Tag: chief resident

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What It’s Really Like To Be Pregnant During Radiology Residency!

Dear Dr. Julius,


I am writing in response to the post that I recently saw on the Radsresident.com blog regarding pregnancy in radiology residency. While I commend you for your efforts to assist aspiring radiologists in their search to balance the stresses of training with life-altering decisions such as family planning, I must admit that the responses seem overly simplified and downplay the stresses that one faces while enduring this transition.

Having entered radiology residency with a child, who I had given birth to at the end of my third year of medical school, I certainly am not an expert on the stresses of having a first-time child during this portion of the training. I did, however, decide to have my second daughter during residency training. And, she was born towards the end of my R1 year.  If you were so kind as to indulge me, I would like to add some insight into the questions previously posed now that I am about the finish my R4 year keeping in mind the lessons I have learned along the way.

Is pregnancy in radiology residency doable?

Short and long answer: Yes. Starting or expanding a family in residency is ultimately a choice.  It is doable, but that doesn’t mean, you will not have to make sacrifices. Some days you will feel like a great mom and other days you will feel like a great resident. Every once in a while, you will feel both. Your time will be stretched; your attention will be split. You will have to work hard just like anyone else who has personal issues they are dealing with at home. If you commit though, you can make it work and not just survive residency but also thrive. I would also argue that my children have helped me keep perspective through this all, and I don’t believe I would be as good as I am if not for my desire to show them the rewards of working hard.

Are programs supportive of students who expand their family during residency?

The answer to this question depends but generally the answer is yes.  Most programs have some form of leave for residents. However, this does not mean that the program will pay for the entire time off. The Family Medical Leave Act (FMLA) should guarantee that you receive up to 12 weeks of time off if you need/want it, but this does not mean that you will be paid for the entire time. Additionally, the program may expect you to use your vacation time during your maternity/paternity leave. So, consider this when planning.

Some programs like mine have built in time for new parents (both male and female), which is up to 6 weeks PAID leave in addition to any vacation time you want to use up to the 12 total weeks off. However, standards may vary, and the best people to ask would be the residents themselves. As per the NRMP, programs cannot legally ask you about your family plans during an interview unless you ask questions that open the door to this subject. However, this doesn’t mean you cannot probe the current residents about their experiences (and honestly you should).

Are there radiation exposures that I would need to avoid in a diagnostic radiology residency?

As Dr. Julius said, the only potential for significant exposure you will face is during fluoroscopy or interventional radiology rotations. If you find out you are pregnant, you can alert your radiation safety officer and officially declare the pregnancy. Once a pregnancy is declared, you will receive an additional radiation badge that tracks the radiation you receive over your pelvis (the badge goes UNDER your lead). The badge measurement should represent an estimated amount of exposure to the growing fetus.  The most important time to avoid radiation exposure is during the first 12 weeks when organogenesis and rapid cell division is highest. However, you do not have to perform IR or fluoro duties later in the pregnancy if you don’t want to.

I had my IR rotation early on, so it wasn’t an issue. But, I ended up shifting my fluoro rotation to another academic year because I didn’t want any unnecessary exposure. Your program and the chiefs should be willing to work with you. If you feel comfortable talking to the chiefs ahead of time, you may even be able to coordinate those rotations earlier/later to avoid having to cause scheduling changes later on. Of note, some women choose not to declare their pregnancy and continue to work. I know of IR attendings who worked during their pregnancy the entire time. But the point is, it is your right to decide how much potential exposure you will receive. You need to feel comfortable.

Is there a typical year of residency easier to have a baby than others?

I think this sincerely depends on the program and how it distributes residents among services. I would agree that the R4 year may have more flexibility due to elective time. But, R1 year is also relatively light given the lack of call. In my hospital, R2 year is especially difficult and demanding, but the toughest year can vary depending on the program.

I tried to time my pregnancy on purpose towards the end of my R1 year. By doing this, I was able to take advantage of the six weeks of paid leave offered by my hospital. In combination, I was also able to take two weeks of vacation from R1 year and tack it on to 2 weeks of vacation from R2 year for a total of 10 weeks off. I will be finishing on time. And, I did not have to remediate any rotations except the few weeks of fluoroscopy I missed during an R4 elective.

