing is, they aren't the Mr/Miss Congeniality type where they are beloved by all and just the All American person nobody could say a bad thing about. They are more like the go-getter who has a plan in mind and if anyone stands in the way, they better watch out. Like I said, hypercompetitive and always trying to outdo everyone else, and it's their way or the highway. Kobe Bryant said he was going to outwork everybody to be the best, so I respect the grind, but I don't respect the way they go about it because it's now permeating the chief power position. The attendings think this chief is a rockstar/allstar because of the innumerable accolades and stuff they've done, but that my way or the highway approach doesn't jibe well with me when they are a third year and I'm a fourth year. And based on the description above, you can imagine how he/she carries him/herself when I "call them out" on their shenanigans and trying to get out of stuff. More likely than not, they want to work less weekends so while I'm performing clinical duties for patients all weekend, they can be at home working on publications and case-in-point articles to keep the neverending beefing up of the CV going. It's all about "what will this do for me" to this person, and it's always about getting ahead.

Much to ruminate on here.

1) That person is clearly a prick.
2) That person is playing "the game" that is rewarded in academic radiology. Good for them. Attendings obviously love those people because they add to the department's prestige and sometimes the individual attendings' CV. Conversely, attendings will never remember the glue guy who caught the list up to the last-modify-time so everyone could leave on time. ("you remember drosophila? that guy was a list-reading sonnuvabitch"). That's just academics. However, I personally would never endorse my ****ty chief resident or chief fellow to join my private group.
3) You don't sound like the kinda guy who wants to be doing a ton of research anyway. You doing clinical work while the other person is doing research doesn't strike me as too far fetched. Yes of course the inequity can become too much at some point. But you don't sound like you'd rather being doing what that person is doing.
4) As has been said earlier, its probably easier to chill out and just avoid the wake of that person's meteoric rise to Ivory Tower Professorship.

 

[RangerBob]

Well the OAD specialities are all 3 years long. So clearly you are in a radiology program.

Isn't rads 5? The others are 4.

They all require a prelim year, but residents are called a PGY4/4th year if they are in their third year total of residency. Except anesthesia, which uses different terminology.

For the OP-I agree the situation sucks. Chiefs should have the same or heavier workload. The buck is supposed to stop with them. If it bothers you a lot talk with the senior chief. Otherwise it’s best to suck it up as best you can-it’ll be over soon.

In the end, sometimes you have to determine what battles are worth fighting, even when you’re right.

 

[greatnt249]

It could be less that your chiefs (particularly the 3rd year) are power-hungry and more that he/she is worried that the program director will think that he/she is not able to carry out the duties of being chief if people are going over their heads, especially if he/she is gunning for academia. Chief wants as many good marks on his/her CV as possible, and the thought of not being viewed as anything other than a model chief could jeopardize that (in his/her mind).

 

[GoSpursGo]

Are you close with the fourth year chief? If you’re going to complain to anybody I’d start there.

Mostly I still think you should keep your head down and just get through the year. But if you decide this is just a travesty that cannot stand, this is probably the best person to approach first.

 

[Dave1980]

Isn't rads 5? The others are 4.

They all require a prelim year, but residents are called a PGY4/4th year if they are in their third year total of residency. Except anesthesia, which uses different terminology.

For the OP-I agree the situation sucks. Chiefs should have the same or heavier workload. The buck is supposed to stop with them. If it bothers you a lot talk with the senior chief. Otherwise it’s best to suck it up as best you can-it’ll be over soon.

In the end, sometimes you have to determine what battles are worth fighting, even when you’re right.

In radiology it is common to call the R1's (who are PGY-2) first-years. I think this is because you really are starting from 0 in Radiology.

 

[HemeOncHopeful19]

As a former chief, your chief sounds like a tool, sorry about that. If the other residents all feel the same way then maybe you can all bring it up to the (A)PDs AS A GROUP. They may not give a crap tbh but that’s your best chance at getting change accomplished and not singling yourself out for more BS.

