This month starts our inaugural ALiEM Chief Resident Incubator and this post is the culmination of a 7-day intensive writing project by our 100+ Chief Residents. Incredibly we were impressed by the caliber of writing and insightfulness of our members. Congratulations especially to the lead editors, Dr. Melissa Joseph (LAC+USC) and Dr. Jimmy Lindsey (Univ of Chicago). Looking forward to an exciting year ahead of us!
10 Things Your New Chiefs Want You to Know
The upcoming year will hold new challenges and learning experiences for all of us. Know that our door is always open for you, and we shouldn’t be hard to spot in the department: Chief Residents in the House!
Expert Peer Review
You deserve our congratulations for putting together this remarkable collaboration! I know of no other published open letter like this. Your group is diverse in gender and geography and represents a wonderful mix of thoughts and advice. What a great platform to engage your colleagues.
I am just now finishing my Chief Resident year and wish I had thought of something like this 12 months ago. I hope my experiences over the past year can lend some insight into your writing.
Overall, so much of what you write is spot on. It is indeed important to share these sentiments and your writing gives your juniors a good sense of what you value and how you think.
Starting with education, Dr. Joseph’s charges residents to participate and take control of their learning to maximize their training. I couldn’t agree more. The difficulty lies in how to motivate learners to do that. This post is a good start, but the challenge will come once the academic year is in full swing and people are tired and burnt out. Along those lines Dr. Schneberk also implores his colleagues to take advantage of the chiefs for career advice. I hope the new chiefs can fill this role in connecting juniors to the right mentorship.
Speaking of burnout, Drs. Stuart and Wojtal give one of the most important messages chiefs can give. Your residents have to know that it is ok to have a hard time and to feel some form of burnout. The sentiment he shares, “we might not be able to make that SICU rotation any less painful, but we’ll at least buy you a beer and share some stories…” is one of the most effective examples of leadership that I can think of. I can’t tell you how many crises have been averted and how many residents have been walked off the ledge by having a beer with a trusting colleague. This is huge. Dr. Wojtal punctuates the attitude when she writes, “we’ve got your back.”
Drs. Paetow, Sheehy, and Cohen touch on important elements of leadership, teamwork, and communication. These topics are hard to teach but are absolutely vital in professional development. The job of the Chief Resident is to model this behavior at all times. Your co-residents will look to you now as an example of how to consult, how to play nice, how to communicate and you must rise to the challenge. You must quickly become communication experts in the different domains listed by Dr. Sheehy.
The concept of trust among residents is fraught with difficulty. Dr. Patel’s model of honesty, reliability, and competence is what we should strive for. It is absolutely important to be trusted as chiefs. There are times, however, when confidence between resident and chief must be broken (e.g. a resident shows up to work intoxicated). Clearly outlining the circumstances when the chief has no choice but to involve the Program Director would go a long way toward ensuring no one feels their trust is violated.
“Think before you click” is so crucial. I’ll pretend I have no personal knowledge of this topic and let Dr. Gopalsami’s lesson speak for itself. The stock email program on Android lets you change the setting for “delay email sending” so that you can cancel after you click send. I may or may not have mine set to 30 seconds.
Finally, the tough love comes from Dr. Lindsey. This is what I was waiting for as it will account for so much of your personal struggle this year. So much time and emotional energy is spent on the schedule and all the issues that surround it. It is a good reminder to the troops that you are human and are doing your best for ALL residents, and sometimes that means that people don’t get what they want. If only this message would sink in. Part of your challenge is to be stellar in the other areas of leadership so that you have credibility when this inevitable challenge arises.
To this stellar group from Los Angeles to Chicago, Fresno to New Jersey, Ohio and Minneapolis to Delaware: thank you. This was a treat to read and I hope it is broadly circulated to all residents. It concisely conveys several crucial messages that give those you lead some insight into the mind and heart of our Chief Residents.
Diagnose on Sight series;
UCSF-Fresno Emergency Medicine Residency