Chief Resident Job Descriptions
There are several opportunities for individuals to hone
their teaching and administrative skills following training. Descriptions
of the positions available at each site follow.
Harborview Medical Center
Harborview – Ambulatory Chief Medical Resident
The HMC Outpatient Chief Resident position is a one-year experience that offers a unique blend of education, patient care, advocacy, and administration, with heavy emphasis on teaching outpatient medicine in a clinical context. These key components include the following duties:
- One half-day clinic session per week staffing resident patients in the Adult Medicine Clinic (AMC) in parallel with Dr Jill Watanabe
- Organize, schedule, and contribute to weekly AMC, Madison, and Pioneer Square Preclinic Conferences
- Weekly chart review with interns on clinic block rotations who have their continuity panels at AMC, International Clinic, and Pioneer Square Clinic
- Chart review with senior residents on clinic block rotations who have their continuity panels at HMC, International Clinic, Madison Clinic, and Pioneer Square Clinic
- Coordinate and facilitate Thursday Morning Resident Didactics Conference at UW (shared responsibility with Roosevelt Chief)
- Co-direct the Patients, Physicians and Society (PPS) course. The Roosevelt and HMC chiefs determine the content and activities and share responsibility for coordinating and facilitating sessions. In recent years these activities have included visits to the jail infirmary, art tours, narrative medicine sessions, poetry interpretation, Bastyr medicinal herb walks, and visits to skilled nursing facilities
- Present HMC Ambulatory Chief of Medicine Rounds twice monthly
- Facilitate monthly AMC Journal Club sessions
- Participate in and shape the curriculum of the clinic immersion blocks
- Shape the curriculum and function of clinic resident-attending teams
- Options to attend on HMC ward team for 2 weeks
- Options to participate in curriculum design and teaching on various Ambulatory/Thematic Blocks for residents (examples include: Addiction Medicine, Clinician Educator blocks)
- One half-day clinic session per week staffing patients in the AMC and one session per week at the Downtown Emergency Services Center (DESC) Shelter with 3rd year medical students
- One evening per week in the AMC Student Evening clinic with 4th year students and Dr. Thronson.
- Weekly didactic sessions with 3rd year students
- Weekly physical diagnosis rounds with 3rd year students and Dr Watanabe
- Precept residents and students in the above clinic sessions
- Maintain one’s own primary care panel at AMC one half-day per week
- Unique opportunity to advocate for very vulnerable patients, particularly those in the homeless shelter setting, and transition them into primary care.
- Central figure for promoting resident morale in the HMC ambulatory environment
- Attend monthly Medicine Residency Advisory Committee meetings
- Historically, the outpatient CMRs have also been key figures for promoting and maintaining moral among the PC track resident cohorts
- Organize and schedule the educational conferences outlined above
- Bi-monthly chief resident meetings with Residency Program leadership staff
- Assist with scheduling and coverage arrangement for housestaff
- Serve on various committees (some optional) and/or attend meetings: Clinical Competency, MRAC, AMC Leadership, AMC Staff, AMC Team Care, AMC Opiate Review, HMC Quality Improvement, HMC Patient Experience
- Assist with recruitment activities for the Internal Medicine Residency, particularly around Primary Care Track recruitment
This is a clinically active position, with patient care and direct teaching responsibilities comprising half of the work week: 2 half-day clinic sessions with 3rd year students, 1 clinic session with 4th year students, 1 clinic session with residents, and 1 clinic session of the CMR’s own panel of primary care patients. The truly unique features of this position are: 1) the way in which resident and student education is heavily tied to patient care in a longitudinal fashion, and 2) the unparalleled opportunities for advocacy on multiple levels. For many of our vulnerable homeless patients, the HMC Outpatient Chief, in conjunction with the 3rd year medical students, can serve as an important link between the shelter environment and the Adult Medicine Clinic. On a residency program level, the HMC Outpatient Chief becomes the primary advocate for those residents who have their continuity clinic at HMC, Madison, International Medicine, or Pioneer Square, as well as an advocate for the cause of advancing and improving primary care training within the University of Washington Internal Medicine Residency Program. While academic endeavors such as research are not required, there is both time and support for doing so if desired.
Harborview – Inpatient Chief Medical Resident
The HMC Inpatient Chief Resident position is an exciting and fulfilling, and busy position. It is a year-long leadership position tasked with education, administration and resident morale. HMC has the largest number of residents, interns, and students of the three inpatient sites making it a vibrant and bustling institution!
