What's the benefit of being Chief Resident in IM?

[Aclamity]

Is it a resume booster? Does it improve your chances of getting an attending slot in the hospital you're at? The Chief Residents at my hospital seem to do a lot of work, but get paid the same as any other resident, when they could very well be out making real dough as an attending. There must be some reason they opt for an extra year

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[Perrotfish]

Is it a resume booster? Does it improve your chances of getting an attending slot in the hospital you're at? The Chief Residents at my hospital seem to do a lot of work, but get paid the same as any other resident, when they could very well be out making real dough as an attending. There must be some reason they opt for an extra year

Enormous resume booster for competitive fellowships. Also when chief residents are staff they should get paid more than the rest of the residents.

 

[swamprat]

Enormous resume booster for competitive fellowships. Also when chief residents are staff they should get paid more than the rest of the residents.

Rlly? Enough to make it so competitive fellowships wouldn't want u otherwise ?(kinda like step 1 score and certain fields).. cause idk I feel like taking on an extra year of low pay with no further advancement to ur ultimate goal seems like a rlly big waste of time unless its absolutely necessary to get lets say cards or gi or something..

 

[ArcGurren]

Rlly? Enough to make it so competitive fellowships wouldn't want u otherwise ?(kinda like step 1 score and certain fields).. cause idk I feel like taking on an extra year of low pay with no further advancement to ur ultimate goal seems like a rlly big waste of time unless its absolutely necessary to get lets say cards or gi or something..

GI very frequently requires you to do either hospitalist, hepatology, or chief year in order to get in because of how competitive it is (almost, not always). Cards doesn't always require it and is usually more reasonable but very frequently a chief year can boost your chances of getting into cards. Also keep in mind that, just as with residency, some fellowship programs are a LOT better than others, and in cardiology, typically people don't just stay as general noninvasive cardiologists - they'll go into interventional or EP. Getting into an even better cards program is sometimes worth the extra chief year.

Also, cards and GI are the most competitive overall, but many of the "less competitive" fellowships have different tiers of competitiveness within the fellowships - especially heme/onc, critical care, and ID. Some programs are far and above better than others.

For what it's worth, I've been to programs where of, say, 5 chiefs, 3 were planning to go into a hospitalist career. They didn't want to dive right into it and were basically getting paid while having a relatively low workload* compared to clinical duties, all the while being able to apply for jobs, go and interview, got more time to study for the IM boards, and catch up on family raising and all that good stuff. It also teaches a LOT about hospital management, managing a team, and generally being a "boss", which is something you don't get a lot of training or education about during medical school. One chief I talked to wanted to do it because he wanted to join a teaching institution and ultimately do a lot of administrative stuff, teaching, etc. and it made sense to agree to doing a chief year.

*(Not to say that a chief year isn't a lot of hard work otherwise, just different kind of work)

 

[swamprat]

GI very frequently requires you to do either hospitalist, hepatology, or chief year in order to get in because of how competitive it is (almost, not always). Cards doesn't always require it and is usually more reasonable but very frequently a chief year can boost your chances of getting into cards. Also keep in mind that, just as with residency, some fellowship programs are a LOT better than others, and in cardiology, typically people don't just stay as general noninvasive cardiologists - they'll go into interventional or EP. Getting into an even better cards program is sometimes worth the extra chief year.

Also, cards and GI are the most competitive overall, but many of the "less competitive" fellowships have different tiers of competitiveness within the fellowships - especially heme/onc, critical care, and ID. Some programs are far and above better than others.

For what it's worth, I've been to programs where of, say, 5 chiefs, 3 were planning to go into a hospitalist career. They didn't want to dive right into it and were basically getting paid while having a relatively low workload* compared to clinical duties, all the while being able to apply for jobs, go and interview, got more time to study for the IM boards, and catch up on family raising and all that good stuff. It also teaches a LOT about hospital management, managing a team, and generally being a "boss", which is something you don't get a lot of training or education about during medical school. One chief I talked to wanted to do it because he wanted to join a teaching institution and ultimately do a lot of administrative stuff, teaching, etc. and it made sense to agree to doing a chief year.

*(Not to say that a chief year isn't a lot of hard work otherwise, just different kind of work)

Ohhh ok cool thanks that makes sense.

 

[Socrates25]

I was a peds chief which is pretty similar to IM.

