The Chief Radiology Resident- An Insider’s Perspective
Every year around the dead of winter in our program, the program directors sit around a table and discuss who is going to be the next year’s chief resident. Some years the decision is so easy that it takes no more than a few minutes. Other years the discussion is extremely cumbersome and may slog on over days or weeks. Some years everyone is happy with the decision. Other years no one is happy with the decision. Some years the chief resident role seems like a natural fit. Other years it is a role that we cannot imagine anyone to fill. Some years everyone wants it. Other years no one wants it.
It may seem like a mystery box to many of you why we have a chief resident, what exactly he/she does, and how this decision is made. So, this is a perfect opportunity to enlighten the audience. Today I am going to talk about the roles of a chief resident, the perks and downsides of the job, the issues that can make the decision to be a chief radiology resident easy or difficult, and how the choice is finally made.
What is the Role of a Chief Radiology Resident?
Roles and responsibilities may vary slightly from program to program across the country. But the essence of a chief radiology resident usually remains the same. The chief resident is the liaison between the resident program and the program directors/attendings. Issues that arise with the residents are often brought first to the chief resident and then to the program director or responsible attending. Likewise, issues that arise from the attendings that affect the residents are often brought to the attention of the chief resident first, who then disseminates the information to the residents.
The duties of a radiology resident can include but are not limited to administrative scheduling of residents, scheduling noon conferences, scheduling board reviews, running review courses for medical students and junior residents, voting as a member of the educational committee, attending chief resident conferences such as the AUR meeting, scheduling guest lecturers, planning budgetary arrangements for the residency, interviewing medical students, and more. The responsibilities are great and the chief resident needs to command the respect of both the attendings and residents alike.
Downsides and Benefits
Just like any role with important responsibilities, there are significant ups and downs to being the chief resident. Let’s start with the downside. From my experience over the years, the chief resident is often held responsible for conflicts that can occur among the residents and between the attendings and residents. In fact, they tend to be caught in the middle of many of these issues. Often times, there are no perfect outcomes. In addition, the role of chief resident can be time consuming and challenging. The scheduling of residents alone is often fraught with lots of emotion and charged conflicts. Each resident wants the best possible schedule for himself/herself and many times not everybody can be accommodated. The chief resident may be held accountable.
However, there are some significant perks to the role. First and foremost, it can’t hurt to have the words “chief resident” on you resume when you are applying for fellowships and later attending radiology positions. Sometimes the chief may get to attend free conferences or may get an additional stipend at some programs. Other times, they benefit from getting inside information about the inner workings of the residency program before any other residents. And, occasionally it may help to get a position within the hospital or private practice where the residency is situated.
What Do We Look For In A Chief Resident?
The first and most important feature of a good chief resident is the ability to command respect among both the fellow residents and the attendings. We do not want to pick a resident that shows up late, gets involved in numerous conflicts with other attendings or residents, or who is not a “team player”. Second, we look for a resident who has generally performed well academically and can handle the additional load of chief resident administrative responsibilities. And finally, we look for a chief resident who possesses a calm demeanor and is likeable by all.
All these personality traits and features will allow the residency to continue to run smoothly and reduce the potential for significant conflict that can make the program director’s job even more difficult. Also, it gives the program directors an additional “ear to the ground” and an advisor that can be extremely useful to prevent miscommunication.
What Makes The Decision To Find A Chief Resident Easy or Difficult?
Assessing who is to become chief is not a decision that is taken lightly. In fact, a very serious discussion ensues on a yearly basis among those that make the final decision. Some residency years, one or two residents have clearly been responsible for organizing the class, settling issues within the program and are performing well academically. And, you may have several interested parties in performing the role and responsibilities of chief resident. When these stars align, the choice to make chief resident is very simple.
Other years, you have many interclass conflicts or there is no clear leader that makes decisions for the class. On occasion, we have a class with no one interested in performing the role of chief resident, knowing there are additional responsibilities. These factors can make it very difficult to come up with a final choice.
How Is The Chief Resident Finally Chosen?
Different programs have distinct policies regarding the installation of a new chief resident. At our program, the program directors choose the chief resident during the third year with input from fellow attendings and residents alike. The chief resident will typically begin his/her duties when the final year begins in July. Some years we have both educational and administrative chief radiology residents and other years we have had a single chief resident that takes care of both responsibilities. Other programs have a democratic policy with the residents forming a voting body that may vote upon individual or multiple chief residents. The bottom line: there is no right or wrong way. But rather, the individual culture and traditions of the residency often determines how the choice of chief resident is made.
“To Be or Not To Be” A Chief Resident
The chief resident has a significant role in the smooth running of a residency program. The responsibilities can be overwhelming for some and can be a great leadership opportunity for others. If you are chosen to be a chief resident, it is certainly an honor. But, it also involves a lot of extra work and hard choices. Make sure you are up to the task!!!