Teaching – The HMC CMR is responsible for several educational experiences per week for the residents and the medical students. For morning report conference, the CMR selects cases to be presented, facilitates the discussion and provides clinical teaching relevant to the case. Intern report occurs once weekly and is a protected hour for intern-level teaching and skill building. The CMR is responsible for coordinating 4 lunch conferences per week, recruiting and scheduling high-quality speakers. Chief of Medicine Mortality and Morbidity, or Autopsy conference are presented once weekly and the CMR is responsible for identifying and presenting the cases and arranging discussants. The HMC CMR plays a large role in the education of the MS3s during their clerkship providing bedside teaching during physical exam rounds and small group teaching during weekly didactics.
Administrative – A large and important component of the HMC CMR position is the ongoing coordination of the residents and medical students on the teaching services. The CMR provides orientation for all rotating residents and students. Throughout the rotation, the CMR provides guidance for struggling residents, serves as a resource for clinical and administrative questions, arranges sick coverage, and facilitates end-of-rotation feedback. In addition, the CMR serves as a liaison between medicine and other services to maintain strong relationships and facilitate the residents’ experience on off-service rotations. The CMR works closely with the Chief of Medicine to identify needed changes and plan solutions. Additionally, the CMR works closely with the Residency Program in coordination of program-wide events, program changes, resident feedback and supervision and other administrative duties.
Morale – The HMC CMR serves as an important resource and provides ongoing support for the residents rotating through HMC. From guiding struggling residents to planning morale-boosting events, the CMR is intimately involved in the well-being of residents on service at HMC and serves as a mentor to many. The CMR works closely with the residents incorporating their feedback into future changes within the teaching environment.
University of Washington Medical Center
UWMC Roosevelt Clinic – Outpatient Chief Medical Resident
This position has been designed to enhance independent teaching for residents and medical students, provide regular patient care opportunities, and offer protected time for scholarship. It is a year of excellent preparation for a clinician-teacher position as well as general internal medicine practice or ambulatory based fellowship.
The UWMC outpatient chief medical resident (CMR) plays an important role as a teacher for the medical student and residents on outpatient rotations. There are many outstanding UWMC faculty that will help the UWMC CMRs hone their teaching skills. To hone the bedside teaching skills, the UWMC inpatient and outpatient chief residents participate in Specialty Rounds weekly. Each week at Specialty Rounds, the chief residents round at the bedside with 1-2 outstanding faculty from neurology, pulmonary, cardiology, dermatology, endocrinology, rheumatology, or general medicine to learn the finer points of history taking and physical examination.
The UMWC Outpatient CMR position also features the following:
Direct Patient Care Opportunities
- One month of UWMC ward attending, divided into two sessions
- Continuity clinic for your own panel of patients one or two half days per week
Resident Teaching Opportunities
- Precepting Roosevelt residents in clinic
- Leading weekly chart review sessions (with Dr. Deb Greenberg) for interns and second year residents on ambulatory blocks
- Developing and leading pre-clinic conference didactics several times per year
- Coordinating and facilitating ambulatory care teaching conferences on the Thursday morning academic half-day for six months of the year (alternating with Harborview Ambulatory Chief Resident)
- Co-direct the Patients, Physicians and Society (PPS) course. The Roosevelt and HMC chiefs determine the content and activities. In recent years these activities have included visits to the jail infirmary, art tours, narrative medicine sessions, poetry interpretation, Bastyr medicinal herb walks, and visits to skilled nursing facilities
- Conducting UWMC Chief of Medicine Rounds “Ambulatory Cases” sessions once monthly
- Serve as a central figure for promoting resident morale in the Roosevelt Clinic environment
Medical Student Teaching Opportunities
- Precepting third year medical students in your continuity clinic one month per year
- Medicine 665 (3rd year Medicine clerkship): Developing and presenting core ambulatory didactic sessions to outpatient third year medical students weekly
Curriculum Development/Administrative Opportunities
- Serve on the Housestaff Representatives and Clinical Competency committees
- Bi-monthly chief resident meetings with Dr. Ken Steinberg and Kelli Corning for residency program development
- Opportunity to create/facilitate intern orientation didactics and ambulatory immersion block didactics
- Protected time for scholarship each week
- Research mentoring by Dr. Brad Anawalt and others
UW Medical Center – Inpatient Chief Medical Resident
The inpatient chief medical resident (CMR) is a linchpin in the Department of Medicine and the inpatient services at the UWMC. Taking advantage of the extraordinary clinical experiences at the UWMC, the inpatient CMR has unparalleled opportunities to learn and teach medicine. The inpatient CMR is also an important role model for housestaff and students, and a source of advice and mentorship. The inpatient Chief Medical Resident (CMR) at the UWMC primarily plays an educational role, but also has academic, administrative, and clinical opportunities. The CMR organizes and leads most of the UWMC conferences for the housestaff, many of which are also important for faculty education as well. The inpatient CMR also plays a critical role in the education of third year medical students during their inpatient clerkship (Medicine 665) including dedicated teaching sessions.