Timing is not always doable, and you may experience stresses related to just trying to get pregnant during training – just something to keep in mind. I even met a girl last year who was eight months pregnant while taking her boards examination. She passed. Life goes on. Ultimately, there’s no perfect time to have a child, and the program should help you work through your needs as you encounter new challenges.

With radiology being a male-dominated specialty does this cause strife between residents during maternity leave? (Is there maternity leave?)

I can only speak from personal experience that I had very supportive co-residents. But, I believe this stems from the underlying culture of my program/hospital. I believe that resentment may be a little harsh to describe the sentiments of the other residents. Certainly, if additional/compacted call falls on your colleagues, they may be anxious for your return to mitigate the stress of call.  Not one of my co-residents ever questioned my dedication to the program during or upon my return from my leave. If anything, you may have some challenges with the attendings once you come back. And, you may find yourself having to prove your knowledge in light of a prolonged absence.

I would argue that as long as you are meeting milestones and keeping your major/minor change percentages on par with your colleagues, you should not have to worry. You need to understand, however, that your choice to take time off will require dedication and discipline. Upon your return, you will make up for the time you lost to “catch up.”

How do you decide if a program is family friendly and future-family friendly?

I would advise asking the residents during your time with them on interview day or during pre-interview dinners. Don’t single yourself out, but ask general questions like, “How many residents have families?”; “What’s the program’s family leave policy? Is it paid? Do you have to use your vacation?” As Dr. Julius mentioned, having support nearby or having a supportive partner is probably the most important thing. Radiology residency may be less demanding in terms of physical time in the hospital. However, you will need to read and study during your off time to excel. You will be preparing case conferences during off hours if your program doesn’t give you dedicated time. You will need to carve out time for yourself and your well-being. All this work requires the support of others.

Feel free to allow your readers to contact me directly with questions on Twitter @KVincentiRad.

Thank you for your time.
Kerri Vincenti, MD
Chief Radiology Resident
Pennsylvania Hospital of the University of Pennsylvania
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Top Ten Pitfalls Of The Chief Resident Year

chief resident

Traditionally, the chief resident plays one of the most critical roles in the well-being of the resident community. To that end, the chief resident often becomes responsible for much of what happens in her residency program. Unfortunately, in most programs, however, there is no playbook. And for most, the new chief residents learn their role in a “trial by fire.” Since most chiefs do not arrive as experts in this new role, they make many errors (To be expected!) So, what are the most significant blunders you can make throughout your tenure if you catch yourself in a position as a chief resident? I thought maybe we could all learn from others’ mistakes!

Make Different Promises To Residents And Staff

Before starting, many chief residents commonly will tell their classmates one thing only to realize later that the staff will not accept the change. For instance, when scheduling, a new chief may promise everyone that they will have a night float for only ten days. But, when they sit down and create the schedule, he discovers it is impossible. Now, he puts himself in a bad situation. The residents’ expectations differ from reality, and all the residents become upset. Politics is everything! So, be careful what you say!

Set Bad Examples

Unfortunately, as chief resident, you are constantly under scrutiny. What is the easiest way to lose the respect of the residents and administration? Set a bad example for the rest of your residents. Everything you do serves as a model for everyone else. If you don’t show up, who will? Who else will do the same if you decide not to step in when a resident struggles? Once a chief resident does not fulfill the role of a good leader, the rest of the residents will follow suit.

Create The Schedule And Give Yourself The Most Benefits

Chief residents typically play an essential role in scheduling. Therefore, if the program selects you as a chief resident, you will wield a lot of power over giving yourself the best shifts at the expense of others. If you want to piss off your classmates, take those times everyone else wants or vacation on the best months. That will go over well!

Poor Follow Through

Trust can be complicated to establish in any profession. But, as a chief resident, your word is your bond. Perhaps, you do not follow through on reprimanding a resident because they made a mess in a call room and did not clean up. Or, you let a resident off the hook even though they continue to skip out on noon conferences. If you don’t follow through, you lose the respect of your fellow residents and faculty. So, if you promise, make sure you deliver.

Create Cliques

One of the worst feelings in any job- is to feel left out! So, you need to be even-handed and fair. Invite only half your class to a house party. Or, instigate your fellow residents to hate a fellow resident because you don’t like them. These are surefire ways to reduce your chief resident position to rubble!

