Chief Resident Job Descriptions

HMC Ambulatory
HMC Inpatient
Roosevelt Ambulatory
UWMC Inpatient
VA Boise
VA Puget Sound
VA Clinician Teacher Fellow

Harborview Medical Center – Inpatient

The HMC CMR coordinates the majority of the housestaff teaching conferences. There is a housestaff lunch conference 5 days per week, and the CMR selects and schedules speakers for the majority of these conferences, including selecting and presenting cases to be discussed at weekly Chief of Medicine Rounds as well as identifying cases for monthly Morbidity and Mortality Conference. Morning Report occurs four days per week, and Intern Report one day per week. The CMR selects cases to be presented at report, facilitates residents’ discussion of the cases, and provides clinical teaching related to the cases. In addition to coordinating the scheduled educational activities for the residents, the HMC CMR also provides direct teaching to the MS3 students on the medicine clerkship. This teaching consists of bedside physical exam rounds each week, as well as a one hour didactic session on Wednesday afternoons.

Clinically, the HMC CMR accepts all transfers to the medicine service from non-medicine services within the hospital. The CMR also implements the admission cap system and helps distribute patients within the medicine service when the back up methods of caring for patients admitting over the cap have been exceeded.

A large component of the HMC CMR’s job is the administrative task of ensuring the quality educational experience of the residents and students rotating through the medicine service at Harborview. These administrative duties include providing orientation to the rotation, and organizing feedback sessions at the end of rotations. The CMR provides guidance for struggling residents, arranges coverage when residents are ill, and acts as a liason for relationships with the non-medicine services. The CMR helps to ensure that the Esprit de Corp of the housestaff remains high. The CMR works with the Chief of Medicine in identifying the need for and planning upcoming changes to the organization of the medical service.

Harborview - Ambulatory Chief Resident

Education
Residents

1. One session per week staffing resident patients in the Adult Medicine Clinic (AMC) in parallel with Dr Jill Watanabe
2. Organize, schedule, and contribute to weekly AMC Preclinic Conferences
3. Weekly chart review with interns on clinic block rotations who have their continuity panels at AMC, International Clinic, Madison Clinic, and Pioneer Square Clinic
4. Coordinate Primary Care Case Conference and General Medicine Conference at the UW each Thursday morning when “active”
5. Orchestrate weekly Behavioral Medicine conference when “inactive”
6. Conduct weekly Ambulatory Report for interns when “active”
7. Present HMC Ambulatory Chief of Medicine Rounds monthly
8. Facilitate monthly AMC Journal Club sessions

Students

1. One 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
2. One evening per week in the AMC Student Evening clinic with 4th year students
3. Weekly didactic sessions with 3rd year students
4. Weekly physical diagnosis rounds with 3rd year students and Dr Watanabe

Patient Care

1. Precept residents and students in the above clinic sessions
2. Maintain one’s own primary care panel at AMC one half-day per week

Advocacy
Patients

Unique opportunity to advocate for very vulnerable patients, particularly those in the homeless shelter setting, and transition them into primary care.

Residents

1. Central figure for promoting resident morale in the HMC ambulatory environment
2. Author monthly AMC newsletter
3. Conduct Primary Care Quarterly meetings in conjunction with Roosevelt CMR and outpatient site directors to solicit feedback from residents on Primary Care training and education
4. Attend monthly Housestaff Representative meetings

Administration

1. Organize and schedule the educational conferences outlined above
2. Bimonthly chief resident meetings with Residency Program leadership staff
3. Assist with scheduling and coverage arrangement for housestaff
4. Serve on various committees (some optional) and/or attend meetings: Clinical Competency, Housestaff Reps, AMC Leadership, AMC Staff, AMC Chronic Care

Summary
This is a clinically active position, with patient care 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 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.

Roosevelt – Ambulatory Chief Resident

• Precepting residents in clinic, supervised the first six months and independent precepting the second six months
• One month of UWMC ward attending
• Continuity clinic for your own panel of patients
• Precepting students in clinic and teaching physical diagnosis to students on ward med
• Teaching didactic sessions to students on inpatient and outpatient medicine rotations weekly
• Participating in the UWMC Roosevelt teaching program, including chart review and conducting pre-clinic conference
• Optional teaching for pre-clinical students (including Introduction to Clinical Medicine)
• Chief resident activities:
• serve on housestaff reps and clinical competency committee, and developing the residency program
• conducting UWMC Chairman's Rounds one session per month
• coordinate the primary care activities and teaching conferences 6m/year (along with the Harborview primary care CR)
• Protected time for scholarship each week

University of Washington Medical Center – Inpatient CMR

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.  Administrative responsibilities include scheduling conferences, some committee work related to housestaff and education issues, and coordinating patient transfers to the UWMC inpatient medicine service.  