I got really annoyed when people went over my head, but that’s because 100% of the time I told someone “no” to some BS request I had either already run it by the PD or told them I would talk to the PD to try and work something out. If you ran to our PDs office immediately after leaving mine then I just assumed you didn’t really want my help with your extra 3 days of vacation to go on a cruise or whatever silliness

 

[Dr.LeoSpaceman]

This chief is hyper competitive and has run/won seats on national resident committees, done lots of research, and buttered up every influencer in the field that he/she wishes to go into in fellowship.

I suspect everyone at an academic program knows someone like this. Yes, it's frustrating...but the chances of you doing anything about it are slim to none. It's honestly best to just learn how to let it roll off your back the best you can, because this won't be your last run-in with someone like this. Focus your time on making sure you're getting what you need out of the program, not how this other person is extracting a potentially disproportionate share. If you feel you absolutely must say something, absolutely take the advice of others and go.to the 4th year as a group. Saying something on your own is putting yourself out there to a degree that can backfire.

Also, take solace in the fact that being the "glue guy" does pay off. It just takes a lot longer. Your faculty will recognize this, whether it feels like it or not. And it's this qualities that will make you a good partner once you hit practice.

 

[Mass Effect]

Now he/she feels very large and in charge, empowered, and I think a major underlying issue is her/him feeling like the alpha dog while I feel that I'm a year older, been here a year longer, and I'm in the senior-most class and should be more alpha

I think this right here is your main problem. Now granted, it sounds like the PGY 3 is a jerk, but that's a person problem, not a chief problem. In every single industry, there is a protocol. You can have say in the protocol in most hospitals, but in some, it just is. The PD is aware of the so-called "chain of command" and has decided that's best for whatever reason, so residents go through the chiefs before coming to him/her. That's how it is and I don't know of a job that isn't set up in a similar fashion, so your argument is a poor one, imo.

I think where your program went wrong (aside from making this particular PGY 3 chief) is having a PGY 3 as a chief in the first place. Chiefs should always be the most senior residents for this very reason.

Also it's July 24th. It's going to be a hell of a long year if you don't try to get the chip off your shoulder.

 

[Mass Effect]

Basically, this resident came into residency guns blazing with a whole agenda in mind to advance himself/herself and propel them into a top flight fellowship and opportunities. Which hey, more power to you, I wish I had that kind of initiative. I do my job, am collegial, dabble in a few extracurricular activities but not the class president-prom king-QB of the football-captain america type. I'm more of a "glue guy" who brings a lot of flavor to the program and is socially active but not gung ho about turning every waking second into a CV boosting opportunity. This chief is hyper competitive and has run/won seats on national resident committees, done lots of research, and buttered up every influencer in the field that he/she wishes to go into in fellowship. Good for them, it has worked like a charm and they are in a great position. The only thing is, they aren't the Mr/Miss Congeniality type where they are beloved by all and just the All American person nobody could say a bad thing about. They are more like the go-getter who has a plan in mind and if anyone stands in the way, they better watch out. Like I said, hypercompetitive and always trying to outdo everyone else, and it's their way or the highway. Kobe Bryant said he was going to outwork everybody to be the best, so I respect the grind, but I don't respect the way they go about it because it's now permeating the chief power position. The attendings think this chief is a rockstar/allstar because of the innumerable accolades and stuff they've done, but that my way or the highway approach doesn't jibe well with me when they are a third year and I'm a fourth year. And based on the description above, you can imagine how he/she carries him/herself when I "call them out" on their shenanigans and trying to get out of stuff. More likely than not, they want to work less weekends so while I'm performing clinical duties for patients all weekend, they can be at home working on publications and case-in-point articles to keep the neverending beefing up of the CV going. It's all about "what will this do for me" to this person, and it's always about getting ahead.

Frankly, this post right here tells me way more about you than about him. I've known people like the one you're describing and I've also known people who were very hot and bothered by said person. I think you need to spend less time thinking about this individual and more time thinking about why this person's approach to things bothers you so much. This goes beyond working more call or whatever. You are bothered on a personal level by this individual's accomplishments/popularity and if you don't get a handle on it, you're going to have the roughest year of residency.

