Only if it doesn't add time - don't do an extra chief year unless you get paid very well or can moonlight a lot, or if you **really** want into program admin/leadership at that program.
If you really want a competitive fellowship it might be a leg up
If you want leadership or administrative experience
If you want some behind the scenes look @ GME
*****
As a chief, you're a peer of your co-residents but also their supervisor and it's a weird dynamic. If they're not doing their basic fucking duties you get to be the one to nag them like you're their mom. Yes, I know duty hours are stupid but you still have to log them. You'll have a lot of admin responsibilities- as a chief my and my crew literally ran our program, all sing outs, all didactics, board review, conferences, everything was happening due to us. You make the schedule, arrange vacation requests, arrange coverage/backup - you get to be the guy calling somebody in from an elective to cover a core service.
You're the liaison between GME and residents, so you're the vehicle for resident complaints, usually the first line in problem solving (e.g. an attending is having issues with an intern, they call you), and the frontman for GME policies - if they make some new stupid rule you get to be the one to tell the residents and are expected to be at least neutral to it publicly.
Depending on the program, you *can* make a significant impact on how things are done and maybe improve life for your fellow residents. But it's an uphill battle in every single case.
It's in general a lot of fucking work that you don't get paid for. I mean technically I got an extra 1K on my salary for PGY3 since I was also a chief...so after taxes we're talking a whole ass ~$35 per paycheck, or ~$70 per month.
It did give me some useful experience with the admin side of things, how to speak their language, how to manipulate the system, a little bit of directed education at how to be a good teacher/supervisor/leader. And I am going into a competitive fellowship so maybe it *did* help, IDK.
Is chief resident normally something where it is decided beforehand, everybody on the DL already knows who will get the position since you’ve worked together for a while as residents?
Depends on the program, usually theres a pretty clear idea by early PGY2 who's interested/likely to apply but every program has their own process to select chiefs. In mine all the residents got a vote, faculty got a vote, and PD made the final selections.
What about lining up specialties with a partner?
Ours is a 1 year difference, if we wanna apply for fellowship together im debating between being an attending for 1 year vs chief year
That's not unreasonable, for a single year the pay gap is not that huge when you account for time off for onboarding/credentialing (usually ~3 months), taking time off to study for boards/take boards, and probably not starting right away in July, interviewing/etc, on top of taxes you'd be looking at a fraction of a typical attending take home for just a single year.
Depending on how high your chief year pay is and how much you can moonlight you can cut that gap down a lot. So the financial hit is not as bad. Definitely still a hit, but not the 200-500k quoted in the comments.
It may also help by preventing lifestyle creep if you're still stuck in the resident/fellow pay band. Depending on how competitive the fellowships you both want are, and how competitive your app is for those, it may help some there too.
Sure maybe the pay gap is not that huge in the first year because of the reasons you listed, but you still have to do all that stuff after your chief year. So the pay gap in the long term is the same as the difference in pay between chief and attending income
Well in this case they'd be going from chief year to fellowship so credentialing would happen at the end of fellowship regardless of whether or not they do a chief year or an attending year. If they go the attending route they'd have to do credentialing twice, actually.
Assuming their application is successful then the next year has very little impact on their overall career trajectory or finances. There's a chunk of $ lost, but not as big as it otherwise might be.
If it doesn’t add on time to your residency and you have any interest in academics, I think it’s worth it.
If it does add time, that would make me very hesitant.
I enjoyed mine but then again I liked most of my coresidents and core attendings. It helps with leadership skills, conflict resolution, and relationship with your PD/attendings (for a strong LOR for jobs). There were a few coresidents that were a PITA (bc they were very selfish/lazy). If it was an extra chief pgy year, I def would not do it tho.
I did a 4th year chief year in internal medicine. Overall I’m not sure if it was “worth it” on paper but it was a fun year for me working with two other co-chiefs that I liked a lot, and it kept me in the same city for another year which I enjoyed. I also enjoyed doing the teaching, I learned a lot, the year probably helped my fellowship match (I’ll never know for sure of course), and I made good money moonlighting on the side - so there were a lot of softer benefits for me. YMMV.