Perform Poorly

If you want to have others question your capabilities as chief, what is the simplest way? Here are some possibilities: Don’t read; Perform poorly on quizzes; Or fail your core exam. Once you establish yourself as a chief resident that cannot pass the rigors of a radiology residency, should you be a chief resident?

Poor Attendance After Passing Boards

As a chief resident, you wield a lot of power. But absolute power can corrupt absolutely. Just because you have taken and passed your boards does not give you the right to skip out on conferences or take unscheduled time off. In the end, you are still a resident. So, don’t abuse your status. It can bite you if you ever decide to get a recommendation!

Unwillingness To Help Out Faculty

Since you are stuck between the faculty and residents as a chief resident, your role becomes to appease residents and the faculty. So, what does this mean for you? Make sure to follow at least some of the reasonable demands of the faculty, or else you will fast lose respect. It could be as simple as asking residents to participate in a department-wide research project or ensuring all residents take a resident survey. Neglecting the faculty’s demands can upset your superiors and make your chief resident year miserable!

Inappropriate Relationships Within Class Or Faculty

Nowadays, with the “#metoo” movement, you must watch out for your actions. Beware what you say and how you say it. Other residents and attendings can interpret subtle cues as harassment. So, if you want to ruin your chief resident year and possibly your career, follow the rules!

Final Thoughts About The Chief Resident

As chief resident, you play a significant role in running a residency. And, because a proper leadership position such as chief resident is a new experience for most, I can guarantee you will make some mistakes. Therefore, more than others in the residency program, you need to act like a leader without taking advantage of your colleagues and faculty at their expense. Think of this year as a political learning experience. So, heed these ten warnings of what not to do as a chief resident. If you can avoid these mistakes, you will miss most leadership pitfalls. Like becoming an excellent chief resident, learning to perform a leadership role well will be handy for the rest of your career!

 

 

 

 

 

 

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The Chief Radiology Resident- An Insider’s Perspective

chief radiology resident

Every year around the dead of winter in our program, the program directors sit around a table and discuss who will be the next year’s chief radiology resident. For many of you, this process may seem like a mystery box. Why do we even have a chief resident anyway? What exactly does she do? And, how do we make this decision? These are some of the questions you may be asking.

To enlighten you on the world of the chief radiology resident, I will answer these questions. To do so, I will talk about all the nitty-gritty details such as the myriad roles of a chief resident, the perks and downsides of the job, why some years it can be easy or challenging to decide who should be the chief, and how many programs make a choice.

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. Residents will bring issues that arise among their classes first to the chief resident and then to the program director or responsible attending. Likewise, faculty will bring problems that occur to the chief resident’s attention first, then disseminating the information to the residents.

The duties of a radiology resident include 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 significant, and the chief resident needs to command both the attendings’ and residents’ respect alike.

Downsides and Benefits

Like any role with essential responsibilities, there are significant ups and downs to being the chief resident. Let’s start with the downside. The chief resident is often held responsible for conflicts among the residents and between the attendings and residents. They are front and center in many of these issues. Usually, there are no perfect outcomes. Also, the role of the 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 your resume when applying for fellowships and later attending radiology positions. Sometimes the chief may get to participate in free conferences or get an additional stipend at some programs. Other times, they benefit from getting inside information about the residency program’s inner workings before any other residents. 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?

The first most critical feature of an excellent chief resident is to command respect among fellow residents and 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 likable 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 we take lightly. An earnest discussion ensues every year among those that make the final decision. Some residency years, one or two residents have 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 straightforward.

Other years, you have many interclass conflicts, or there is no clear leader that makes decisions for the class. On occasion, we have a year with no one interested in performing the chief resident’s role, knowing there are additional responsibilities. These factors can make it very difficult to come up with a final choice.

How Do Programs Choose The Chief Radiology Resident?

Different programs have distinct policies regarding the installation of a new chief resident. In our radiology residency, the faculty and program directors choose the chief resident during the third year with attendings’ and residents’ input. The chief resident will typically begin his/her duties when the final year starts in July. Some years we have had 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 instead, the individual culture and traditions of the residency often determine how they choose the chief resident.

“To Be or Not To Be” A Chief Radiology 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 an excellent leadership opportunity for others. If the program chooses you to be a chief resident, it is undoubtedly an honor. But, it also involves a lot of extra work and hard choices. Make sure you are up to the task!!!