The Role Of The Chief Resident In The Podiatric Residency Experience

It is an honor during residency training to serve as chief resident but what does that experience look like at different programs throughout the nation? Panelists discuss the duties, benefits and drawbacks of taking on that leadership role.

Q:

At your residency program, what are the specific responsibilities of the chief resident? Are the expectations primarily administrative, collaborative, academic or do they include other areas, as well?

A:

Among many responsibilities that come with being chief resident at his program, Matthew Modugno, DPM assists in creating the rotation and surgical schedule for all the residents at his program as well as the monthly resident call schedule. Collaborating closely with his residency director and attending physician faculty, he participates in periodic curriculum committee meetings in which attendees review the program and discuss what is going well along with any needed changes to ensure that the program and residents are constantly improving. 

Dr. Modugno also shares that he joins in on periodic meetings with program directors and chief residents from other services and with hospital administration. 

“This provides excellent insight into the administrative workings of a busy hospital system as well as an opportunity to continually improve the already strong relationship between podiatry and other hospital services,” says Dr. Modugno. 

As chief residents at the same residency program, Donald Cohen, DPM and Ellen Roberts, DPM share responsibility for obtaining and assigning all surgical cases and clinical rotations. However, they point out that expectations are not solely administrative. In addition, they put together the residents’ academic schedule as well as train junior residents and rotating students by putting on workshops and skill labs. Drs. Cohen and Roberts also relate that at their program, chief residents are the main pipeline of information and communication between the attending physicians and the residents.

Priyanka Begur, DPM, a recent residency graduate, explains that chief residents at her previous program are in charge of ensuring that the clinic runs smoothly and are also in charge of the residents’ surgery schedule. 

“The chief resident makes sure that everyone in each residency class level gets an equal number of surgeries each week,” notes Dr. Begur. 

Q:

How does your program select the chief resident(s)? What do you feel are the potential benefits as well as the drawbacks to serving as a chief resident and why?  

A:

At his residency program, the podiatry attending physicians vote to select a single chief resident, says Dr. Modugno. He feels the opportunity to further his leadership skills is a significant benefit and, as a result, would like to be an attending physician at a residency program in the future. 

“Being chief resident allows me to share my knowledge and experience with my co-residents as well as refine my teaching skills,” maintains Dr. Modugno. “It also allows me to serve as a mediator between my residency director, attendings and co-residents.”

He continues to say that potential future Chief Residents should understand that the added responsibilities along with the existing expectations of a third- year resident at a very busy program are challenging but worth the opportunity.

At Dr. Cohen’s and Dr. Roberts’ residency program, all of the third-year residents take on the role of chief resident for the year. They share that in years past, a single chief resident served at the selection of the residency program director at the hospital. However, the director then decided that the third-year residents should work in tandem as chief residents due to their unique individual qualities.  

“We continue that tradition because we each are able to provide different approaches to make the best set of chief residents,” says Dr. Cohen.  

“A major benefit of being a chief resident includes gaining administrative and managerial experience,” says Dr. Roberts. “But a drawback to the position is attempting to keep everybody happy.”  

Both Dr. Cohen and Dr. Roberts say that when assuming responsibility for the behavior and training of others, they realized that it is impossible to satisfy everyone despite sincerely wanting to do so.  

Taking a different approach, Dr. Begur shares that her residency program rotates the role of chief resident among the third-year residents in order to allow each one to take on a leadership role during a set period of time, and foster leadership responsibility as part of the last year of training. 

“I found that allowing all the senior residents to have a feel for being chief resident helped us work together better as a team,” explains Dr. Begur. “I also found that some individuals enjoyed the leadership skills more than others and this was a vital learning experience for the future career paths we each would choose.” 

Q:

What impact do you feel a chief resident can have on a program and his or her fellow residents? Can you share an experience as an example?  

A:

Each of the panelists feel that a chief resident has significant potential to positively influence his or her residency education along with that of their co-residents. 

Dr. Modugno shares participating in a recent restructuring of academic events to enhance educational value along with credentialing to add resident attendance to foot and ankle cases at a new facility. He cites the support of his residency director as a key component in influencing the improvement of these opportunities.

Dr. Cohen and Dr. Roberts feel chief residents take significant responsibility for training programs and activities at their program. 

“We cannot control how many surgeons will hand over the blade but we can provide extra activities like cadaver labs to ensure that residents can master hand and dissection skills,” note Drs. Cohen and Roberts. 

They cite arranging and executing several labs with various medical product representatives to learn about forms of fixation with plates and screws, different wound care and biologic products, or surgical skills like ankle arthroscopy.  

Drs. Cohen and Roberts also cite the importance of open communications and meetings with the program directors and attendings in which they advocate for resident needs and learn what attendings expect of fellow residents as well as themselves. 

Dr. Begur feels that helping her co-residents and fostering a positive learning atmosphere can be extremely impactful for both the chief resident and junior residents. 

“I found it furthered my learning and promoted enthusiasm and motivation among us all,” shares Dr. Begur. 

Specifically, Dr. Begur outlines a time when she double scrubbed for an ankle fracture open reduction and internal fixation case with a second-year resident. She shares that she gained confidence and knowledge while supporting her fellow resident’s learning as well by teaching him how to reduce and fixate the fracture in the way she found best. 

Dr. Begur believes that through motivation and hard work, any residency can be a strong and successful one, producing well-trained, knowledgeable physicians. 

“It is important in our profession to understand that we are all one community working together to treat our patients the best we can,” says Dr. Begur. “I am excited to continue my journey in this way from student to resident to chief resident and now a practicing physician.” 

Dr. Begur recently completed her podiatric medicine and surgery residency at the Carl T. Hayden VA Medical Center in Phoenix, Ariz., including a podiatric research fellowship and is now in private practice in Phoenix, Ariz. 

Dr. Cohen is a third-year podiatric medicine and surgery resident and a chief resident at a hospital in New England.

Dr. Modugno is a third-year podiatric medicine and surgery resident, and chief resident at Bryn Mawr Hospital in Bryn Mawr, Pa. 

Dr. Roberts is a third-year podiatric medicine and surgery resident, and a chief resident at a hospital in New England.

Dr. Bernstein is the Director of the Podiatric Residency Program at Bryn Mawr Hospital in Bryn Mawr, Pa. He is a Fellow of the American College of Foot and Ankle Surgeons.