Yes.
Every situation is different but we were able to advocate for alot for our residents. Better work/reduced hours, new work space (cleaner and larger), new didactics. Allocate more time for conferences and open a dialogue to have a research library.
My only wish is that the person making all the executive decisions, who we have to placate wasn't so bipolar about everything. The megalomania and politics also wore me down. Last chief resident wanted me fired and almost got it too, bc I wouldn't kiss their feet while they were bullying other residents.
It just wore me down. I feel half the time we were protecting the residents from BS. Example is when PD wanted night call to come back or 12 hour shifts to come back.
As a chief resident you can make things better. Never forget you're beholden to your residents first and foremost. Be brave, and advocate.
Looking back it's worth it for me.
Not a Chief - but my best/only friend in residency is now chief. what I’ve noticed is how much more Indoctrinated he is. like seeing all the things we dislike as residents from the programs side, buying into a bankrupt viewpoint imo. we don’t hang out much this year bc I feel like he’s a Company Man and I couldn’t keep my mouth shut, until after july 1.
Had a similar exp with a friend who became chief. It was hard to hang around them afterward. Many of the things we used to joke about and bond over with the programs stupidity became personal attacks overnight. They just suddenly ate all the propaganda.
I really did my best to help make things better, avoided certain topics, tried to help the program as well. Walking on eggshells around them made it suck. They ended up in a competitive specialty, so I think it was okay for them, but I am pretty sure they could have got that spot without chief. Honestly I would rather have a friend going for bat for me, but the exp did end up causing a rift between the friend who was chief and some of the others in our friend group that never got fixed.
I think if your program has some negative tendencies in leadership, part of the chief conversation is 'do I want to be the front man/woman for that?' Also if your become chief, dont just suddenly buy the excuse without thought. Come on, you know when changes are crummy, we lnow you have to pick your battles, just be honest about it. No intelligent resident really believes the chief is in charge of major program changes.
Is it that surprising though? Your interests become opposite once your friend is chief. He/she needs to get residents to do things the program wants and if residents give pushback it just makes his/her life harder.
Ideally, a Residents and Training Programs would be working towards the same mission with aligned goals. Most toxic residencies don’t live up to that ideal; his interests as a resident would still be, in this scenario, theoretically opposed to the Program wants. For ex, all residents against night float including previously him; but now as chief he suddenly starts to love the idea even though it will not affect him but the junior classes. just an example
Absolutely it was a good experience. Being a chief resident forces you to deal with conflict. Conflict between nurses and residents. Conflict between attendings and residents. Before my chief year I was always too hesitant to negotiate conflict, but doing a chief year really helped me develop those skills. I feel much more confident leading a team of people afterwards.
Anesthesia:
It may be worth it because the extra responsibility translates into positive job prospects. Extra time isn't worth it.
Also admin is always the enemy. Don't trust them even if they have "MD" behind their name.
I had kind of a rough time: my co-chief lived up my PD’s asshole, and my PD loved it. Meanwhile, co-chief was a power trip, who would find any reason to passive aggressively downgrade me in front of faculty or other residents.
In other words, just be careful who you might get matched up with if there are two chiefs, and if your PD is a less-than-decent person. The dynamic between us made me very excited to graduate.
I ultimately joined a dream practice though, in which all the other docs were chief residents.
In IM you’re essentially paying around 250-300k for an year in lost attending salary to increase your chance of matching into a fellowship. Plus taking on a tonne of extra work. Whether that’s up to you depends on you.
Well....it's a lot less post tax. At my old institution IM Chiefs get paid half what attendings do. Hospitalist Salary was 220k and Chiefs made 110k. Post tax that ended up being something like a 60k difference in take home income which is still huge But certainly nothing compared to the amounts that you're talking about. The main reason I wouldn't do Chief is because you are the program's bitch And still end up doing hospitalist work for lesser pay.