The UWMC is divided into two half-years:  six months 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:

1. A chief medicine resident year is an extraordinary opportunity to develop teaching skills.  A strength of the UWMC inpatient CMR position is the availability of faculty to assist with conferences and provide teaching mentorship.
2. Residents’ Report:  4 days per week
3. Interns’ Report:  Friday
4. Noon Conference:  Monday, Wednesday (the Ambulatory CMR organizes Thursday lunch conference).
5. Chief of Medicine Rounds:  Inpatient Cases one week per month; Morbidity & Mortality one week per month; Autopsy Conference one week per month; Outpatient Cases one week per month (organized by the ambulatory care chief resident).
6. Medicine 665 (3rd year Medicine clerkship):  Didactic session on Tuesday afternoon & physical diagnosis rounds on Friday afternoon.
7. Grand Rounds:  Each Thursday from September through June.  The UWMC inpatient CMR is largely responsible for coordinating the Grand Rounds schedule, with input from other chief residents and faculty leadership.

Academic:

1. The inpatient CMR at the UWMC will have 6 months either at the beginning or end of the academic year to spend developing or completing an academic project.
2. Ideally, this time will be mentored and will help further interests relevant to professional goals.
3. Dr. Bremner and other members of the Department will be pleased to assist inpatient CMRs with identifying potential mentors.

Administrative:

1. 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. 
2. 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.
3. The inpatient CMR is responsible for coordinating and triaging transfers of care to the UWMC inpatient general medicine service.  Transfer discussions and arrangements typically occupy parts of every weekday.  Weekend call and transfer responsibilities are shared among all of the inpatient CMRs (the UWMC inpatient CMR is on-call approximately 1 out of 4 weekends).  We are working to develop a hospital-based transfer system.

Clinical:

• The inpatient CMR can maintain an outpatient clinic during the chief year.  The inpatient CMR often maintains one ½ day of clinic every other week.
• 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 chief year is the opportunity to learn from the extraordinary breadth of clinical material (patients, studies, pathology) at the UWMC.

VA Puget Sound Health Care System – Inpatient

VA Chief Medical Resident Job Description

During the administrative block, the chief’s duties include arranging and attending teaching conferences on Monday and Wednesday for the housestaff, the weekly chief of medicine conference on Tuesdays, twice monthly ICU professor’s rounds, in addition to helping arrange weekly Monday conference, daily morning report and Thursday intern report.  The administrative chief resident organizes morning report (where patient care is discussed) and the weekly interns’ 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 outside hospitals..  Teaching activities include medical student teaching rounds 2-3 times per week, teaching at morning report and periodically giving the didactic session for intern’s report.  In addition, the administrative chief resident will often be the speaker at one of the Chief’s rounds.  Clinical duties include helping supervise housestaff on procedures when needed, in addition to weekly clinic.  In addition, the administrative chief attends his or her own primary care continuity clinic weekly. 

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, etcClinically, the chief resident on the scholarly block one month as a ward attending and attends a primary care continuity clinic weekly.  The chief resident on the scholarly block provides back up to the administrative chief for vacations, illness or emergency leave.

VA Puget Sound Clinician Teacher Fellow

VA Boise

Inpatient responsibilities include:
Organizing Morning Report four times per week
Organizing weekly Interns Report
Recruiting and coordinating speakers for Grand Rounds
Arranging and cleaning lecture rooms and ordering breakfast for Grand Rounds.
Coordinating Inpatient Resident team assignments and patient Redistribution.

Ambulatory responsibilities include:
Recruiting and coordinating speakers for Noon conference three times per Week.
Arranging and cleaning lecture rooms and arranging lunch sponsors.
Medical student physical diagnosis rounds each week.
Medical student EKG conference each week.

Other responsibilities for each chief resident:
Ward Attending for 2 months of the year
Supervisor in Resident Group Practice (optional)
One half day in clinic per week managing a personal clinic panel of ~100 Patients.
Two-three medical student teaching lectures per quarter.
Read  EKGs one day per week (typically ~15-20)
Assist with procedures including bone marrow biopsies, exercise treadmills, etc.
Serve as Medical back-up for two weeks out of the year.
Member of the Following Committees:
Resident Curriculum and Education Committee
Medical Records
P&T Committee

The Chief Residents also perform the essential function of maintaining the morale of the residents and interns, accomplished by being everything from sounding board to social host.  Each day brings a variety of stimulating and challenging activities.  The faculty and staff at BVAMC have been teaching residents and students for over 30 years, and the learning environment is terrific.

The Chief Resident year can be modified with the approval of the Site Program Director to allow each Chief Resident to pursue research or educational opportunities which would allow personal and professional growth.