Administrative and leadership responsibilities include scheduling conferences, committee work related to housestaff and education issues. These responsibilities are tremendous opportunities to be involved in advocating for the housestaff and for improving patient care.
The UWMC inpatient CMR year is divided into two halves: six months are spent as the “active” inpatient chief resident and six months with an opportunity to develop an academic project. It is anticipated there will be some sharing of the inpatient CMR responsibilities during the six months of academic time.
Teaching & Conferences:
The UWMC inpatient CMR plays an important role as a teacher for the medical student and residents on inpatient rotations. There are many outstanding UWMC faculty that will help the UWMC CMRs hone their teaching skills. To hone the bedside teaching skills of the UWMC inpatient and outpatient chief residents, they participate in Specialty Rounds weekly. Each week at Specialty Rounds, the chief residents round at the bedside with 1-2 outstanding faculty from neurology, pulmonary, cardiology, dermatology, endocrinology, rheumatology, or general medicine to learn the finer points of history taking and physical examination and how to teach these skills to trainees.
The UWMC inpatient CMR will lead or help schedule the following conferences.
- Resident/Morning Report: 3 days per week
- Senior Report: Tuesday morning
- Interns’ Report: Thursday
- Noon Conferences:
- Monday conference is organized by the Associate Program Director for Education, but it is facilitated by the UWMC inpatient CMR
- Wednesday conference is organized by CMR
- Chief of Medicine (COM) Rounds: inpatient CMR coordinates inpatient COM rounds and autopsy conference 2-3 times per month
- Medicine 665 (3rd year Medicine clerkship): Didactic session on Tuesday afternoon & physical diagnosis rounds on Wednesday afternoon.
- Grand Rounds: Each Thursday from September through June. The UWMC inpatient CMR has the opportunity to create the Grand Rounds schedule, with input from other chief residents and faculty leadership.
- Imaging Rounds: Each Tuesday morning with Dr. Godwin
- The inpatient CMR at the UWMC will have 6 months during the first or second half of the academic year to spend developing or completing an academic project.
- Ideally, this time will be mentored and will help further interests relevant to professional goals.
- Drs. Anawalt and Bremner and other members of the Department will be pleased to assist inpatient CMRs with identifying potential mentors.
- The inpatient CMR is uniquely positioned to participate in improving the educational experience of the housestaff and medical students, and to improve the quality of the inpatient medical service. To optimize the effectiveness of this unique leadership role, the inpatient CMR office is located in the same suite as the internal medicine residency program and student program leadership and just down the hall from the Chief of Medicine and Department Chair’s office.
- The inpatient CMR participates in several committees that provide oversight to housestaff programs, including the Housestaff Representatives Committee, the Graduate Medical Education Committee, and the Department of Medicine Education Committee.
- There are ample opportunities to be involved in additional committees and projects pertinent to future career interests. Examples include the Medical Emergency Response (code blue) Committee and multiple ongoing quality improvement initiatives.
- The inpatient CMR will attend for one month on the inpatient service during the six-month academic period.
- Inpatient CMRs may choose to moonlight in the community as an opportunity to augment their clinical experience provided such moonlighting does not interfere with their responsibilities as CMR.
- One of the great opportunities of the year is the opportunity to learn from the extraordinary breadth of clinical material (patients, studies, pathology) at the UWMC.
Veterans Affairs Puget Sound Health Care System
VA – Clinician Teacher Fellows
The clinician-teacher fellowship incorporates structured time for teaching of residents and medical students, regular patient care responsibilities, and protected time for scholarship, in a year-long position intended to develop phenomenal teachers and clinicians. This year provides one of the best opportunities to prepare for a Clinician-Educator leadership position in the future, as well as general medicine practice. The clinician-teacher has his/her own patient panel and clinic sessions in the Primary Care Clinic. Some of the countless teaching opportunities include inpatient attending, precepting for medical students and residents in the Primary Care Clinic and Women’s Clinic, and creating and conducting resident pre-clinic conference. Clinician-Teachers are actively involved in curriculum development in the residency program as well as resident feedback and evaluation. Scholarship is an important component of the position and one day per week is set aside for development of a scholarly project, in addition to one month during the year. Strong faculty mentors are readily available and accessible to support the Clinician Teacher Fellows’ education, and there is significant flexibility to pursue specific interests as well. The focus of this position is on teaching and clinical work, rather than administrative tasks, and the schedule has been designed as such.