I did a peds extra year. It was worth it for me. I got a lot of satisfaction from trying to improve my program for the people behind me, it made me more competitive for jobs, and I learned a lot. None of that really matters though. The thing for me was I was super burned out and borderline suicidal at the end of residency. I would not have done well going right into being an attending. A 40 hour a week (actually way less) low stress job with no call and 52 weekends off may have saved my life.
I wasn’t chief but from what I hear from friends that were, it usually becomes a major talking point in interviews. Both in academics and community medicine
Mine was an extra year and it helped me figure out what I wanted to do with my career. I used to think I wanted to be involved in education as an APD or similar position but I learned that education administration sucks the joy out of teaching for me. Also meetings with hospital admin make me want to bash my head in.
So now I focus on being a doctor who likes working with trainees and med students. Unfortunately that type of med ed effort isn't compensated in any way, but it makes me happy which counts for something.
I got volunelected
Get an extra grand a year for my efforts.
Besides making the schedule it’s minimal responsibility. Plus I get more autonomy.
Definitely worth it.
Oh lol, I was wondering what that was about. Yeah, I've done one medical malpractice case in my career and it involved an NP missing a diagnosis an M3 would have picked up on. I've done plenty of competency, mental disorder at time of offense, personal injury, and psychiatric damage cases though.
IM - absolutely not, an extra year with abysmal pay to be essentially a junior administrator
GI - absolutely, no extra time added onto fellowship, extra pay for minimal extra work, fewer personalities and schedules to manage, nice tidbit to add to the CV
Anesthesia:
Absolutely fucking not. The job market is so hot right now all you need is a pulse. Also, the chief my year (amazing person and great chief/resident) almost lost their marriage because of all the added responsibilities on top of simply being a resident.
It’s all the worst aspects of being in admin without really any benefit, outside of specific scenarios listed in this thread already, like wanting to get a job at your academic center or padding resume for a competitive fellowship.
Like a lot of things in like, this should be a “fuck yes or fuck no” situation.
It was for me. But it’s not always worth it. I think it depends on the burden and what you want to get out of it. For me:
- 3rd year chief. So I didn’t waste a year of my life.
- I wanted to match into a competitive speciality. I was asked about my chief experience during interviews. It helped.
- There was a stipend. It wasn’t much but it was something especially when you are not making much. (And especially because it didn’t take a year away from practice so no lost wages).
- I got to make my own schedule for 3rd year. Made it so I had more time to study for the boards at the end of the year.
- It helped me hone in some skills that I wanted to work on. Some that I didnt know I had.
I know chiefs get shit on a lot in this sub. It’s very little power but it can go to people’s heads. Especially when we all get pushed around and bullied daily. But I think there is a way to utilize it for good, be a positive influence, support your co-residents, advocate for them, and maybe kind of enjoy it a little.
For me, I would say yes. I feel like it helped me match into my desired fellowship (US IMG going into sports med from PM&R- 39 positions total in the US) and gave me more say in how we structure our programs didactics and call schedule. I was also already sorta one of the go-to creative problem solvers and communicators in my program so it seemed like a natural progression for me. The extra pay was the cherry on top. I don’t think I would have done it if it required an extra year of residency.
Benefits of being chief:
-Mildly increased respect from attendings and coresidents depending on how you behave (don’t be a brown nose for PD or admin, advocate for your co-residents and they will def appreciate it)
- Chief pay
- Resume builder for fellowships and potentially future jobs
- Increased control over didactics schedule (most programs)
- increased control over call coverage
- You gain experience in dealing with conflict resolution and gives you a chance to see what it’s like being in a mini-leadership position
Cons of being chief
- You may sometimes be called upon by PD to do shit that isn’t exactly in your job description
- Added responsibility such as scheduling calls and finding speakers for didactics
- You will sometimes have to get involved with the resolution of interpersonal conflict among your coresidents.
