- Trust your fellow residents! Find a clear balance between setting clear expectations but not micromanaging.
- Don't be biased! Even though you've made friends with your fellow residents, don't treat anyone differently. Be a fair leader.
- Make accurate, fair schedules, and get them out as early as possible.
- Develop a thick skin, and try not to take things too personally. You're bound to make decisions that don't make everyone happy.
- Take care of your own mental health! It's a hard job, so make sure you're taking care of yourself, too.
We've scoured Reddit to bring you the best tips on how to be a good chief resident once you have the position.
If you need a little debrief, go back and read our blogs: Everything You Need to Know Before Becoming Chief Resident & How to Become a Chief Resident.
Trust your fellow residents
u/frosty12 got 38 upvotes for their input on the thread What (in your opinion) makes a good chief? What makes a bad one? Any stories that particularly exemplify one or the other? They cover 4 aspects of a great chief resident, including proper management of team workload, owning up to mistakes, recognizing hard work, and confidently controlling the service.
- They properly manage the team workload, they don't dump work on people below them but do trust people to get work done and don't micromanage.
- When a mistake happens they take ownership of the mistake regardless of what happened. They ultimately feel that the service is there's to manage and everything stops with them. They do pull aside juniors when they make a mistake and explain what went wrong, etc. But when it comes time to talk to the attending they own up to the mistake as their own.
- They make sure everyone knows that their hard work is appreciated. This doesn't need to be any grand gestures. It's simple things like, 'hey you did a great job in that case doing x, y, and z', 'thanks for going the extra mile for this patient', etc.
- They are in control of the service. Bad chiefs usually are barely holding unto the service. They are overwhelmed and it comes out as aggression towards juniors. On the other hand good chiefs can make the most hectic service feel fun and exciting...because everyone knows that the chief has things under control." - u/frosty12
u/iamafish gives some examples of what not to do as chief resident in the same thread. They bring up a point that is brought up often in these threads—don't micromanage. An example they give of what micromanaging can look like for a chief is making non-call people stay even if there is nothing to do. Try not to be too strict about insignificant things.
Don't be biased
u/hyper_hooper sums it up pretty well in this comment about making sure you treat everyone the same. We know you've made friends throughout residency and it can be hard not to give them special treatment. But, a good chief is a fair leader, especially when it comes to the schedule!
"Make the schedule fairly. Give everyone the same number of calls when feasible. Make the schedule in an objective manner without factoring in your personal opinions about residents." - u/hyper_hooper
u/juls2587 got 87 upvotes for their advice to always be as approachable as possible! New residents especially appreciate a chief that is approachable for advice and teaching. They also bring up that as a chief, you are in charge of adults, so treat everyone with respect and understanding.
"Feel the pulse of a room. Be firm when necessary, loose when possible, but always as approachable as you can be. Treat people like they're actually adults in an unfamiliar environment when starting, not like a child." - u/juls2587
Set clear expectations
u/catscratch23 commented their example of a good chief on the thread What (in your opinion) makes a good chief? What makes a bad one? Any stories that particularly exemplify one or the other? They advise to set clear expectations from the beginning and reiterate how a good chief doesn't micromanage.
"Good chief: Set clear expectations from the beginning for your residents and medical students. Tell them what you expect, but don't micromanage them. Once you set that bar for expectations, keep it. Don't raise it at the end of the rotation without telling your subordinates and then tell them that they're crappy or subpar because they didn't go above and beyond your expectations. Set the bar at a reasonable level and hold your team accountable to it, but most importantly hold yourself to it as well." - u/catscratch23
Properly manage mistakes
u/r2805869 admits to a mistake in this thread and talks about how their chief explained how to do it properly and told them that if they needed assistance in the future to ask for help. u/r2805869 also mentions that because their chief handled the situation so well, it made them want to stay overtime and make the chief's life easier. When you're a good leader, your followers will want to help you, too!
"The best thing a great chief can do is properly manage a mistake.
I once screwed up a patient's dressing to the point where we might have had to re do her skin graft. The chief first and foremost fixed my mistake. It took a very very long time to detangle the cotton from the graft. They then asked who was responsible, not that they needed to because I was oozing guilt from my pores and wringing my hands the entire time.
They mentioned to come to their office before I left for the day. Once I was there and sure I was going to be kicked out of the hospital, they told me "you messed up today. The proper steps to dressing a skin graft are x, y, z. I trust you won't forget it again. Also, next time you aren't sure of something, it is okay to not do the task at hand until you have told a person who can properly guide you."
Just the fact that they didn't chew me out when I already felt so bad was amazing. But their way of handling that mistake and preventing more was something else. I would have stayed overtime every day of that rotation (and often did) to make their life easier." - u/r2805869
Be on top of scheduling
Like we mentioned earlier—don't be biased especially when it comes to the schedule. We had to bring this topic back! It's also important to be on top of scheduling as much as possible since time off is hard to come by and it's nice to make some plans when you have some time (especially a golden weekend)!
"Get those schedules out as early as humanly possible. Time off is hard to come by and if I’m getting a weekend off, I want to plan some fun things ahead of time." - u/bassejm0
Leave paper trails
Cover your butt as well as your residents'! u/traumaprotocol mentions in a thread in r/medicine that if residents switched, they both signed a form (as well as a chief) to make sure everyone was in the know/approved.
Don't take things too personal
u/huper_hooper had even more great advice in the r/residency thread How to be a great chief?. They commented that it's important to develop a thick skin to be chief resident. Realize that you won't be able to make everyone happy all of the time. They also bring up that it's never a good idea to badmouth addendings/PD/APDs in front of residents.
"Develop a thick skin and don’t take things personally. You will inevitably have to make some decisions that make certain people unhappy, or be unable to change circumstances that are making people unhappy. Be fair and equitable in regards to these decisions.
Take care of your own mental health
This one is super important! So important that we brought in two comment examples. u/IcemanMD and u/rohrspatz talk about how important it is to focus on your own mental health while chief resident. Make sure that while you're taking care of everyone else, you're taking care of yourself, too.
"The job is inherently frustrating, depressing, sometimes rage-inducing. Take care of yourself. Get a therapist, vent to a friend, meet with your chiefs, a department director, or your program director to discuss a problem, throw yourself into a QI project, go take it out on the weights at the gym. Do not take your feelings out on the people around you." - u/rohrspatz
Whatever your end goal is, fellowship or attending, your medical knowledge is important too. Another thing related to this is giving lectures. At my program the chiefs have to give a ton of lectures. Put a bit of effort into making these fun. People will notice the effort when you do, instead of copy pasting UpToDate." - u/IcemanMD