Direct Patient Care and Clinic Responsibilities:
- At least four weeks of inpatient VA ward attending responsibilities, divided into two week blocks.
- Continuity clinic for your own patient panel one half-day per week.
- Present at Primary Care Clinic Journal Club for faculty and staff once a year, with active guidance from a faculty mentor.
- Attend regular Primary Care Clinic Staff meetings and Journal Clubs weekly
Resident Teaching Responsibilities:
- Precepting (attending with residents) two half days per week in both Primary Care Clinic and Women's Clinic, with guided feedback from co-attendings.
- Leading weekly chart review sessions for all residents on ambulatory blocks.
- Developing pre-clinic conference didactics twice a year, and leading preclinic conference when scheduled to attend with residents in the afternoon.
- Conducting VA Chief of Medicine Conference once monthly
- Opportunity to coordinate with HMC and UWMC Outpatient Chief Residents for creation or facilitation of particular PPS didactics and/or Thursday morning conferences.
Medical Student Teaching Responsibilities:
- Precepting third year medical students in primary care clinic two half days a week.
- Developing and presenting core ambulatory didactics to outpatient third year medical students during their clinic time.
- Opportunity to coordinate with inpatient VA chief resident to share responsibilities for inpatient medical student teaching didactics and physical exam rounds.
Curriculum Development/Administrative Responsibilities:
- Bi-monthly Chief Resident meetings with Dr. Ken Steinberg and Kelli Corning for general residency program development.
- Participation in the Medicine Residency Advisory Committee and Clinical Competency Committee
- Opportunity to create/facilitate intern orientation didactics and ambulatory immersion block didactics with Dr. Maryann Overland
- One full day of protected unstructured scholarly time each week
- One month of protected "sabbatical" time to develop scholarly project.
- Project mentoring by Dr. Joyce Wipf, Dr. Ginger Evans, and other excellent VA Faculty.
VA – Inpatient Chief Medical Resident
The VA chief job is divided into two six-month blocks: an administrative/leadership block of six months devoted to inpatient administration, teaching and patient care and an academic six months with a focus on scholarly work plus some teaching and patient care.
During the administrative block, the chief's duties include arranging and attending teaching conferences on Monday and Tuesday for the housestaff, in addition to the weekly chief of medicine conference on Wednesdays, pathology conference on Friday, as well as daily morning report and Thursday intern report. Additional administrative duties include reviewing and modifying policies governing student and resident activities, and acting as liaison between admitting officer and housestaff regarding admissions from in-hospital transfers. Teaching activities, in addition to morning report, include medical student teaching rounds two times per week, which are generally a physical exam rounds and a didactic session. Educational opportunities also include a weekly Masters' Rounds led by Drs. McGee and Hirschmann. Clinical duties involve supervising resident procedures if necessary as well as an optional once weekly primary care clinic.
During the scholarly block, the chief resident completes scholarly projects designed by each individual chief with the assistance of the chief of medicine. Scholarly activities might include graduate courses on statistics or research methods, doing basic science or clinical research, and writing review or original research articles. It also includes opportunities to help out with general residency program administrative and teaching opportunities (help organize intern procedure course the following year, volunteer for medical student procedure teaching, etc.) Clinically, the chief resident on the scholarly block spends one month as a ward attending split into two week blocks. As above, they also have the opportunity to maintain a weekly primary care clinic. Most CMRs choose to moonlight in the VA ER or in the community to augment their clinical experience provided this work doesn't interfere with their chiefly duties. The chief resident on the scholarly block provides back up to the administrative chief for vacations, illness or emergency leave.
VA – Quality and Patient Safety
The Chief Resident in Quality and Patient Safety (CRQS) position will develop future leaders in healthcare service delivery who can improve clinical performance and disseminate knowledge to trainees and staff. At the completion of the one-year experience, the CRQS will graduate with strong experiential and theoretical foundations in quality improvement (QI), patient safety (PS) and healthcare operations.
The experience will entail direct ownership of QI/PS projects and access to QI/PS mentorship throughout the UW system. To support these activities candidates will have structured local and national education opportunities. You will have direct access to operational data and design innovative UW resident curriculum on QI/PS which integrates real time feedback on actual performance. At graduation you will have experience implementing QI projects, educational credentials, and a mentorship network to prepare candidates for leadership positions in health care service delivery.