I think it makes a HUGE difference for fellowship if you want to stay at your home facility and there are lots of other people gunning for it. Probably doesnt make as much of a difference at outside fellowships, but I think it still helps some. You get to deal with attendings, department chairs in all kinds of social/administrative settings that no ordinary resident ever gets to do.

Chief residents get to work DIRECTLY with people like the department chair, and there are opportunities for working with the medical school dean and hospital CEO if you work the angles right. That can help open up a lot of connections.

The downside is that you have to deal with a bunch of whiny, complaining residents. It is a pain in the ass when you have some fool complain because he was put on call for one more time that month than somebody else was.

 

[Socrates25]

Enormous resume booster for competitive fellowships. Also when chief residents are staff they should get paid more than the rest of the residents.

I agree, i've never heard of an IM/peds chief resident getting paid the same as the rest of the residents. That is ridiculous. I got paid about double a resident's salary.

Surgery does it, but only because everyone is a "chief" and therefore its pretty irrelevant.

 

[duckie99]

GI very frequently requires you to do either hospitalist, hepatology, or chief year in order to get in because of how competitive it is (almost, not always). Cards doesn't always require it and is usually more reasonable but very frequently a chief year can boost your chances of getting into cards. Also keep in mind that, just as with residency, some fellowship programs are a LOT better than others, and in cardiology, typically people don't just stay as general noninvasive cardiologists - they'll go into interventional or EP. Getting into an even better cards program is sometimes worth the extra chief year.

Also, cards and GI are the most competitive overall, but many of the "less competitive" fellowships have different tiers of competitiveness within the fellowships - especially heme/onc, critical care, and ID. Some programs are far and above better than others.

For what it's worth, I've been to programs where of, say, 5 chiefs, 3 were planning to go into a hospitalist career. They didn't want to dive right into it and were basically getting paid while having a relatively low workload* compared to clinical duties, all the while being able to apply for jobs, go and interview, got more time to study for the IM boards, and catch up on family raising and all that good stuff. It also teaches a LOT about hospital management, managing a team, and generally being a "boss", which is something you don't get a lot of training or education about during medical school. One chief I talked to wanted to do it because he wanted to join a teaching institution and ultimately do a lot of administrative stuff, teaching, etc. and it made sense to agree to doing a chief year.

*(Not to say that a chief year isn't a lot of hard work otherwise, just different kind of work)

I don't know the ins and outs of fellowship selection but obviously it is not required for a prospective fellow to be a chief for a year. I think at high end institutions the chief year is a resume builder that gives you a huge leg up since during the chief year you'll probably have some time for research as well. So for a smaller field like GI a chief year plus more research would be a tremendous help even for already good applicants.

I do know it is not required for cards. There are almost 500 cards spots nationwide... At my home program only one person going cards was chief the year before. I think for an otherwise below average applicant a chief year is a huge help. But if you're a good applicant you can probably get a spot (>90% match rate for US grads).

Oh and heme/onc match rate was around 85% (US grads).

 

[Socrates25]

I don't know the ins and outs of fellowship selection but obviously it is not required for a prospective fellow to be a chief for a year. I think at high end institutions the chief year is a resume builder that gives you a huge leg up since during the chief year you'll probably have some time for research as well.

Research time is part of it, but I think the biggest resume "booster" is the personal connections.

For example, when I was chief I got to work one on one with the department chair almost daily for a 4-5 week period for a big project (non-research) and even outside of that time I met with him at least once a week.

I also got to meet at least once a month with the hospital exec committees including the CEO and the dean of the medical school.

You dont get that kind of exposure as a resident.

Our department chairman writes letters for a lot of people (including residents) based on request, but there's a HUGE difference in what he says in those letters which makes a difference in fellowship matching.

 

[ArcGurren]

I don't know the ins and outs of fellowship selection but obviously it is not required for a prospective fellow to be a chief for a year. I think at high end institutions the chief year is a resume builder that gives you a huge leg up since during the chief year you'll probably have some time for research as well. So for a smaller field like GI a chief year plus more research would be a tremendous help even for already good applicants.

I do know it is not required for cards. There are almost 500 cards spots nationwide... At my home program only one person going cards was chief the year before. I think for an otherwise below average applicant a chief year is a huge help. But if you're a good applicant you can probably get a spot (>90% match rate for US grads).

Oh and heme/onc match rate was around 85% (US grads).

Yea definitely for cards it's not as necessary, but definitely for GI given how much lower the match rate is compared to cards.

