Would someone explain Chief Resident to me?

[asunshine]

What do they do? Doesn't sound like a lot of patient care....just managing the residents and other administrative duties. Do they get paid like a resident, too? Who picks them? Why would you want this job if you could be starting your fellowship or practice? 😕

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[MinnyGophers]

I am not quite sure so dont jump at me, but I believe chief residency is offered to the best senior resident, meaning you sill are in your last year of residency.

 

[Captain Fantastic]

Chief depends on the program. In some programs, as you mention, the chiefs are residents who didn't match into a fellowship and are sticking around another year boosting their application so they'll (hopefully) match the next time. Other programs the chief is an outstanding last year resident who is selected to take on an administrative role for a few months -- basically replacing elective rotations with administrative ones.

Chiefs are picked by the residency program director -- often in conjunction with the department chair.

What do they do? It depends on when you're the chief. They all manage the jeapardy pool (if you get sick, you call the chief and he pulls in the jeapardy resident to cover for you). They field complaints from residents about other residents and from nurses about residents. Some will make next years rotation and vacation shedule for all the residents. Basically you are the program directors little helper and get to be on the front lines of all the BS involved with managing a group of doctors. This can be a resume booster in and of itself -- managing doctors is somewhat like herding cats.

 

[LizzyM]

The chief resident (some times there are several who work as a team), do administrative tasks such as scheduling the residents (on-call, vacation, etc), some supervision/teaching of the more junior trainees, and patient care. It is the top of the residency pyramid after which one goes into private practice, or on to a fellowship. It is a preliminary test of one's administrative skills and a plus for those interested in a leadership position in academic medicine).

 

[gujuDoc]

The chief resident (some times there are several who work as a team), do administrative tasks such as scheduling the residents (on-call, vacation, etc), some supervision/teaching of the more junior trainees, and patient care. It is the top of the residency pyramid after which one goes into private practice, or on to a fellowship. It is a preliminary test of one's administrative skills and a plus for those interested in a leadership position in academic medicine).

I don't know specifics beyond what she quoted above and just informed us. However, the neurologist I shadowed was the chief resident at USF at the time. I believe her position allowed her to attend and present at certain conferences that the other residents didn't have, and that they chose residents based on who they felt was like the most knowedgable and seemed to really really really be the best of the best of their residents for that year. Don't take my word because I am not sure, but that is the impression I got. I also got the impression they choose the senior resident to be the best from the last year residents, meaning that if residency is 4 years, it would be the most qualified 4th year resident each year.

the chief resident I shadowed was very very very good and had been an internist in her own country before doing residency in neurology here at USF. She is now a non teaching faculty member of the USF Neurology Department and was hired on with USF because she was extremely good at what she did. I believe her other colleagues who I observed went on to do private practice. The indian doctor who I shadowed probably ended up joining her hubby who was also a neurologist.

 

[Captain Fantastic]

I also got the impression they choose the senior resident to be the best from the last year residents, meaning that if residency is 4 years, it would be the most qualified 4th year resident each year.

This is very program dependent. Examples: here the Peds chiefs work just as you describe -- best of the last year. Compare that with the IM chiefs, whom have all finished their residencies and are hanging around boosting their apps because they didn't match into a fellowship last year. This is two very different methods of selecting chiefs at the same hospital/medical school.

Boiled down, the program director decides how chiefs will be selected and that can vary from program to program even with in specialties.

 

[albaniandoc]

Two of our anesthesiologists that join the group a couple years ago finished their residency at USF. They shared chief resident duties their last year of residency. They managed the OR boards, managed schedules and helped around when needed. Pretty much what LizzyM said.

 

[gujuDoc]

This is very program dependent. Examples: here the Peds chiefs work just as you describe -- best of the last year. Compare that with the IM chiefs, whom have all finished their residencies and are hanging around boosting their apps because they didn't match into a fellowship last year. This is two very different methods of selecting chiefs at the same hospital/medical school.

Boiled down, the program director decides how chiefs will be selected and that can vary from program to program even with in specialties.

I see!!! Yeah I think the neurology program at USF was like the Peds program you are describing. But then that's just the general impression I got. I don't know any specific details about those sort of things.

