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1. What I wish I knew before my chief year A (non) Evidence-Based review
2. Who are your role models?
3. You all are entering an elite family of chief residents. Looking back at some famous former chief residents can be insightful and inspiring. Anyone know who this is?You all are entering an elite family of chief residents. Looking back at some famous former chief residents can be insightful and inspiring. Anyone know who this is?
7. Jason Seaver and Cliff HuxtableJason Seaver and Cliff Huxtable
9. In your group, brainstorm the following:
What do you think are the 5 biggest challenges you’ll face (or have faced) as chief resident?
How do you plan to address each one of these?
10. Be OK with things not being perfect all the time (e.g: not enough beds in the hospital):
If problems: Faculty and Residents will come to you first
You are NOT ultimately responsible for success/failure of the program
Listen attentively, stay calm and cool, hear them out
Give yourself time to think, process, explore the alternatives
It’s OK to say “I don’t know the solution right now…”
There will be problems you can’t solve
FOLLOW-UP
Even if there isn’t a solution right now, at least the individual was heard and knows their concerns matterBe OK with things not being perfect all the time (e.g: not enough beds in the hospital):
If problems: Faculty and Residents will come to you first
You are NOT ultimately responsible for success/failure of the program
Listen attentively, stay calm and cool, hear them out
Give yourself time to think, process, explore the alternatives
It’s OK to say “I don’t know the solution right now…”
There will be problems you can’t solve
FOLLOW-UP
Even if there isn’t a solution right now, at least the individual was heard and knows their concerns matter
13. Mediator/Negotiator Get all sides of any story
Be OK with things not being perfect all the time
Get to know other chiefs in other departments
Might see people you admired in a different way – i.e. you now have a “behind the scenes look” at faculty Get all sides of any story example: an intern comes to you furious about an RN because the RN went above the intern’s head and called the senior resident to assess their patient. Instead of bringing it up with the RNs unit director, you go to hear the RNs side of things, and they tell you that they’d been paging the intern and not getting responses all night, so they had to start bypassing them. Now you have a different issue – is there something wrong with the intern’s pager? Were they really ignoring pages? Problem with setting priorities? Should the RN have handled it differently. Alternative example: residents say the faculty aren’t teaching them anything. Faculty say the residents are never available when they try.
Be OK with things not being perfect all the time:
If problems: Faculty and Residents will come to you first
You aren’t ultimately responsible for success/failure of the program
Listen attentively, stay calm and cool, hear them out
Give yourself time to think, process, explore the alternatives
It’s OK to say “I don’t know the solution right now…”
There will be problems you can’t solve
FOLLOW-UP
Even if there isn’t a solution right now, at least the individual was heard and knows their concerns matter
Get all sides of any story example: an intern comes to you furious about an RN because the RN went above the intern’s head and called the senior resident to assess their patient. Instead of bringing it up with the RNs unit director, you go to hear the RNs side of things, and they tell you that they’d been paging the intern and not getting responses all night, so they had to start bypassing them. Now you have a different issue – is there something wrong with the intern’s pager? Were they really ignoring pages? Problem with setting priorities? Should the RN have handled it differently. Alternative example: residents say the faculty aren’t teaching them anything. Faculty say the residents are never available when they try.
Be OK with things not being perfect all the time:
If problems: Faculty and Residents will come to you first
You aren’t ultimately responsible for success/failure of the program
Listen attentively, stay calm and cool, hear them out
Give yourself time to think, process, explore the alternatives
It’s OK to say “I don’t know the solution right now…”
There will be problems you can’t solve
FOLLOW-UP
Even if there isn’t a solution right now, at least the individual was heard and knows their concerns matter
14. Mediator/Negotiator A word on complaints
Used to drive me crazy
Some level of complaining drives program improvement
Consider complaints as an endorsement
They trust you and they believe you can make a difference
Overly negative or unreasonable complaints
help folks re-frame their complaints ? constructive
sometimes all someone needs is someone to listen and they just need to vent. That’s OK (consider the resident’s mental health) Example of an overly negative complaint: the cafeteria STINKS! It’s a total rip off, and I hate it. Re-framing the complaint: the cafeteria prices are too much for our meal budget, or the speediness in the cafeteria is making it really hard to get to conference and I’m frustrated. Now you can brainstorm on solutions. Also, might want to explore why they’re so angry about something like this – did they just leave rounds and get mistreated on rounds about something, and they’re displacing the anger on the cafeteria situation? Example of an overly negative complaint: the cafeteria STINKS! It’s a total rip off, and I hate it. Re-framing the complaint: the cafeteria prices are too much for our meal budget, or the speediness in the cafeteria is making it really hard to get to conference and I’m frustrated. Now you can brainstorm on solutions. Also, might want to explore why they’re so angry about something like this – did they just leave rounds and get mistreated on rounds about something, and they’re displacing the anger on the cafeteria situation?
16. Keeping it in balance – Personal/Professional Life YOU need to vent, too!
Find a constructive way to release
You can work non-stop at the job, if you let yourself – set limits
Administrative duties – avoid getting too bogged down
Set some limits for yourself, e.g. check your email 2 times per day MAX
Talk to your program director or co-chiefs if you are out of balance
prioritize, prioritize, prioritize
(Be OK with things not being perfect all the time)
18. Counselor Listen and be available
Follow-up
Utilize your resources
When someone is talking with you, think about their overall goals
Try to maintain the balance of being “friendly/supportive” with “pleasing everyone”
you can end up being treated like a friend rather than respected like a chief resident / attending Be available
Be positive but also be real – it’s OK to level with folks when they’re upset
don’t have to convince someone who’s complaining that they’re wrongBe available
Be positive but also be real – it’s OK to level with folks when they’re upset
don’t have to convince someone who’s complaining that they’re wrong
20. Leaving Your Legacy Set priorities or else the year will pass you by
Break big projects into small/realistic pieces
re-vamp continuity clinic scheduling, introduce a new curriculum item (sim center? EBM? other?), collaborate with neighboring residency programs, research xyz…
21. Leaving Your Legacy
22. Leaving Your Legacy
24. Carving your Professional Path See yourself as a colleague/faculty member
Take advantage of career development opportunities that arise
Just like in med school and residency, you deserve to give/receive feedback, e.g.
Discuss expectations with PD early
Share your priorities with your PD
Schedule weekly coffee with PD, to f/u
Discuss clinical cases with senior faculty
26. Administrator Identify the administrative/programmatic tasks for the year
agree to division of labor with co-chiefs.
If only you, then set a timeline for yourself for these tasks
Tough decisions:
You will likely have to make tough decisions and say/do something outside your typical comfort zone, e.g.
calling people in for emergency call
calling someone into the office to give negative feedback is difficult for many people,
advocating on behalf of your residents to a faculty member can be extremely difficult, etc…
but that’s why YOU were chosen…because people believe you have the talent and skill to do this effectively
Get to know other chiefs in other departments
28. Clinician Prioritize your clinical development
Patient safety is critical, so is your ability to sleep without worrying about a decision you made
Identify your clinical allies
Rely on your mentors
They (should) expect you to ask questions
Set time each week to read or study for boards
30. Educator Hold people to a reasonable but high standard
People often more respect those who tell them when they aren’t meeting expectations than when they avoid confrontation and say nothing
Discuss teaching techniques with PD
Different strategies:
Set aside time on rounds or clinic while attending
Participate in formal teaching activities:
Medical student rotations / experiences
Journal clubs / didactics
…
31. Nike Dunk SB Dr. Huxtable / Bill CosbyNike Dunk SB Dr. Huxtable / Bill Cosby