All NYC EM Chief Resident Conference 2014

On April 28th, 2014 I was privileged to take part in the ALL NYC EM Chief Resident Conference. This experience was incredibly high-yield and filled with a range of pearls on working with department administration to attaining better leadership skills. It served as an excellent think-tank and networking experience for residents. Below is a brief overview of the salient points from some of the lectures.


The day began with Kaushal Shah giving a concise but thoughtful introduction on what it takes to be selected as chief resident. He says chief residents require the right ingredients; they must be responsible, hard working, and approachable. Faculty and residents see a chief resident as a leader who is trustworthy, clinically strong and ready to make departmental changes.

The introduction had the expected intimidating comments such as “next year will be the hardest year of your life.” But there was an overwhelming amount of encouragement that left the room thinking, “I will survive this year and leave a positive mark.” It was the perfect opening to describe the themes of the lectures and breakout sessions of the day.

Ice Breaker

This was a unique idea for unifying a group of strangers. The goal was for each group to create a logo that defines who we are as NYC EM chief residents. In the end, everyone voted for the best design. Groups were formed randomly and we all got to talk briefly about experiences being new chiefs. The logo ideas were a bit insane, mildly inappropriate and incredibly hilarious. The room was definitely having a blast! The winning logo will be placed on buttons for all NYC EM chiefs to wear at SAEM 2014. You’ll have to look out for the winning design of this competition in Dallas at the resident leadership forum.

Be a Great Leader

Dr. Mark Silverberg opened his talk with a dose of inspiration saying that “those of you sitting here will be the next generation of program directors.” One of the best take away messages from this lecture is that to be chief resident, “many people must have believed in you” and now we must live up to those expectations.

The key concepts Dr. Silverberg addressed are below and applicable to all physicians, especially those in leadership positions.

Agreements versus Disagreements

At some point we will disagree with the directors of our department or residency on an important decision. This is expected as everyone is entitled to an opinion. The steps to address this disagreement are crucial. First, as chiefs, we must think about our opinion in detail (all the pros and cons). Then we discuss the topic with all relevant parties—this meeting should be in private. Finally, as a group of leaders representing all sides of the discussion, we must come to a consensus that unifies all parties involved. The final verdict may not be the opinions of the chiefs, but to outside parties we will all share that one opinion. This helps avoid division among the leadership groups.

Become an Inspiring Leader

This is not a position where we can project the mantra of “do what I say, not as I do.” People can recognize a sham and we should avoid anything that resembles one. We must be good listeners, compassionate, trustworthy, consistent, and ultimately, someone who others consistently want to follow. We should always have the best interests of the residency and department in mind. A big pearl he gave was to come to work passionate about our job and what we do. We should set the tone for our shift to be “I love my job. Let’s go take care of patients together.”

Choice and Timing of Words

“Better to remain silent and be thought a fool than to speak and to remove all doubt.” -Lincoln

Main lesson here is to think before we speak. Being chief is in many ways a political role where our word choice can be later used against us. Take 1-2 days to respond to even the most borderline controversial situations. This will give time to truly analyze the situation, decide the best wordage for a response and have another responsible person give input, if needed.

Continue to Be a Good Physician

Remember, we are doctors first and everything else second. We must continue to improve our medical fund of knowledge because that is the primary goal during residency. We were given this responsibility because someone believed we could handle it in addition to clinical responsibilities.

Look the Part

Words of the day by Silverberg, “No one likes B.O.” So shower, dress business casual at important meetings, and go to conference appearing groomed. When speaking, have a positive attitude, good posture, and make eye contact. Everyone is looking at us so be on time and form a positive reputation of using admirable habits. If we are on time, happy to be at work, willing to work hard, people will look forward to shifts with us.

Be Consistent and Fair

The most valuable lesson I have learned from this conference is to be consistent and fair. The main idea is to never ask of others what you are unwilling to do yourself. If you look out for the well being of others it will be appreciated. Never give yourself the best schedule, do not play favorites, and do not break promises, because it will be noticed. Know your policies and continue to revisit and improve them, because you can always reference them when you make a decision that is not warmly accepted by another resident.

Promote Others

This was an interesting approach that is worth considering. If we acknowledge and publicize accomplishments in the department it will tell residents that we care about their success. We should encourage creativity and give good constructive feedback. If we continue to back our residents they will feel empowered to accomplish more. No good leader wants to do all the work and take all the credit for doing it.

Conflicting Agendas-Residency versus Administration

This was a creative activity where the room of residents was split in half. One portion represented residency leadership and the other portion represented residency administration. The objective was for all chief residents to try to understand the perspectives of each group so they can make better collaborative decisions later in the year. Each group was given a few frequently seen scenarios and told to find a resolution from their perspective.

Scenario One—Funding for Residency Retreat

Every year a residency wants to have a residency retreat and that is usually paid for by the department at $90/person for 60 residents. This year the cost of the retreat increased to $125/person. How can this cost be obtained?

Administration Responses

  1. The retreat could alternate each year between inexpensive and expensive locations
  2. Residents could fundraise the money themselves
  3. Attendings could help subsidize the cost via donations
  4. Invite attendings to the retreat and charge them $200/person to help offset the cost of residents
  5. Simply find a cheaper location

Residency Leadership Responses

  1. Cut costs elsewhere to shift funds to cover retreat (less money on conference food, less money on graduation, etc…)
  2. Ask attendings for help to fund the retreat
  3. Contact the alumni fund or larger organizations like CIR to help subsidize cost.

Scenario Two—Send Residents to ACEP/SAEM with Financial and Shift Coverage

Every year residents want to be sponsored to go to national conferences like ACEP or SAEM. How do you decide which residents are financially covered?

Administration Responses

  1. Need to have an application process where residents submit a reason for financial sponsorship
  2. Cover the cost of all residents given oral or poster presentations
  3. Make residents find their own shift coverage

Resident Leadership Responses

  1. Select a particular PGY class to go to one conference on an annual basis (i.e. PGY3s go to SAEM each year with PGY4s covering shifts and PGY4s go to ACEP with PGY3s covering shifts)
  2. Split the conference in half where some residents go to the first few days and the remaining go to the last few days
  3. Pay for costs if presenting or accepting an award or given oral or poster presentation

Concluding Thoughts

Again, these are only a few of the highlights of this very impactful conference. Overall, it was a great success and full of helpful tips and tricks for all chiefs residents. Truly worthwhile for other regions to consider hosting their own regional chief resident conference!

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