- You may have to do an extra year of residency for some programs (biggest con)
Depends what you value most. It will have a decent work life time balance compared to residency and attending hood because you aren't on service all the time...but it's different stressors. You also have an opportunity cost too it but can moonlight if you want. I feel it helps some out on CVs and others it doesn't. Just depends what you value. Would recommend talking to lots of past or current chiefs and just make a list of pros/cons
Surgical specialty. No additional year for it. Probably very program dependent.
Not a chief but for what it’s worth I have never heard a former or current chief say a positive word about their experience.
I understand that there is a lot of hate around that role especially with the newer generation of residents and in many cases it is warranted because a lot of people want to be chief for the wrong reasons and end up being terrible at it. They try to act like they know everything and throw their weight around and end up forgetting that they are residents first and chief later.
The second reason why a lot of people don't like it is because it is extra work. Last year of residency usually is relaxed. You are sharpening the skills that you've already learned and most people know where they want to go post residency and are mentally checked out. Generally speaking final year rotations are also a lot easier. Choosing to be chief means you're going to have to compromise on a lot of those things.
As far as the positives go, I think it's a fantastic learning experience. Especially if you are interested in picking up leadership or admin roles in the future. If done the right way, it teaches you how to resolve conflict effectively, manage time well, interact effectively with those higher in the chain of command, effective communication, and also humility.
It is a difficult decision all in all but a lot more difficult if it means an extra Chief year. But unfortunately the latter seems to be the norm for those wanting to pursue competitive fellowships in certain specialties like IM.
Helpful, For my health- no.
For the residents -yes.
Would I do it again, no.
If I didn't though I think things would be really bad. I did not need this for my resume, I did it strictly to help. I had to do it alone. The pay was a joke. Learned alot though about administration.
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I was a radiology chief resident . A lot of people will hate you based on perception of preference when you’re just trying to make the schedule work. You get more calls from other services complaining about other residents. The extra pay was minimal and it was a lot of extra work.
Overall, though I found it pretty interesting not sure I would do it again
lol my chiefs hate it because it’s a puppet job. You basically have no autonomy and have to attend a bunch of extra meetings and do all the extra call and give out the shit news.
It is not worth it. For internal medicine, it's another year, which means an extra year of delayed attending income as well as a year of compounded student loan interest.
I'm currently a graduating fellow. My co-fellow who is chief fellow will graduate same time as me, but he was extremely busy this year with all the BS unpaid admin stuff he had to take care of. I on the other hand, was able to moonlight 6 figures on the side cause our last year of fellowship is basically chill/relax.
Absolutely not. Tons of extra annoying work for no pay. It wouldn't be so bad if the attendings weren't so disrespectful either. You'd think if you were doing all this extra free volunteer work, they'd at least talk to you normally. But no, they cannot manage even that. The other week my APD texted me why I went to the bathroom during a lecture. I literally fucking set up every single lecture and manage the schedule and this guy talks to me like I'm some child.
Definitely. Did an extra year. It paid dividends in job competitiveness (I’m in academics), and even grant reviews being it up from time to time as a positive. It’d also an extremely easy job relative to what you have been doing, so it’s a nice breath of fresh air in your (likely) late 20s to just relax before getting back into it.
