Building Capacity Within a Residency Program
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The chief resident plays a critical role in the educational, administrative, service, and research mission of the residency program. As the future leaders in academic medicine, we felt it was prudent to nurture the leadership skills and capacities of residents in ways that would serve and support the health of the program both during their time with us, but also as they move forward into their professional lives. A review of past practices had revealed weaknesses. For example, in the selection processes, there was a lack of clear role defini-tions, eligibility criteria, a transparent selection process, training or support for the role, or even clearly delineated responsibilities. Despite the ambiguity, past chief residents have all succeeded in their roles and have provided excellent role models for our newer chiefs; however, the training committee decided that this was an area that could be strengthened. A goal was established to conduct a needs assessment and then to research and document a plan to address the shortcomings. Our research revealed that our lack of attention to this area was actually quite common; few programs had clear processes, criteria, or policies in place. There also appeared to be conflicts between the ways in which the chief resident's role was conceptualized, compared to how it was carried out in practice.