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Chief residents lauded for commitment by Cindy Abole Public Relations Handling the job of chief resident within an institution’s residency program is no easy task. So as MUSC’s 50 chief residents welcome 130 new residents July 1, they’re helping them as they step forward in their next stage in graduate medical education (GME).   At times being chief can be a lonely, sometimes thankless job that tests an individual’s patience, competence and organizational abilities. Despite the comparisons, chief residents are considered among the hospital’s most responsible, hard-working, misunderstood, undervalued, yet resilient leaders working within hospitals today.   Outgoing pediatric chief Dr. Adrian Lavery, right, meets with incoming chief Dr. Andy Little to discuss their transition and prepare for new residents. They provide the leadership and management  skills that keep a medical program vibrant while providing the education, experience and skills necessary to teach and prepare future physicians.   Outgoing pediatric chief resident Adrian Lavery, M.D., knows just what it’s like. Lavery and co-chief Jennifer Jarrett Hoover, M.D., helped manage 44 pediatric residents and eight medicine/pediatrics residents in the Department of Pediatrics last year. Both Lavery and Hoover completed their pediatric residency training in three years and stayed to take on the full-time role as pediatric co-chief residents. The departments of Pediatrics and Internal Medicine are the only residency programs whose chief residents are selected from a short list of qualified residents who’ve already completed their residency training and desire the challenge. With few exceptions, all other chief residents are in their final year of their residency programs.   “Being a chief resident has been one of the most rewarding experiences for me,” said Lavery,  who earned his medical degree from the University of Eastern Virginia Medical School and a master’s in public health from Boston University. “I feel I’ve gained so much knowledge and experience in these past 12 months. I’ve especially learned to value the educational and teaching aspect of the job. It’s been a great year.”      Pediatric chiefs, as well as most chief residents, are multi-talented individuals whose job defines them as educators, managers, coordinators, schedulers, liaison between residents (specialty and subspecialty) and faculty, spokespersons for the department, counselors, problem solvers and mentors.      Their jobs range from preparing resident call schedules, coordinating morning reports, arranging midday teaching conferences, case presentations and guest lectures, to meeting regularly with residents. By nature of their roles, chiefs deal constantly with change especially as it relates to call schedules, staggered work hours and unforseen emergencies. Areas such as surgery, neurology, orthopaedics and other sub-specialties rely on a night float system to assure round-the-clock clinical support. It’s their job to maintain 24/7 resident presence in patient care areas.   Tools like the E*Value  system  are helpful resources provided by the GME office to help manage work hours, maintain training and manage other educational requirements.   Aside from their administrative duties, chiefs are also teachers and mentors guiding residents towards successfully completing their clinical rotations, core competencies and specialty training. As members of pediatrics faculty, both Lavery and Hoover are board certified pediatricians who share rotations working weekends in the Children’s Hospital Emergency Department.      “I’ve had great experiences working with our neurology chief residents each year,” said Olivia Burch, residency coordinator with the Department of Neurology, who's helped manage her program since 2001. Last year, Burch assisted two chiefs who managed 14 residents and a subspecialty resident. “All of us work very well together. I do everything I can to try and work hand-in-hand with them.”   Despite the crazy work hours, many duties and heavy administrative load, Lavery has always been there for his residents. He and Hoover maintained an open door policy keeping regular office hours between 9 a.m. to 5 p.m. for residents to stop by and talk. According to Franklin Medio, Ph.D., associate dean for Graduate Medical Education (GME), chiefs are usually the first person to hear about a resident who is having performance problems or personal difficulties.   “Staying in touch and being accessible has been a big part of communicating with residents this year,” Lavery said. “Residents want to feel comfortable knowing that they can trust us and come forward to discuss anything personal or professional.”      As with their residency counterparts, the co-chiefs meet regularly with pediatric residency director George Johnson, M.D., residency program coordinator Colleen Thomas and pediatrics chairman L. Lyndon Key, M.D. in breakfast meetings to discuss problems, address issues or changes in GME training or curriculum.     Dr. Franklin Medio introduces MUSC Medical Center director Dr. John Heffner during the June 23 new resident's orientation. Each month, Medio meets with chief residents to discuss problems, share successes, and/or review GME policies and procedures. Medio and GME office staff also meets monthly with residency program coordinators to review and discuss GME matters.      “I count on our chief residents for their insight, input and opinions,” said Medio. “They are among the key players to improving the quality of a GME program. They serve as the eyes and ears of the GME office. Whenever there’s a GME issue or problem, I go to the chiefs for their perspectives and they often direct me to other residents. I rely a lot on them and have a great deal of respect for what they do.”   