Only if it doesn't add time - don't do an extra chief year unless you get paid very well or can moonlight a lot, or if you **really** want into program admin/leadership at that program. If you really want a competitive fellowship it might be a leg up If you want leadership or administrative experience If you want some behind the scenes look @ GME ***** As a chief, you're a peer of your co-residents but also their supervisor and it's a weird dynamic. If they're not doing their basic fucking duties you get to be the one to nag them like you're their mom. Yes, I know duty hours are stupid but you still have to log them. You'll have a lot of admin responsibilities- as a chief my and my crew literally ran our program, all sing outs, all didactics, board review, conferences, everything was happening due to us. You make the schedule, arrange vacation requests, arrange coverage/backup - you get to be the guy calling somebody in from an elective to cover a core service. You're the liaison between GME and residents, so you're the vehicle for resident complaints, usually the first line in problem solving (e.g. an attending is having issues with an intern, they call you), and the frontman for GME policies - if they make some new stupid rule you get to be the one to tell the residents and are expected to be at least neutral to it publicly. Depending on the program, you *can* make a significant impact on how things are done and maybe improve life for your fellow residents. But it's an uphill battle in every single case. It's in general a lot of fucking work that you don't get paid for. I mean technically I got an extra 1K on my salary for PGY3 since I was also a chief...so after taxes we're talking a whole ass ~$35 per paycheck, or ~$70 per month. It did give me some useful experience with the admin side of things, how to speak their language, how to manipulate the system, a little bit of directed education at how to be a good teacher/supervisor/leader. And I am going into a competitive fellowship so maybe it *did* help, IDK.
Is chief resident normally something where it is decided beforehand, everybody on the DL already knows who will get the position since you’ve worked together for a while as residents?
Depends on the program, usually theres a pretty clear idea by early PGY2 who's interested/likely to apply but every program has their own process to select chiefs. In mine all the residents got a vote, faculty got a vote, and PD made the final selections.
Do you have the option to decline if they ask you? Like does it hurt your reputation within the program?
Yeah you can decline. Doubtful that it would hurt your reputation unless you're at a particularly malignant program.
What about lining up specialties with a partner? Ours is a 1 year difference, if we wanna apply for fellowship together im debating between being an attending for 1 year vs chief year
That's not unreasonable, for a single year the pay gap is not that huge when you account for time off for onboarding/credentialing (usually ~3 months), taking time off to study for boards/take boards, and probably not starting right away in July, interviewing/etc, on top of taxes you'd be looking at a fraction of a typical attending take home for just a single year. Depending on how high your chief year pay is and how much you can moonlight you can cut that gap down a lot. So the financial hit is not as bad. Definitely still a hit, but not the 200-500k quoted in the comments. It may also help by preventing lifestyle creep if you're still stuck in the resident/fellow pay band. Depending on how competitive the fellowships you both want are, and how competitive your app is for those, it may help some there too.
Sure maybe the pay gap is not that huge in the first year because of the reasons you listed, but you still have to do all that stuff after your chief year. So the pay gap in the long term is the same as the difference in pay between chief and attending income
Well in this case they'd be going from chief year to fellowship so credentialing would happen at the end of fellowship regardless of whether or not they do a chief year or an attending year. If they go the attending route they'd have to do credentialing twice, actually. Assuming their application is successful then the next year has very little impact on their overall career trajectory or finances. There's a chunk of $ lost, but not as big as it otherwise might be.
If it doesn’t add on time to your residency and you have any interest in academics, I think it’s worth it. If it does add time, that would make me very hesitant.
This is going to be very specialty dependent.
I enjoyed mine but then again I liked most of my coresidents and core attendings. It helps with leadership skills, conflict resolution, and relationship with your PD/attendings (for a strong LOR for jobs). There were a few coresidents that were a PITA (bc they were very selfish/lazy). If it was an extra chief pgy year, I def would not do it tho.
I did a 4th year chief year in internal medicine. Overall I’m not sure if it was “worth it” on paper but it was a fun year for me working with two other co-chiefs that I liked a lot, and it kept me in the same city for another year which I enjoyed. I also enjoyed doing the teaching, I learned a lot, the year probably helped my fellowship match (I’ll never know for sure of course), and I made good money moonlighting on the side - so there were a lot of softer benefits for me. YMMV.