 

[hallowmann]

If you think they are abusing the call schedule, talk to the 4th year chief or other residents, and if enough of you see a problem with it then bring it up en masse. I will say though that its generally not ideal to be in a bad position with someone like that, because chances are they'll develop high up friends.

I do agree with Mass Effect that your posts seem overly annoyed given the context. Being a chief sucks. Its a ton of extra work and usually little benefit. If they are using it to get a little extra time for ECs, who really cares? I get you might have 1-2 more calls or something across the year, but does that really amount to anything? I don't remember my calls from last year, let alone through all of residency. My advice would be not to take things so seriously, just keep your head down, and finish training, you're almost there.

 

[Logi9]

As a former chief, your chief sounds like a tool, sorry about that. If the other residents all feel the same way then maybe you can all bring it up to the (A)PDs AS A GROUP. They may not give a crap tbh but that’s your best chance at getting change accomplished and not singling yourself out for more BS.

I got really annoyed when people went over my head, but that’s because 100% of the time I told someone “no” to some BS request I had either already run it by the PD or told them I would talk to the PD to try and work something out. If you ran to our PDs office immediately after leaving mine then I just assumed you didn’t really want my help with your extra 3 days of vacation to go on a cruise or whatever silliness

Why did you feel annoyed? I’m curious. Maybe they didn’t feel comfortable to discuss things with you. In reality, though you were a chief you didn’t employee them. I have and would rather discuss things with my pg director. Chiefs didn’t take offense at all.

 

[Logi9]

Hi all,

I apologize for going into a bit of an upcoming rant in advance. I am curious to know if others feel the way that I do and have had similar issues. If you think I'm acting like a brat/child or have nothing nice to say, that's fine. I used to be in general surgery and I can handle criticism. It's an anonymous online message board and if you want to "call me out" or simply want to troll, well that's what people behind computer screens do, have at it.

I am in a small residency program (so as not to identify, I will say it is a ROAD program and leave it at that--radiology, ophthalmology, anesthesia, or dermatology) with a total of 10-15 residents. We have a third and fourth year acting as chiefs, who have been elected by the attendings and residents (there are 10-15 attendings as well, almost equal to the number of residents). They are elected at the end of their second year (running against their other classmates) and become a chief as a rising third year with the already-existing rising fourth year chief.

I have had a few issues with my specific chiefs, as well as the chiefing system in general and again, I'd like people's feedback -- has your experience been similar or do you have similar grievances (or maybe not)? This is mostly to vent, I am well aware that I am not going to change the world here.

With regard to the chief system, I really don't like the idea that two residents have been selected to basically be the boss. Hear me out. I know someone has to do the scheduling, handle vacation requests, etc, and that is not my issue. But at least at our program, every issue has to go through the chief, any complaints, any resident issues. If you go to the PD first, the chiefs get very upset--which kind of encapsulates the problem that I have with them. It is a "how dare you go over my head!" mentality. I feel like the power has gone to their head, i.e. why are you getting all in a tizzy because someone talked to the PD about an issue instead of coming to you first? They take themselves way too seriously. They would tell you they aren't power hungry and probably believe themselves, but there is no reason to be upset over something like that if you aren't, am I right? I don't know why I haven't mentioned this sooner, but my issue with it is, I don't like that two people have been anointed "in charge" and now have the authority to tell of the other residents what to do -- you aren't better than us, you aren't my boss, my attendings (who I work with directly daily) and in particular my program director are. I know, I probably sound like I have oppositional defiant disorder (hooray for me remembering what that is) but seriously, I've never had an issue with authority in my life. I was always respectful with my parents and bosses and I've held jobs in the legal and hospitality industries in the past. One of the points of resentment for me is that I am in my 4th year and I really don't like the concept of a 3rd year telling me what I can and can't do, when just a few months ago when I was a 3rd year resident and he/she was a 2nd year resident, I was considered a more senior resident, they were not a chief, and I was higher in the pecking order so to speak. Now he/she feels very large and in charge, empowered, and I think a major underlying issue is her/him feeling like the alpha dog while I feel that I'm a year older, been here a year longer, and I'm in the senior-most class and should be more alpha. But I digress. Trying to broaden the scope to a wider discussion, regardless of whose side your on, I just feel like this system breeds internal battles and somebody feeling like they can control everyone/everything, and people (in this case) are bound to resent that.

