When Sarah Lassey, MD, was a junior resident in the Department of Obstetrics and Gynecology, she looked at the program’s chief residents with “so much respect and awe of their knowledge base and how they managed their teams.”
Now, Lassey supports and guides junior residents as one of 10 chief residents in the BWH/MGH Integrated Residency Program in Obstetrics and Gynecology, a four-year program.
“Being a chief resident is the experience of learning what it’s like to be a young faculty member,” said Lassey. “There’s a lot of leadership responsibility, including figuring out how to manage teams. It’s the first time people are looking to you for all decision-making. It’s a wonderful culmination of learning from the prior three years of residency.”
Depending on the specialty, chief residency either occurs in the final year of one’s residency or as an additional year after residency. In some specialties, all residents in their final year become chiefs; in others, a select number of chiefs are chosen. In BWH’s OB/GYN and Neurosurgery Residency programs, for example, all residents who are in their final year are chiefs, but a few chiefs are selected each year for BWH’s Internal Medicine Residency, which consists of an additional year of residency.
Across the board, chief residents handle everything from managing care teams and teaching residents and medical students to coordinating residents’ schedules and serving as a liaison between faculty and trainees.
The linchpin for residents
“For each resident, chiefs are the linchpin for one’s lives,” said Matt Vestal, MD, one of two chief residents in the Neurosurgery Residency Program. “Chief residency was constantly on my mind going through the seven-year program. I would see good things my chiefs did and think, I want to be that kind of chief someday, as well as things I’d want to avoid. I got to see what it was to be a conscientious chief – protecting junior residents and educating them amid the craziness of the ebb and flow of what we do.”
As a chief, Vestal oversees the Intensive Care Unit service and senior residents on the floor service. He rotates being on-call with his fellow chief resident every week in addition to his other clinical duties. Vestal also gets to choose the operations he takes part in, coordinates the schedules of all residents, works closely with Anesthesiology and Operating Room leadership and creates operating schedules.
Michelle Jose-Kampfner, MD, one of four chief residents in BWH’s three-year Internal Medicine Residency Program, says that chief residency is a position that requires many different skills.
“The chief residents function as a unit of four and play off each other’s strengths,” said Jose-Kampfner. She says attention to detail, organization, an ability to find creative solutions to problems and being able to take something complicated and make it digestible for trainees are extremely important.
“High-yield teaching moments make a really good chief, as well as being approachable, warm and someone people can come to when they’re having an issue,” she said. “Since it’s a clinical position, too, of course, learning to be a good doctor and modeling good attending behavior are also critical.”
Jose-Kampfner says that most internal medicine residents complete a year or two of fellowship before coming back to be a chief. Since she does not plan to specialize, Jose-Kampfner was chosen to become a chief after completing her residency last year.
She says her days as a chief are vastly different from earlier years in residency. While she still has clinical responsibilities as an attending on an inpatient service and holds weekly clinic, she also spends a lot of time teaching, including leading daily morning reports, presenting cases to residents and organizing other didactics like noon conference. She has a great deal of administrative leadership, including supporting residents and managing their schedules – no simple task for a program of roughly 200 trainees.
Life after chief residency
After Jose-Kampfner finishes her chief year this summer, she plans to move to Cleveland with her fiancé, who will be pursuing a cardiology fellowship. She says she looks forward to finding a position that will allow her to care for underserved populations of patients.
Looking back on her residency, Lassey is amazed by how quickly four years have gone by and by how much she and her peers have learned.
“When you start intern year, you’ve never been a doctor before or performed a surgical procedure,” said Lassey, who will stay at BWH for a fellowship in Maternal-Fetal Medicine, high-risk obstetrics. “Residency quickly brings you to a level of competence and leadership. You learn so much from physicians, patients and each other. The Brigham has been a wonderful place to learn and train.”
After residency, Vestal will go on to finish his MBA before pursuing a fellowship in pediatric neurosurgery, but not before taking a long-overdue vacation with his wife, who is a psychiatrist. He describes the end of the long and challenging road of neurosurgery residency in a close-knit program as bittersweet.
“I can’t explain how ecstatically happy I am since it feels like this really hard thing is ending,” he said. “I came into residency as such a different person, and it has become such a huge part of my life now. I’m not sure what life outside of residency will be like; it shapes us for the rest of our lives.”