Like other chiefs, the yearlong experience has opened doors to other training opportunities and professional development. Starting this month, Lavery will begin a prestigious neonatology fellowship at the Cincinnati Children’s Hospital in Ohio. For the past few weeks, Lavery and Hoover have been busy preparing their pediatrics successor, Andy Little, M.D., sharing contacts and reviewing administrative details. 2005 - 2006 MUSC Chief Residents Anesthesiology: Curtis Brown, Clint Farris Dermatology: Angela Hutcheson, Elise Jackson, Brad Soder Family Medicine: Curtis Franke, Marty Tucker Internal Medicine:Brad Keith, Jesse Roach Neurology: Roy W. King Neurosurgery: Christopher Chittum OB/GYN: Lea Mahoney Ophthalmology: Hawke Yoon Oral Surgery: Michael Morgan    Orthopaedic Surgery: Roger Bryant, Brian Straus, Michael Wildstein, Robert Yarbrough Otolaryngology: Bradford Woodworth, Marcus Moody Pathology/Lab Medicine: Lydia Christiansen, Jennifer Laudadio Pediatrics: Andy Little Pediatric Dentistry: Kimberly Coxe, Mike Myers, Mike Hansen Periodontics: Cheria O’Neal Plastic Surgery: Marc Bisseck, Stephen Gauthier     Psychiatry: Michael Smith, Jennifer Osborne, Yates Brown Radiology: JB Mitchell, Doug Lake Radiation Oncology: Jennifer Harper Surgery-General: Will Yarbrough Surgery-CT: Matt Toole Urology: Mallory Reeves, Scott Wingo          Subspecialty Chief Residents    Child Psychiatry: Melanie Hatzis, Susan Kozel Endocrinolgy: Christina Cox Infectious Diseases: Kevin Boatwright     Pulmonary/Critical Care: Fitzgerald Drummond, Jay Heidecker, Brian Zeno     Nephrology: Thomas Powell     Med/Psych: Baron Short, Stinson Tillerson Chief residents gather, learn job at workshop When it comes to guiding chief residents in their new roles and responsibilities, chiefs have been traditionally on their own. Recently, residency programs and sponsoring institutions began to formalize training that has helped chief residents through the transition from learners to leaders.   In early June, a total of 60 chief residents from MUSC and other residency programs across the country gathered for a three-day training conference organized by MUSC’s Office of Graduate Medical Education.   For the past five years, MUSC has gathered medical educators, leadership and management experts and physicians in a formal training program for chief residents. The program was established by Associate Dean Franklin Medio, Ph.D., who is also MUSC's Designated Institutional Official for GME. Medio wanted to create a customized training program that would aid MUSC’s chief residents. He collaborated with Associate GME Dean George Arana, M.D., Tom Gordon, Ph.D., Internal Medicine Residency program director Ben Clyburn, M.D., and others in gathering training materials, experiences and resources.   Today, the conference, “Handling the Job of Chief Resident,” is held in early June, and has attracted participants from as far away as Connecticut,  Illinois, Ohio, Oklahoma, New York, Pennsylvania, Tennessee, Texas, and California.          “Everyone has an inherent desire to do well,” said Medio. “It would be unfair to have certain expectations of our chief residents without giving them the proper type of training. What we’ve done is help them define their roles and assist hem by providing the  basic tools and knowledge to help them perform their jobs and communicate in the most effective, professional manner.”   Driving this interest in improving chief residency training is a number of factors including current changes in medicine, emphasis on patient safety and the addition of new guidelines and policies affecting graduate medical education (GME), especially the monitoring of resident duty hours.   “Chief residents have always managed to take on a lot of responsibilities,” Medio said. “In most cases, they get little, if any preparation for their roles. Standard training has focused on the energy and effort chiefs make in their administrative work. They’re not really prepared to handle residents and their personnel matters, as well as educational development and duty hour issues.”   The conference featured guest presenters speaking on areas such as leadership, developing management skills, medical ethics, communication skills, and cultural competency in health care. Participants were encouraged to participate in discussions and dialogue and benefitted from the opportunities for collaboration and sharing.   Workshop attendees Jennifer Laudadio, M.D., and Lydia Christiansen, M.D., are both new MUSC pathology co-chief residents who’ve had time in their leadership roles since March 1. Although the pair got a jump ahead of their counterparts managing 22 residents in the Department of Pathology, they’re still eager for training and learning new approaches with their jobs.   “The conference brought us a new set of ideas and perspectives to our jobs,” said Laudadio. “I’ve gained a greater understanding of people and their personal characteristics. I’m sure we’ll implement some of the management and communications skills we’ve learned already.”   Participant Dwayne Henry, M.D., is one of a pair of internal medicine/pediatric chiefs from the University of Oklahoma Health Science Center in Oklahoma City who also attended the conference. Acting on a recommendation by his residency program director and coordinator, Henry and co-chief, Sowmya Mohan, M.D., made the 1,020-mile journey to attend the event at Charleston’s Wild Dunes Conference Center.    “The sessions have been great,” said Henry, who will help manage 15 residents in their program. “I’m especially learning more about management skills and assessment methods that can really add and complement our program. The ideas and tools we’ve already learned will be helpful in establishing GME guidelines within our department.” Friday, July 1, 2005 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.