Now you might already be saying to yourself, hmm, I think maybe you have something interpersonal going on between you and a chief(s) and that's the issue at play here. Well, you wouldn't be entirely wrong, and I seek advice in this department as much as your insights. This new chief, the third year, is in charge of scheduling and constantly taking advantage of weaknesses in our system. We technically have a few research weeks that can be taken, but they are almost always used for studying for our boards. When he/she wants a day off, she/he just tells her partner in crime, the other chief, "I'm going to take a research day" with no intention of paying it back--he/she has even told me so, this is not speculation. He/she expects to have just as much time to study as the other residents who never took a research day/week, and he/she knows our program director doesn't want to babysit us and trusts the chiefs to manage the vacation time and scheduling. The latest issue we've run into is him/her giving himself/herself less call weeks and night float weeks than the other residents, even the more senior residents (such as myself a year ahead of him/her) when traditionally it has always been by class and if anyone has fewer weeks, it's always the 4th years. I just received a schedule where he/she has fewer weeks call than all of the senior residents when every year as a junior resident, I took the most call and the seniors had it best. I could go on and on with examples but simply put, this resident is out for himself/herself and is very self-serving when it comes to all of the chiefs duties. They have the authority/power and they are taking full advantage of it, in plain sight because the program director trusts us to govern ourselves. I don't want to be a tattle tale, but I don't see how he/she is going to lay off the throttle--they are getting away with more and more because they are unchecked, and simply put, I have had enough of it. I know rocking the boat is never necessarily the best option, but I also don't see it getting any better. I frankly have no trust in our chief(s) at this point because I know they put themselves first and rather than being impartial and a responsible chief, they are self-serving. I see right through all of the little days off here and there, the less call than everybody else, and the BSing through it if I call him/her out. They don't care who they screw over, as long as they get their way and "get out of" as much work as they can.

Sorry, this is a bit of a winding rant from someone who is tired physically and tired of this system in more ways than one. Feel free to share your own stories, feedback, advice, or what have you. It sickens me to think that this chief is so highly regarded by the attendings because he/she has projects going on and is a brown-noser.

Simply put...Karma is quick and real. Let them learn the hard way. With power comes great responsibility. All to often ppl can get appointed to things at work and then assume they have all these other wonderful qualities that they don’t in fact have. Personal growth does not stop in residency. Across the board, ppl get promoted to supervising others and are horrible at it- and hate it. Rising to the level of their incompetence.
I would watch the situation and hang onto to people you trust. If you don’t feel comfortable to go to the chief and would rather discuss with a head doc then so be it.

 

[HemeOncHopeful19]

Why did you feel annoyed? I’m curious. Maybe they didn’t feel comfortable to discuss things with you. In reality, though you were a chief you didn’t employee them. I have and would rather discuss things with my pg director. Chiefs didn’t take offense at all.

I would never get annoyed at going to the PD if they didn’t feel comfortable discussing with me. I would get annoyed if they discussed it with me and I said “yeah I don’t think we can do this but I will talk to [PD] this week and get back to you next week,” and then 15 minutes later PD comes by the office and let’s me know they just met with the resident and told them “yeah I don’t think we can do this but I’ll check with the chiefs.” The residents always conveniently left out that they had just talked to me and it came off like trying to play dad against mom. 95% of residents never did this but the 5% that did would do it all the time.

I would estimate about ~75% of requests were “can I have extra vacation” or “can you make someone else work my shift for me” for mostly ridiculous reasons. You really can’t imagine the kinda crap some of your peers try to pull if you’re an average/good resident IMO. To stay on topic, I would file “making the schedule and giving myself less weeks of call/night float than my peers” in that category.

