Discussion in 'General Residency Issues' started by TXDO, May 6, 2009.
What is the Chief Resident? and How is one elected?
It depends on the residency.
In IM or Pediatrics the Chief Residents are selected, usually from the second year class, by the program director. They stay an extra year after graduation and perform additional teaching and administrative duties related to the residency program.
I believe that in Surgery and Ob/Gyn the Chief Residents are selected from the best senior residents in the program, but they do not do an extra year.
The selection factors are generally above average in-service exam scores and notable performance as a resident.
In Surgery, as far as I have experienced, every 5th year resident was a chief of whatever service they were on. A few were administrative chiefs who made schedules and organized, and they were selected by the PD and Chairman, people like that. This is announced in like the fall of the 4th year (so the chiefs for the following year). This helps for fellowships that have 4th year appointments as there is prestigue involved in being a chief. My program has 7 residents/yr though, and 3 administrative chiefs this coming year. Places that have like 2-3 residents/yr, all pretty much act as the administrative chief I would believe. Another place i rotated had 5 residents with 1 administrative chief and 1 other titled chief, I forget what exactly.
For Peds, IM, FM, the chief resident is one additional year that you apply for and then is selected by PD, Chairman. I don't know how many residents are in the medicine residency, but I know that they select 6 people to be chiefs (we have 3 hospitals they rotate through, and 2 chiefs per hospital including a VA, university hospital, and private hospital) I know at my host program, the Medicine Chiefs are selected during the 2nd year (so current 2nd year medicine residents know who will be chief resident for 2010-2011 year already) which makes sense because that is when many apply for fellowship and those wanting fellowship might not want to be a chief resident (although one big advantage of being a chief is it looks good on fellowship apps and for academic placements post fellowship).
Thank you for your post. I understood now.
In surgery, all final year residents are considered Chief residents. They are not elected nor do they spend an extra year. On some services, the 4th year resident may serve as Chief, but isn't really a "Chief" resident.
There may be an Administrative Chief, who does the schedule, etc. for some small pittance extra or they may divide the duties.
There is no prestige in being a Chief resident as a surgery resident, and it does not help with fellowship matching, as everyone does it. The Administrative Chief position is not prestigious - it is generally chosen to be the resident who can be bullied into it.
How to be a chief resident depends entirely on each individual program.
Some are chosen by the program director
Some are elected by their peers
Some are bullied into it
Some are chief if they are the senior most resident(s)
and in my residency program, the chief resident rotates on a monthly basis during my last year of residency. So everyone in my residency class will be "chief" for a month.
I can't imagine who would want the job of chief at a busy residency like mine. I think the administrative crap of medicine is the absolute worst part. Going to committee meetings, managing schedules, calling in lunch orders for every random event - I sure didn't go into medicine for that.
Plus, as a chief, all the attendings and administration complain to you about the residents, and the residents complain back at you. It's career suicide not to cater to the program's every whim, but the residents will still see it as betrayal when you're forced to crap on them.
Of course the perks are a near-attending salary for a (mostly) good schedule of 9-5 work. Not worth it in my opinion, but some people can't get enough of this kind of thing.
For IM the chief thing is basically as described above.
At our program, they were chosen early in 2nd year, and basically it's based on some combination of probably in service exam scores + how much the PD likes you. There is no application and the house staff are not asked for any input about this. The process by which the chiefs are chosen is completely nebulous...but I assume the PD and chair, with probable input from other attendings, do the choosing. At some IM programs the PD takes applications from residents who want to be a chief, and at some programs the other house staff also have some input into who is chosen (which I actually think would be a good thing). At our program, the IM chiefs make the schedule, and since they've completed residency already, they also serve for several months as an attending on inpatient services.
Agreed. Being Chief can be a real pain in the *****.
I thought this was only my program. Here's the "privilege" of doing extra work for basically no extra pay...sucker.
Fellowships should screen candidates out of the process based upon whether or not they were administrative chief. Unless they're looking for a whipping boy.
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