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Med Student Mentor: The Advantages and Disadvantages of Being a Chief Resident

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Med Student Mentor: The Advantages and Disadvantages of Being a Chief Resident

Feb 20, 2015
What do chief residents do and what are their roles on the medical team? If you’re considering whether or not becoming a chief resident is the right fit, the Residency Program Director for Internal Medicine at the University of Utah has some advice for you. Med Student Mentor Natasha Kwendakwema talks to Dr. Caroline Milne about the responsibilities, benefits, and also gets some tips on how medical students can prepare themselves to become a chief resident.

Episode Transcript

Interviewer: So you've all heard of chief residents, but what do you really know about them? What do they do, and what's their role in the medical team? And how do you decide if you want to be one? Find out next on The Scope.

Announcer: Navigating your way through med school can be tough. Wouldn't it be great if you had a mentor to help you out? Well, whether you're first year or fourth year, we've got you covered. The Med Student Mentor is on The Scope.

Interviewer: So you're considering becoming chief resident, but you're not sure if it's the right fit for you. To tell you more about the role and benefits of a chief resident, we have Dr. Caroline Milne who is currently who is the residency program director for internal medicine at the University of Utah. She was also a chief resident during her last year of training here. Dr. Milne, what is a chief resident?

Dr. Milne: A chief resident is different depending on specialties. Internal medicine is quite unique in that the chief resident is an extra year of training. In most other training specialties, the chief resident is the resident that is in their last year of training. So you are automatically a chief resident if, say, you are in your fifth year of general surgery training. Nationally, being chosen to be a chief medical resident in internal medicine is considered to be a great honor. Usually the best and the brightest people that have the support of their peers and the faculty, and most of the time, people that are thinking about careers in academia.

Interviewer: What responsibilities and duties do chief residents have that other residents don't have?

Dr. Milne: When I describe the chief resident's year to people that are considering the year, I describe it as a junior faculty year. It's definitively a year when you're bridged between residency, where we feel like you know the needs of the resident better than most faculty members, but also you're considering, in greater detail, the need of a department and the hospital in ways that residents really aren't taking into consideration those roles.

Interviewer: I guess we're all kind of wondering, is being a chief resident a huge time commitment?

Dr. Milne: I think it depends on who you ask. If you ask the chief residents, they would say yes. If you ask a busy young faculty member, they would say no. It's a really nice year, different than residency in that you're not really assigned shifts of work. So coming out of residency in a specialty like internal medicine, you're used to working overnights and longer shifts, and the chiefs here don't have as much clinical responsibility. But administration is time consuming in its own way.
Most of the chief residents that I've had over the last 12 years would tell me that the role that they found most interesting, and also the role that they disliked the most, is, unfortunately, dealing with different personalities and different people. Because I recently read that there's no leader that's liked by everybody, and certainly a chief resident is that person. I have 120 residents in my training program. You cannot make 120 residents happy. A part of the troubles and the struggles in the chief residency is learning how to appropriately deal with people.

Interviewer: Right, definitely a lot of people skills and leadership skills that you develop during that year.

Dr. Milne: Correct.

Interviewer: Okay, so how do you think being a chief resident enhanced your career?

Dr. Milne: Well, I would say actually a program director is a glorified, long-standing chief resident. I have a few more responsibilities, but my role is just ongoing, the same roles that I picked up as a chief resident. As you pointed out, leadership is really important. And prioritizing things that you want to or should be accomplished in the year become a really important skill set that you have. People skills, very, very important. Learning how to diplomatically deal with people when you're telling them an answer they don't want to hear. Learning how to keep morals high in times that it's difficult to do so, and that's what I do now.
Time management is important too. Teaching time management skills, because one of the big roles of the chief resident is to mentor any people that are struggling in their training. And then, of course, teaching is a huge role because, in our program, the chief resident has the major job of teaching at all of our morning report conferences.

Interviewer: For those of us that who still medical students, what could we do, as a first year resident, to prepare ourselves to eventually become a chief resident?

Dr. Milne: You do have to be the highest quality physician in your group, because to be a chief resident, and to gain the respect of your peers, first and foremost, you have to be a highly competent physician. You have to have been a team player all during residency. That means taking more than their share of the workload. Never letting people think that they're actually trying to give other people the rougher end of the stick, instead of taking it for their own.
So there's lots of little things that people do, early on, and I don't think they are actually vying to be the chief resident, but are just really natural characteristics that are obvious that, "Oh, those are the people that are going to lead this training program someday."

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