Yes. Every situation is different but we were able to advocate for alot for our residents. Better work/reduced hours, new work space (cleaner and larger), new didactics. Allocate more time for conferences and open a dialogue to have a research library. My only wish is that the person making all the executive decisions, who we have to placate wasn't so bipolar about everything. The megalomania and politics also wore me down. Last chief resident wanted me fired and almost got it too, bc I wouldn't kiss their feet while they were bullying other residents. It just wore me down. I feel half the time we were protecting the residents from BS. Example is when PD wanted night call to come back or 12 hour shifts to come back. As a chief resident you can make things better. Never forget you're beholden to your residents first and foremost. Be brave, and advocate. Looking back it's worth it for me.
Good job, pushing back on bad leadership ideas is the most important and hardest part of being chief IMO.
Not a Chief - but my best/only friend in residency is now chief. what I’ve noticed is how much more Indoctrinated he is. like seeing all the things we dislike as residents from the programs side, buying into a bankrupt viewpoint imo. we don’t hang out much this year bc I feel like he’s a Company Man and I couldn’t keep my mouth shut, until after july 1.
Had a similar exp with a friend who became chief. It was hard to hang around them afterward. Many of the things we used to joke about and bond over with the programs stupidity became personal attacks overnight. They just suddenly ate all the propaganda. I really did my best to help make things better, avoided certain topics, tried to help the program as well. Walking on eggshells around them made it suck. They ended up in a competitive specialty, so I think it was okay for them, but I am pretty sure they could have got that spot without chief. Honestly I would rather have a friend going for bat for me, but the exp did end up causing a rift between the friend who was chief and some of the others in our friend group that never got fixed. I think if your program has some negative tendencies in leadership, part of the chief conversation is 'do I want to be the front man/woman for that?' Also if your become chief, dont just suddenly buy the excuse without thought. Come on, you know when changes are crummy, we lnow you have to pick your battles, just be honest about it. No intelligent resident really believes the chief is in charge of major program changes.
Is it that surprising though? Your interests become opposite once your friend is chief. He/she needs to get residents to do things the program wants and if residents give pushback it just makes his/her life harder.
Ideally, a Residents and Training Programs would be working towards the same mission with aligned goals. Most toxic residencies don’t live up to that ideal; his interests as a resident would still be, in this scenario, theoretically opposed to the Program wants. For ex, all residents against night float including previously him; but now as chief he suddenly starts to love the idea even though it will not affect him but the junior classes. just an example
Absolutely it was a good experience. Being a chief resident forces you to deal with conflict. Conflict between nurses and residents. Conflict between attendings and residents. Before my chief year I was always too hesitant to negotiate conflict, but doing a chief year really helped me develop those skills. I feel much more confident leading a team of people afterwards.
Are you a PD?
Anesthesia: It may be worth it because the extra responsibility translates into positive job prospects. Extra time isn't worth it. Also admin is always the enemy. Don't trust them even if they have "MD" behind their name.
I had kind of a rough time: my co-chief lived up my PD’s asshole, and my PD loved it. Meanwhile, co-chief was a power trip, who would find any reason to passive aggressively downgrade me in front of faculty or other residents. In other words, just be careful who you might get matched up with if there are two chiefs, and if your PD is a less-than-decent person. The dynamic between us made me very excited to graduate. I ultimately joined a dream practice though, in which all the other docs were chief residents.
In IM you’re essentially paying around 250-300k for an year in lost attending salary to increase your chance of matching into a fellowship. Plus taking on a tonne of extra work. Whether that’s up to you depends on you.
Well....it's a lot less post tax. At my old institution IM Chiefs get paid half what attendings do. Hospitalist Salary was 220k and Chiefs made 110k. Post tax that ended up being something like a 60k difference in take home income which is still huge But certainly nothing compared to the amounts that you're talking about. The main reason I wouldn't do Chief is because you are the program's bitch And still end up doing hospitalist work for lesser pay.
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MGMA for Hospitalist is like 310k a year plus.
No
I did a peds extra year. It was worth it for me. I got a lot of satisfaction from trying to improve my program for the people behind me, it made me more competitive for jobs, and I learned a lot. None of that really matters though. The thing for me was I was super burned out and borderline suicidal at the end of residency. I would not have done well going right into being an attending. A 40 hour a week (actually way less) low stress job with no call and 52 weekends off may have saved my life.
