As an associate program director, I work with all the residents and faculty. But, one role, in particular, plays an even more significant role in the quality of the residency than the others. Which one would that be? (Hint: Well, if you have not guessed it by now, you may want to look at the title again!)
OK. So, we know that the chair is critical to running a great residency. But what is it about a chairperson that makes the role so important? Well, the importance of the position is what we are going to run through over the next, oh, say, 8oo or so words!
Backbone When The Going Gets Tough
Everyone once in a while events conspire to mangle a residency program. Perhaps, a resident decides to leave for another career, and the hospital wants to take away the residency slot forever. Or, the emergency department determines they no longer want residents to give the final dictations at nighttime. In any of these cases, you need a firm chair to prevent these issues from negatively affecting the residency program. Sometimes you need a leader to fight for your department!
Allocation of Resources To The Residency Program
What would happen if you had a chair that decided to commit more resources to non-residency associated imaging centers at the expense of hospital-based residency program? Chaos, of course! Maybe, you will no longer have enough physical bodies to teach the residents. Or, the chairperson decides to stop giving the program directors administration time to run the residency program. Either way, the chair controls many of these outcomes. And, if she decides to allocate the resources to the outside facilities instead, the residency loses out.
Carrot And The Stick
In any practice, some physicians have more or less interest in teaching. But, what happens if some of the attendings decide that they no longer want to give conferences. Well, the chair has the long arm of the practice to make sure that does not happen. The chairperson can either decide to provide money or non-monetary incentives to make sure that the faculty performs. Or, she can take away incentives from staff members who do not participate. Either way, the chair’s ability to utilize her power directly affects the program’s quality.
Sets The Tone Of The Department
Let’s say your chair runs the department as a dictator. Or, he is always just trying to appease friends instead of doing what is best. What happens to the residency in these cases? In the first case, the residency runs on fear and misery. And in the second case, nothing ever gets accomplished. Bottom line. The chair sets the quality of interactions not only in the department but also the residency.
Liaison Between The Hospital And The Program Director
Some departments have a chair who does not communicate the critical issues of the institution to the residency. What occurs in these situations? First, residents may lose out on remaining compliant with the national requirements such as hospital ACLS training. Or, the residency may not fulfill its obligations to remain accredited. Poor communication between the hospital, chair, and the program director can become a nidus for a residency to implode!
The Ceremonial Function
Sometimes, a chair may decide not to attend essential residency functions. Perhaps, she does not show up to the residency graduation or the annual hospital ball. What does this say about the department? Do you think that the hospital will look fondly upon the residency program when its leader is remiss? Probably not. In this case, the chairperson and department will be much less likely to receive the resources from the hospital that they need. It’s a “give and take” relationship. So, the chair needs to step up and set an excellent example to the residency and hospital.
Often, we as program directors, need to get a feel for how the faculty will respond to a change before implementation. And, residencies constantly need to institute new requirements. But, will the faculty buy-in, so that we can implement the new development? A strong chairperson who knows his department well can ensure that you can fulfill your change. Moreover, she can give guidance as to what works and what doesn’t. Without serving this role as residency advisor, a program director will encounter many more pitfalls during his tenure!
The Chair As Leader
In any medical department, a chairperson plays a critical role in not only running the specialty service but also in making sure the residency smoothly as well. So, when you decide to look into a residency department, observe the chair. Does he participate in the interview process? Can you get a feel for how he behaves toward the department? All these factors will affect you long after the interview day. A chair reflects the face and culture of the department!