 

[operaman]

Sorry you got a crap one. Chiefs should strive for basic fairness and traditionally should be the ones falling on the sword when suckage happens.

1) get data. Quantify the exact numbers with respect to call schedule. Generalities don’t mean much. Get schedules from past years and do the math so you have real data for how outside the norm this is.

2) if data shows actual major issue, then share that hard data with the 4th year chief. Identify any other similarly hosed seniors and get them on board too. Present a unified front.

3) if other Chief hasn’t addressed it, then take it to your PD. Hard data is hard to ignore. If the swing is that dramatic then it will be impressive.

4) if the numbers when written out aren’t all that bad(ie. You have 43 calls when traditionally 4th years have 42) then suck it up and move on. If it’s egregious then the basic principles of fairness should carry the day.

 

[Mass Effect]

I would never get annoyed at going to the PD if they didn’t feel comfortable discussing with me. I would get annoyed if they discussed it with me and I said “yeah I don’t think we can do this but I will talk to [PD] this week and get back to you next week,” and then 15 minutes later PD comes by the office and let’s me know they just met with the resident and told them “yeah I don’t think we can do this but I’ll check with the chiefs.” The residents always conveniently left out that they had just talked to me and it came off like trying to play dad against mom. 95% of residents never did this but the 5% that did would do it all the time.

I would estimate about ~75% of requests were “can I have extra vacation” or “can you make someone else work my shift for me” for mostly ridiculous reasons. You really can’t imagine the kinda crap some of your peers try to pull if you’re an average/good resident IMO. To stay on topic, I would file “making the schedule and giving myself less weeks of call/night float than my peers” in that category.

This exactly. Right before my chief year, the outgoing chief warned me of this, that residents will try to outwit the protocol to get what they want or play people against each other - PD against the chiefs, the chiefs against PD, chief against chief, etc. I didn't believe it because who does such a thing after age 10 with their own parents? But something about residency causes psychological regression in some folks and this really does happen. I would never be offended by a resident going to the PD or attending over me as chief. Who cares? One less hassle for me (unless, as is the case with the OP, that's the protocol for everyone; sometimes that's how the PD wants it). But I will get annoyed with residents who play games. You're an adult in an adult workplace. Time to grow up and realize there's a way we do things. If you don't like the way we do things, that's fine, say so. But don't circumvent it because you can't wait a week to find out if your vacay was approved.

 

[chocomorsel]

It sounds like the issue isn't with the system, but with the fact that the third year is an ass. This wouldn't be a problem if he wasn't abusing his power, but he is, and chances are that trying to change that would result in more trouble than it's worth.

As you know, some people in medicine are jerks, and sometimes you wind up having one who gets to tell you what to do. Just suck it up and get through this final year.

I disagree. I think you all should get together and go to the PD with the schedule in hand. That is if you trust the PD to be fair and intervene.
Total BS. What the hell is the point of a 3rd year Chief anyway?

 

[Frazier]

Sorry about your experience.

I was a chief resident and our role was basically to function as advocates for our co-residents.
...in addition to making the schedule/replacements/vacation/interviewing/extra lectures and other admin things.

I wish you had a better draw this time around.

I will say that is rather bizarre to have someone junior be the chief to someone senior (i.e. a pgy2 chief for pgy3's, or pgy3 for pgy4's). In the world of residency, I could see that causing a lot of unnecessary awkwardness and upset.

 

[drosophilamelanogaster]

I appreciate everyone's thoughtful replies and feedback. The fact you took the time to think about it and consider how you feel and spend a moment to share, I am grateful. For those of you who have given me criticism, know that I take it in stride and you provide a different perspective that I may not have considered and can consider in the future, so thank you for that; no hard feelings. For those of you who have been supportive, also appreciated equally. "guytakingboards," your post pretty much was spot on in every possible way. Man, I feel like I would go to you for advice for nearly anything. Your post pretty much just had me saying "THIS!"

