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Not in the Job Description (A Farewell to the Traditional Chiefs)

May 30, 2021
by Mark David Siegel

Hi everyone,

They knew they'd be making schedules, teaching, and attending. They knew they'd be pulling backup and finding coverage for big events. They knew they'd be giving Grand Rounds. That's what Chiefs always do. It's in the job description.

But the Chiefs didn't anticipate a year dominated by a pandemic. No Morning Reports in person. Lugging lunch carts to the 9th floor. Covering services with depleted backup pools. Fielding frantic requests to respond to surging patient loads. Creating a MICU team. Navigating emotional negotiations. Tracking down safe lunch spaces and keeping crowds out of poorly ventilated work rooms. Ensuring residents' voices were heard. Partnering with the highest levels of school, department, and hospital leadership. It's a lot to ask of physicians fresh out of residency.

Somehow the Chiefs made it look easy, though their work was difficult beyond words. And somehow, despite it all, they gifted us with remarkable innovations, like Morning Report on Repeat, a Resident Procedure Team, and a Distinction devoted to race, bias, and advocacy. They elevated the interns’ role at Report, they burnished our social media presence, they created a lightening round Q&A session during recruitment, they integrated social justice into our curriculum, and they opened up an essential discussion about trainee mental health.

And there was more. Behind the scenes, the Chiefs ensured sick residents were fed and they helped residents dealing with family emergencies focus on their loved ones. They coached struggling learners and they consoled residents overwhelmed by the pandemic. In weekly leadership meetings, the Chiefs were a constant source of wisdom. They spoke well of every resident and they pushed us to be better versions of ourselves.

So, thank you Rachel, John, Chad, Jana, and Thejal for lending your courage, your insights, and your devotion to our residency. Thank you for opening our eyes to innovation, to hidden curricula, to mental health, to structural racism, and to better ways to address social determinants of health. You've raised Chief Residency to a new level.

Thanks also to hospital, school, and department leadership for giving these five young physicians the space and encouragement they needed to grow. We're fortunate to work in an environment that supports junior leaders.

Thanks also to Jadry, Hiam, and Andy for your work this year as Chief Residents for Quality and Safety (Jadry), the NHPCC (Hiam), and the VA Center of Excellence (Andy). You too rose to the challenges of this unforgettable year and your contributions will not be forgotten.

Finally, speaking of going beyond the job description, I'll have more to say about our residents this Tuesday night at graduation. See you there.

Take care and stay warm and dry today,


Submitted by Mark David Siegel on May 30, 2021