 

[cgscribe]

None of us is residents (I don't think), so I don't know if we'll hit the nail on the head. But, from what I hear, our suggestions are right. Usually it's who faculty/chair feel is the best resident. But, sometimes the Chief status is granted to all residents in the final year (often something uber-competitive like Neurosurgery, where's there's only a couple anyways). They act as a liason between residents and attendings, do a lot of scheduling and other management duties. Great resume booster for sure.

 

[A Tree]

Also sometimes they get an additional $10K or so for the time spent on admin activities. It seems to me sometimes the administrative responsibilities are a separate position, but it's often the chiefs that are the ones that hold those positions (for instance someone has the job of scheduling calls for their second and third years and also ends up as a chief during their final year).

Some programs might also require that all of their residents, not just the chiefs, spend a month running a given service during their last year.

 

[njbmd]

What do they do? Doesn't sound like a lot of patient care....just managing the residents and other administrative duties. Do they get paid like a resident, too? Who picks them? Why would you want this job if you could be starting your fellowship or practice? 😕

In surgery, the Chief resident is a PGY-5. This is the last year of residency and these folks generally manage the major services and the administration of the residency program. They do LOADs of patient care and management too.

The PGY-4s are also chiefs or their respective services but not of the residency programs. They are usually referred to as Assistant Chief Residents.

The PGY-3s may or may not be chiefs on a service. Some services only require a PGY-3 chief while others require a PGY-4 or PGY-5 chief. PGY-3 are considered mid-levels.

PGY-1s and PGY-2s are considered junior residents and still fairly early in their training. They are usually not the most senior residents on any service though they can be the only junior resident on a service with a fellow.

In some residency programs like Peds and Medicine, the Chief Resident is a selected and higher paid position offered to a person who has completed the residency program. Often this person will do the administrative running of the residency program. Surgery does not use this type of system. If you make it to PGY-5,you are automatically a Chief Resident and are paid at the PGY-5 level. When you are done, you go onto fellowship or practice.

In some residencies like Anesthesia, Family Medicine, the chief resident is selected or elected and again, is paid at the PG level that they have attained. In the case of Anesthesia, it is the PGY-4 level (CA-3) and in the case of Family Medicine (PGY-3 level).

 

[stinastina]

All of the above posts are great. I would just add or reinforce that it should be considered a position of prestige because hopefully the program director is picking the best. Also, they are generally paid just short of a junior faculty member and twice a smuch as your last year of residency.

 

[asunshine]

Thanks, everyone. No wonder I was confused. It sounds like there are a lot of different ways it's done. My hospital has an IM residency, so it must be like what njb described. 👍

 

[AmoryBlaine]

Esp for IM it's considered a "stepping stone" into academics. So if a person wants to climb the ladder of an academic medicine department doing a chief year is a good gig. At my home institution (in the paraphrased words of the PD) it's the department's way of saying "this was one of the best residents we had and we want them around for another year."

 

[colbgw02]

Forgive the redundancy; I didn't read every word of every post.

Being a chief resident depends, first and foremost, on the specialty.

In shorter residencies, like pediatrics and internal medicine, being the chief resident is a coveted position for most folks because it often indicates the highest level of confidence that a program can place in a person. These chiefs have finished their residency and are either board eligible or board certified. As such, they are qualified to attend on general medicine/pediatrics teams, etc., etc., etc. Even though these folks are delaying their training or passing up a year making the big bucks, very few turn down the opportunity. Also, many of these folks have already matched into fellowships, and the fellowships - who recognize the prestige of the position - will gladly allow them to defer for a year.

Then there are the longer residencies, like surgery, radiology, or OB/GYN. Tacking on an extra year of "residency" for these specialties is considered unbearable, so the chief resident is simply a senior level resident. Plus, these residencies are often smaller in size, so there may not be a need for a designated full-time chief. Compare that to a big IM department that may have 50 residents plus medical students. At many programs, the duties of the chief rotate throughout the year, so to not place an undue administrative burden on a single person who is still preparing for the boards. At other programs, all of the senior residents were known as chiefs; I've even know a general surgery program where all 4th and 5th year residents were called chiefs.

Clear as mud?