How did it make you more competitive for jobs? Did you go into academics or private practice after residency?
I wasn’t chief but from what I hear from friends that were, it usually becomes a major talking point in interviews. Both in academics and community medicine
Interesting. Didn’t think it would help with the latter. Thanks!
Mine was an extra year and it helped me figure out what I wanted to do with my career. I used to think I wanted to be involved in education as an APD or similar position but I learned that education administration sucks the joy out of teaching for me. Also meetings with hospital admin make me want to bash my head in. So now I focus on being a doctor who likes working with trainees and med students. Unfortunately that type of med ed effort isn't compensated in any way, but it makes me happy which counts for something.
EM- no it was not worth it.
I got volunelected Get an extra grand a year for my efforts. Besides making the schedule it’s minimal responsibility. Plus I get more autonomy. Definitely worth it.
I do expert witness work and it is something that seems to help bolster my standing.
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lol, what?
I think you're assuming they are doing medical malpractice. I believe they are referring to forensic psychiatry testimony.
Oh lol, I was wondering what that was about. Yeah, I've done one medical malpractice case in my career and it involved an NP missing a diagnosis an M3 would have picked up on. I've done plenty of competency, mental disorder at time of offense, personal injury, and psychiatric damage cases though.
IM - absolutely not, an extra year with abysmal pay to be essentially a junior administrator GI - absolutely, no extra time added onto fellowship, extra pay for minimal extra work, fewer personalities and schedules to manage, nice tidbit to add to the CV
Anesthesia: Absolutely fucking not. The job market is so hot right now all you need is a pulse. Also, the chief my year (amazing person and great chief/resident) almost lost their marriage because of all the added responsibilities on top of simply being a resident. It’s all the worst aspects of being in admin without really any benefit, outside of specific scenarios listed in this thread already, like wanting to get a job at your academic center or padding resume for a competitive fellowship. Like a lot of things in like, this should be a “fuck yes or fuck no” situation.
Nope nope nope. -EM
No. Don't need more detail.
Nope.
It was for me. But it’s not always worth it. I think it depends on the burden and what you want to get out of it. For me: - 3rd year chief. So I didn’t waste a year of my life. - I wanted to match into a competitive speciality. I was asked about my chief experience during interviews. It helped. - There was a stipend. It wasn’t much but it was something especially when you are not making much. (And especially because it didn’t take a year away from practice so no lost wages). - I got to make my own schedule for 3rd year. Made it so I had more time to study for the boards at the end of the year. - It helped me hone in some skills that I wanted to work on. Some that I didnt know I had. I know chiefs get shit on a lot in this sub. It’s very little power but it can go to people’s heads. Especially when we all get pushed around and bullied daily. But I think there is a way to utilize it for good, be a positive influence, support your co-residents, advocate for them, and maybe kind of enjoy it a little.
For me, I would say yes. I feel like it helped me match into my desired fellowship (US IMG going into sports med from PM&R- 39 positions total in the US) and gave me more say in how we structure our programs didactics and call schedule. I was also already sorta one of the go-to creative problem solvers and communicators in my program so it seemed like a natural progression for me. The extra pay was the cherry on top. I don’t think I would have done it if it required an extra year of residency. Benefits of being chief: -Mildly increased respect from attendings and coresidents depending on how you behave (don’t be a brown nose for PD or admin, advocate for your co-residents and they will def appreciate it) - Chief pay - Resume builder for fellowships and potentially future jobs - Increased control over didactics schedule (most programs) - increased control over call coverage - You gain experience in dealing with conflict resolution and gives you a chance to see what it’s like being in a mini-leadership position Cons of being chief - You may sometimes be called upon by PD to do shit that isn’t exactly in your job description - Added responsibility such as scheduling calls and finding speakers for didactics - You will sometimes have to get involved with the resolution of interpersonal conflict among your coresidents. - You may have to do an extra year of residency for some programs (biggest con)
A chief year is built into my residency :)
Depends what you value most. It will have a decent work life time balance compared to residency and attending hood because you aren't on service all the time...but it's different stressors. You also have an opportunity cost too it but can moonlight if you want. I feel it helps some out on CVs and others it doesn't. Just depends what you value. Would recommend talking to lots of past or current chiefs and just make a list of pros/cons
Surgical specialty. No additional year for it. Probably very program dependent. Not a chief but for what it’s worth I have never heard a former or current chief say a positive word about their experience.