As for why there are third year chiefs, i do not know, the system long pre-dates me. The best assumption I can make is so that "there is continuity of leadership" so when the 4th year graduates, the 3rd year moves up to the 4th year chief role and can be the more senior chief for the newbie. Personally, as has been mentioned by a few of you, I think the chiefs should just be the senior class. It eliminates the competition of receiving the role (we are 3-4 residents per class, and I can tell you me and my other colleague were disappointed that we lost to our third colleague, and I'm sure that's common) but it also eliminates the 3rd year chief vs. fourth year resident battle that I'm currently dealing with.

 

[Logi9]

This exactly. Right before my chief year, the outgoing chief warned me of this, that residents will try to outwit the protocol to get what they want or play people against each other - PD against the chiefs, the chiefs against PD, chief against chief, etc. I didn't believe it because who does such a thing after age 10 with their own parents? But something about residency causes psychological regression in some folks and this really does happen. I would never be offended by a resident going to the PD or attending over me as chief. Who cares? One less hassle for me (unless, as is the case with the OP, that's the protocol for everyone; sometimes that's how the PD wants it). But I will get annoyed with residents who play games. You're an adult in an adult workplace. Time to grow up and realize there's a way we do things. If you don't like the way we do things, that's fine, say so. But don't circumvent it because you can't wait a week to find out if your vacay was approved.

Regression goes both ways. As a chief are you not playing a game to some extent? vacation aside, it can’t give others the right to be difficult or have power struggles with other residents . Its more then just petty requests.

 

[FrkyBgStok]

glad you got it figured out but definitely gotta nip that in the bud early. I am currently a pediatric fellow and have to do some rotations on the adult side of my specialty. I have no problem asking a PGY-2 for help for an adult problem I haven't seen since medical school, but don't get it twisted and try to give me your scut work. that isn't how this is going to work.

 

[Mass Effect]

Regression goes both ways. As a chief are you not playing a game to some extent? vacation aside, it can’t give others the right to be difficult or have power struggles with other residents . Its more then just petty requests.

The game players don't usually become chief in my experience. There are bad chiefs out there certainly, but more often than not, they're the ones who are totally uninvolved and enjoying senioritis. The situation the OP is in is rare, not only because of a third year chief but also because most chiefs don't pull such shenanigans in my experience.

 

[SirGecko]

As for why there are third year chiefs, i do not know, the system long pre-dates me. The best assumption I can make is so that "there is continuity of leadership" so when the 4th year graduates, the 3rd year moves up to the 4th year chief role and can be the more senior chief for the newbie. Personally, as has been mentioned by a few of you, I think the chiefs should just be the senior class. It eliminates the competition of receiving the role (we are 3-4 residents per class, and I can tell you me and my other colleague were disappointed that we lost to our third colleague, and I'm sure that's common) but it also eliminates the 3rd year chief vs. fourth year resident battle that I'm currently dealing with.

It’s competitive in your program to be selected as chief? I’m in a similar sized rads program and we vote and all but I’ve never seen anyone bent out of shape at not being chief. The vibe is closer to “who doesn’t want to do this the least”.

That said we have two fourth years not a third and a fourth year and we make the schedule for the full year ahead of time so not a lot of room for someone to do shenanigans. Maybe that’s part of the solution to your issue? You guys make the full year schedule and you can pretty much gauruntee it’s equitable before you start.

 

[Dr.LeoSpaceman]

The game players don't usually become chief in my experience.

Usually not, but this is another flaw on the described selection system. When the PD either picks or has veto authority, they can usually avoid the people out for glory because they usually have a broader sense for these things. But when everyone is voting, and the faculty have a similar number of votes, it's certainly possible someone could Eddie Haskell their way in.

 

[hallowmann]

It’s competitive in your program to be selected as chief? I’m in a similar sized rads program and we vote and all but I’ve never seen anyone bent out of shape at not being chief. The vibe is closer to “who doesn’t want to do this the least”.

That said we have two fourth years not a third and a fourth year and we make the schedule for the full year ahead of time so not a lot of room for someone to do shenanigans. Maybe that’s part of the solution to your issue? You guys make the full year schedule and you can pretty much gauruntee it’s equitable before you start.