I'm not sure if I'd want to be a chief, but it doesn't seem too bad overall (the good outweighs the bad at least).

 

[OveractiveBrain]

Is it a resume booster? Does it improve your chances of getting an attending slot in the hospital you're at? The Chief Residents at my hospital seem to do a lot of work, but get paid the same as any other resident, when they could very well be out making real dough as an attending. There must be some reason they opt for an extra year

People who do a chief year to "get a fellowship" are doing it because they didn't get in the first time around through normal applications, and, more than likely, they have already secured a spot THE FOLLOWING YEAR outside of the match and need something to do.

Chief Resident is an opportunity to learn the ins and outs of residency administration. It is best if the intended career path is academics or administration. It looks good if you want to be a private hospitalist, and eventually want a leadership position (chief of service, CEO, program director). It looks good if you want to be an academic, and run something (clerkship director, program director, department chair, dean).

Some people do it because it keeps them in the same city while their significant other finishes what they are doing.

Some people do it because they legitimately want the future residents in the program to be exceptional, and are staying to make sure that everyone gets a fair shot vacation and rotations, and are willing to take time out of their lives to actually educate.

There is also the prestige associated with being chosen. To be chief satisfies the internal motivation of success, of being recognized for your excellence, since (most of the time) you must be elected to the position.

The career benefit is actually quite minimal, except for specific directed paths listed above. Generally, its the more academic people that go into a chief spot.

 

[OveractiveBrain]

I don't know the ins and outs of fellowship selection but obviously it is not required for a prospective fellow to be a chief for a year. I think at high end institutions the chief year is a resume builder that gives you a huge leg up since during the chief year you'll probably have some time for research as well. So for a smaller field like GI a chief year plus more research would be a tremendous help even for already good applicants.

I do know it is not required for cards. There are almost 500 cards spots nationwide... At my home program only one person going cards was chief the year before. I think for an otherwise below average applicant a chief year is a huge help. But if you're a good applicant you can probably get a spot (>90% match rate for US grads).

Oh and heme/onc match rate was around 85% (US grads).

You get a fellowship spot by doing research with your department, getting in good with your fellowship's program director, getting excellent letters, and meeting people at conferences and meetings. There is absolutely no requirement to do a hospitalist year or a chief year to secure a fellowship position. Most of the time, if people choose to do a chief year, they delay their fellowship to do the chief year, not the other way around (doing a chief year to get a fellowship spot).

 

[Aclamity]

People who do a chief year to "get a fellowship" are doing it because they didn't get in the first time around through normal applications, and, more than likely, they have already secured a spot THE FOLLOWING YEAR outside of the match and need something to do.

Chief Resident is an opportunity to learn the ins and outs of residency administration. It is best if the intended career path is academics or administration. It looks good if you want to be a private hospitalist, and eventually want a leadership position (chief of service, CEO, program director). It looks good if you want to be an academic, and run something (clerkship director, program director, department chair, dean).

Some people do it because it keeps them in the same city while their significant other finishes what they are doing.

Some people do it because they legitimately want the future residents in the program to be exceptional, and are staying to make sure that everyone gets a fair shot vacation and rotations, and are willing to take time out of their lives to actually educate.

There is also the prestige associated with being chosen. To be chief satisfies the internal motivation of success, of being recognized for your excellence, since (most of the time) you must be elected to the position.

The career benefit is actually quite minimal, except for specific directed paths listed above. Generally, its the more academic people that go into a chief spot.

Thanks for the excellent post, OveractiveBrain! The bolded portion was what I was originally wondering about, because it just seems like they do so much more work than the other residents (or maybe it's just at my hospital). The 6 of them all seem quite smart and none are going for competitive fellowships (e.g. at least 2 of them are entering geriatrics), so I can't imagine them NOT matching into a fellowship

 

[ArcGurren]

You get a fellowship spot by doing research with your department, getting in good with your fellowship's program director, getting excellent letters, and meeting people at conferences and meetings. There is absolutely no requirement to do a hospitalist year or a chief year to secure a fellowship position. Most of the time, if people choose to do a chief year, they delay their fellowship to do the chief year, not the other way around (doing a chief year to get a fellowship spot).

I'm sure it's not a *requirement* per se but nearly every GI fellow I've met has been either a chief or hospitalist at some point in order to try and make themselves more competitive. The match rate is definitely a lot lower than most other residencies from what I've seen.