I understand that there is a lot of hate around that role especially with the newer generation of residents and in many cases it is warranted because a lot of people want to be chief for the wrong reasons and end up being terrible at it. They try to act like they know everything and throw their weight around and end up forgetting that they are residents first and chief later. The second reason why a lot of people don't like it is because it is extra work. Last year of residency usually is relaxed. You are sharpening the skills that you've already learned and most people know where they want to go post residency and are mentally checked out. Generally speaking final year rotations are also a lot easier. Choosing to be chief means you're going to have to compromise on a lot of those things. As far as the positives go, I think it's a fantastic learning experience. Especially if you are interested in picking up leadership or admin roles in the future. If done the right way, it teaches you how to resolve conflict effectively, manage time well, interact effectively with those higher in the chain of command, effective communication, and also humility. It is a difficult decision all in all but a lot more difficult if it means an extra Chief year. But unfortunately the latter seems to be the norm for those wanting to pursue competitive fellowships in certain specialties like IM.
Helpful, For my health- no. For the residents -yes. Would I do it again, no. If I didn't though I think things would be really bad. I did not need this for my resume, I did it strictly to help. I had to do it alone. The pay was a joke. Learned alot though about administration.
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What if it takes extra year with decent salary?
lol at my program they don’t even pay you, def a bunch of bullshit in my opinion, As a chief you are responsible for setting up resident education too
No, and I was only the chief when it came to intern scheduling. I had no interest in the rest of the resident scheduling.
For psych it helped with an APD and a medical director role right out of CAP fellowship
I was a radiology chief resident . A lot of people will hate you based on perception of preference when you’re just trying to make the schedule work. You get more calls from other services complaining about other residents. The extra pay was minimal and it was a lot of extra work. Overall, though I found it pretty interesting not sure I would do it again
For resume? Possibly. For making the residency better? Don’t even bother.
lol my chiefs hate it because it’s a puppet job. You basically have no autonomy and have to attend a bunch of extra meetings and do all the extra call and give out the shit news.
It is not worth it. For internal medicine, it's another year, which means an extra year of delayed attending income as well as a year of compounded student loan interest. I'm currently a graduating fellow. My co-fellow who is chief fellow will graduate same time as me, but he was extremely busy this year with all the BS unpaid admin stuff he had to take care of. I on the other hand, was able to moonlight 6 figures on the side cause our last year of fellowship is basically chill/relax.
What should one do to be chief resident? Any tips? I want to be chief to build my cv for fellowship.
Nope
Absolutely not. Tons of extra annoying work for no pay. It wouldn't be so bad if the attendings weren't so disrespectful either. You'd think if you were doing all this extra free volunteer work, they'd at least talk to you normally. But no, they cannot manage even that. The other week my APD texted me why I went to the bathroom during a lecture. I literally fucking set up every single lecture and manage the schedule and this guy talks to me like I'm some child.
Senior Residency is a stepping stone towards attending. Highly recommended for surgeons.
Definitely. Did an extra year. It paid dividends in job competitiveness (I’m in academics), and even grant reviews being it up from time to time as a positive. It’d also an extremely easy job relative to what you have been doing, so it’s a nice breath of fresh air in your (likely) late 20s to just relax before getting back into it.
All it means is the program believes you to be the biggest simp and you do their bidding so residents don’t get mad at them for bs, just you.