The bolded is ultimately what we do. I'm co-chief to a class above me, but I have 0 impact on their call/rotation schedules because it was already done before I was co-chief. That's ultimately how we've always done it, by virtue of the rotation load in the final year of training compared to the second to last year, its always made sense for our year to be when people are chiefs. I'm involved in approving vacation time, but I'm one of like 6 people involved in that including the PD and APD. I've been fortunate not to have to "govern" over the final year residents, because like I said, they're on a track and things are already scheduled. Plus by then, most people aren't trying to "pull fast ones", they're just trying to get done.

 

[TonsilPlucker]

Not sure if this is the case but a lot of times the chiefs are there so that the PD's/attendings aren't bombarded with residency drama/issues.

It also helps as a buffer so that certain things are handled on a resident-resident level and not to the PD, where it often times gets placed into permanent record.

In terms of the personality of the chief, it sucks but as others have said, they can always hurt you but they can't stop time!

 

[reggiano]

Last year, my program's admin chief played favorites and abused her admin chief power. But of course her friends in the program (who happened to benefit schedule-wise) are convinced she is the best admin chief ever... The funny thing is, she is now slated to become an attending at my program... so holy f*** the universe just never stops giving. In short, I feel your pain. I am sorry.

 

[NuttyEngDude]

Invariably every year at my program, I've seen the new chiefs flex their muscle at first. But after a few months of resident drama and hospital politics, they sort of get beaten down and leave you and the schedule alone. Whatever damage they do in the beginning when they set the schedule remains but you can be rest assured that the rest fixes itself.

 

[j4pac]

Chain of command is a really important concept in the military. I would always show respect toward my senior enlisted but make no mistake about it...only someone your own rank or higher can effectively be your chain of command.

I’d go to your 4th year chief. That’s the next appropriate guy in line. If the 4th year chief says they’ll talk to the PD, I’d ask when to give yourself a good follow-up time and to see if it is reasonable. If the 4th year chief can’t get the job done, I’d let that person know that I will be going to the PD, not to complain about the chiefs, but to get something done.

Unless I know that the 3rd year chief is a really good guy/gal with less work...I would let him/her tend to the juniors.

 

[Matthew9Thirtyfive]

Chain of command is a really important concept in the military. I would always show respect toward my senior enlisted but make no mistake about it...only someone your own rank or higher can effectively be your chain of command.

Not to belabor the metaphor, but positional authority is a thing. It’s how a LT physician can give orders to a CDR nurse, how an E-3 armorer or an E-6 RSO can give orders to a CAPT in the armory or at the range.

Or a more apropos example would be the watchbill coordinator who is usually an E-6, who is creating the watch rotations for everyone, including the officers.

So while the third year might not technically be of the same “rank,” if they are holding the position of chief resident (and not like a chief resident U/I or something) then they would have positional authority just like I had positional authority back when I was a junior enlisted duty armorer, SAMI, etc.

But that’s all kind of pedantic. If there is a 3rd year is a dick, just go to the 4th year lol.

 

[j4pac]

Not to belabor the metaphor, but positional authority is a thing. It’s how a LT physician can give orders to a CDR nurse, how an E-3 armorer or an E-6 RSO can give orders to a CAPT in the armory or at the range.

Or a more apropos example would be the watchbill coordinator who is usually an E-6, who is creating the watch rotations for everyone, including the officers.

So while the third year might not technically be of the same “rank,” if they are holding the position of chief resident (and not like a chief resident U/I or something) then they would have positional authority just like I had positional authority back when I was a junior enlisted duty armorer, SAMI, etc.

But that’s all kind of pedantic. If there is a 3rd year is a dick, just go to the 4th year lol.

You do have a point. But when I was a lowly LT baby doc you better believe I showed respect to my nurse LCDRs. Otherwise I’d completely expect to be squashed. A jerk PGY-3 “chief” should expect exactly the same if they are dicking a PGY-4.