- Personal Development: The CRQS will achieve learning objectives through a mix of formal and experiential learning. Significant proportions of the curriculum will be tailored according to the individual's development goals.
- The CRQS will join CRQS's across the nation to participate in a year-long monthly course series with travel to a 1 week intensive "boot camp" to learn about QI/PS tools;
- Participation medical center leadership retreats and committees ;
- Benchmarking trips to local healthcare and non-healthcare institutions to explore best practice QI systems and cultures – Boeing production facility, Twitter, Virginia Mason, and Group Health;
- Participation in Rapid Cycle Improvement Workgroup, leading and managing a QI project, and disseminating best practices via scholarly work.
- Prior to initiating your Chief year you will have a preparatory series of seminars on critical topics in QI/PS during the final six months of the R3 year with regular meetings to create an individualized development plan and participation in the Block 13 chief resident immersion experience.
- Teaching. Up to thirty percent of the CRQS's time can be spent in developing and teaching QI/PS curricula for the residency program.
- Develop and teach sessions in the Health Care Systems Immersion Block Elective and assist residents in designing a QI project;
- Develop a longitudinal quarterly series of case-based conferences for the residents, to be incorporated into the Resident Teaching Conference curriculum;
- Lead a monthly noon conference on QI/PS;
- Work with residents on their Risk Rotation to help them review their own practice performance.
- Clinical. Clinical experience of the healthcare system, while not a focus of the CRQS year, will be required to allow the trainee to have sufficient understanding of the systems he or she wishes to change. We anticipate the CRQS will participate in 1 of 2 core clinical pathways—Hospital Medicine or Primary Care—and each will be tailored to individual goals. Clinical time is intended to hone skills in QI and remain connected to the busy reality of daily clinical operations, not to be a service obligation, and is limited to no more than 20% of overall time and applicants are encouraged to ensure maximum time for work on QI/PS projects.
District Hospital , Naivasha, Kenya
Clinical Education Partnership Initiative – Chief Medical Resident
The UW Internal Medicine Global Health Chief Resident (GHCR) will lead the Clinical Education Partnership Initiative (CEPI) at the Naivasha District Hospital in Naivasha, Kenya. The position is focused on medical education and based in Kenya for the duration of the year.
Responsibilities will include:
- Supervising and coordinating residents (R2s and R3s) from multiple UW departments (e.g., internal medicine, family medicine, ob/gyn) rotating in outpatient and inpatient settings in the Naivasha District Hospital.
- Supervising UW medical students, both clinical and pre-clinical, rotating in outpatient and inpatient settings in the Naivasha District Hospital.
- Developing and implementing an educational curriculum for 1) students in medicine and nursing from the University of Nairobi (UON); 2) Kenyan interns and clinical officers working at the hospital, and 3) other health care providers at the facility.
- Working with the UON/UW Medical Education Partnership Initiative (MEPI) team to promote a sustainable clinical training program in other decentralized training sites in Kenya that are being established for UON medical students and interns.
- Coordinating the monthly Global Health Residents and Fellows Seminar at UW, as well as talks by GH pathway residents and other events as appropriate
- Functioning as a resource and contact person for UW Internal Medicine Global Health Pathway residents, as well as UW internal medicine residents interested in pursuing global health/international rotations.
The GHCR should have past experience living in a resource-limited setting, preferably in sub-Saharan Africa, and a strong interest in medical education and clinical teaching. The GHCR will be required to work in challenging environments and circumstances, including power outages, water shortages, and shortages of medicine and medical equipment., while adapting the highest clinical standards to a resource-poor environment.
Candidates should be comfortable with using physical exam and history-taking skills to arrive at diagnoses in a setting with limited laboratory and radiologic capacity. He or she will need to become conversant in Kenya National Guidelines and acquire new skills in the standard care and treatment of diseases that are uncommonly taught in US medical training (such as malaria and schistosomiasis) and diseases that are treated differently in Kenya (such as HIV/AIDS and management of acute MI).
The GHCR must understand the social and economic context of patients and how this effects medical treatments and medical care. The chief will be a role model and leader for both UW residents and medical students, and our Kenyan counterparts, and will be expected to take on additional responsibilities as necessary to achieve the goals of the CEPI.
The GHCR will be required to be present on-site in Naivasha daily, starting on July 1st of the chief year. The ABIM examination may be taken in Europe in August of the chief year.