T minus 19 days to APA MEETING - HELLO NYC !! It is going to be a busy week starting with 75 years after Freud and then leading into APA conference plus the chief meeting, before I come back home. Last year when I was about to start my chief year, I had the opportunity to go to TARRYTOWN for the chief retreat. As I think about wrapping up one year of this job leading into year two, I cannot help but realize how I have changed in this job from one year to the next. The natural progression from a newbie to a more confident chief has come on it's own terms and in it's own time. It has pains and gains and moans and groans. Well more groans and pains at times, but nonetheless there it is. Part of this also comes from the fact that transitioning to a 3rd year is terrifying at so many levels that I can't help but be aware of the need to expand my vision, not only as a chief but also as a resident who in 2 more years; is going to be an independent physician and may be also an attending physician to work with new residents.
When I started last year and went to Tarrytown as a spring chicken, I had no idea how over the span of the year with all the experiences and events; I will have a totally different view of what my job actually is. Rewind to this post and I see how much I have grown up in just four months as well.
While for the most part the post I referred to above still holds true, esp the part where I talked about my amazing residents and how much I love being around these people. But I have also learned that I do have a role besides being a liaison between residents and the program. I do play a role in decision making with my boss and I do have a role in working with him to ensure program integrity. There are times when I worry about the lines of authority i.e. should it come from him or me? At times it is a fine line but at other times I know what to do. I do believe that managing physicians is a very hard task.
By nature we are annoyingly narcissistic with the added necessary devil of the learned and mostly productive autonomy needed for our jobs. I am sure I do not need to elaborate. If I have to choose the hardest part of my job, I would choose schedules any day, closely followed by the every day resident issues specific to our setting. But many of those issues are beyond my scope and fan my own frustration as well. I have learned to pick my battles carefully just so I can keep myself sane.
Back to the oh so lovely schedules. I have lost count of how many hours I have spent on creating, recreating and tallying call hours and numbers. Sometimes I look at the folder on my desktop at home and I become nauseous because I remember nights when I have mixed up master tally with master master tally and DONOT ALTER tally and still have altered the tally even though it was named specifically "DONOT ALTER" in ALL CAPS. I have it all corrected now but I have had close calls bad enough to give me a heart attack. Part of me is very proud that I have kept the Tuesdays, Thursdays and Fridays, fair and square between all of us because for our call purposes those days really do matter a lot for every one. I have anxiety regarding giving up the call schedule duties in a few months but I will get over it because I have to.
I have also learned that I have gotten better at having a thicker skin to criticism and have learned to really choose my words wisely. I advice everyone who wants to be a chief in any residency training program, work on being careful about what you say. You are under a microscope and you will need to be able to absorb a lot of anger directed towards you directly or indirectly. You cannot make everyone happy, not as a resident and certainly not as a chief. What I can do is, be fair and approachable. People for the most are aware of your fairness and availability even when a few won't acknowledge it. At the end of the day that is all that matters.
If you plan to hold the chief's office start to expand your vision from a perspective 2-3 years beyond your current training year. I have been guilty of tunnel vision and not seeing the bigger picture because residency is tough, tough, tough but these years no matter how tough, are still protected by the shield the program provides compared to when you are out and about on your own and have to be responsible for all and everything. I do realize now that people are positioned from the beginning mostly unconsciously but at time consciously to hold positions of responsibility, either by themselves or by their superiors. So if you have inclinations of doing the hard job of managing your peers, position yourself maturely. It helps.
What's in a job you ask? The maturity, ability and willingness to go above and beyond what is needed to get things done and understanding that your role; should you pursue this path, is vital for your program whether you realize this or not. It's not as much as being a good or bad doctor in this role but really about being able to be a manager/leader. Being effective without being insensitive and being available without being a push over. What I have really learned is to finally realize that I am not a union leader but rather a resource for both sides to work through issues and concerns. What I am is really a position that is able to voice frustration, concerns, at times anger from my peers to my program with the intention to resolve that frustration, with handling issues that need to be addressed to diffuse the frustration. But I do see now that a big part of this job will be to present better vision and goals to better the program and consequently ourselves as physicians and role models for the next generation of residents.
Here is a great piece to read regarding what other chiefs found out and learned about their jobs. What chiefs learned!
Until next time I leave you with this thought:
A genuine leader is not a searcher for consensus but a molder of consensus.
Martin Luther King, Jr.
WWW.Brainyquotes.com
