Chief Resident Retreat Agenda

Thursday, June 11, 2009, 12:00-4:30

NOTE: VENUE CHANGE:
** Brennan Center, Riverside East **
(Parking will be Validated for those Parking in the Red Ramp)

Time Topic Presenter

Noon Lunch and Introductions Dr. Louis Ling, Associate Dean for GME
12:10-12:30 Navigating UMMC, FV Dr. Jim Breitenbucher, UMMC Vice President
for Medical Affairs & Clinic Operations
12:30-1:15 Surviving as Chief Resident Chief panel
Dr. Lori Ryan, Pathology
Dr. Liz Miller, Medicine
Dr. Sarah Kottke, Psychiatry
Dr. Patrick Testerman, Anesthesiology
1:15-1:30 Break
1:30-3:00 Leading Medical Teams Dr. Karyn Baum, Associate Professor of
Medicine & Special Assistant to the Dean of
the Medical School,
Dr. Jo Ann Wood, Associate Professor of
Medicine
3:00-3:15 Break
3:15-4:30 Conflict Resolution Julius Erolin, U of M, OHR
Adjourn
 Conflict Case Scenarios
U of M Chief Resident Retreat

June 11, 2009

These are examples of conflicts that chief residents encounter. I’ve arranged them from simple to
complex. These will give you some background on the types of issues that present to this group
of new leaders.

Situation 1: I have to work Christmas?!!

Many chief residents are tasked with developing call schedules, conference schedules and other
unfulfilling duties. Regardless of how sophisticated the group, conflicts develop regarding
holidays, number of days off and other issues of perceived equity.

You are pleased that you’ve established the call schedule for the next several months. The
program coordinator is happy that you’ve finished it and you’re thrilled it is finally done. As soon
as it “hits the press”, you receive a page from one of the residents…she is furious and distraught
that she has been scheduled to work the Christmas holiday. You are defeated and almost wish
that you could work the holiday yourself so you wouldn’t have people upset. You know that
someone has to work and you followed the proper procedures. Despite your best reasoning and
explanations, this resident remains upset….

Situation 2: It takes two to tango

Chief residents are often caught in the crossfire between very high achieving adults. As with
many high achievers each may think he/she is right or correct and conflicts ensue. You have two
second year residents that are each very good and very different in how they approach patient
care, intern and student teaching/supervision. The stars have just aligned and these two are both
seniors this month on service. The squabbling has begun and now they’ve got their interns
fighting as well. At first you thought ignoring it would work, but now you are concerned that the
conflict might escalate to the point where patient care could be jeopardized because information
might be withheld when call transitions occur. You agree with and like both of these seniors, but
now are irritated. Ignoring the ongoing battle is not working… Neither is wrong per see, but you
are afraid that care might be compromised…

Situation 3: Good intentions and lots of potential

It is about four months into your tenure as chief. Things are going pretty well and you feel like
you have settled into a zone of relative competence. Your “zone” is interrupted by request of one
of your senior residents. This resident, Dr. Amuzu, approaches you after morning report and
asks if she can talk to you. You agree and the resident tells you that she is concerned about the
performance of one of the interns, Dr. Jansen. Dr. Jansen is a very outgoing and likeable intern
that you haven’t had much direct contact with, but always seems pleasant and agreeable. Dr.
Amuzu tells you that she is very concerned about Dr. Jensen’s performance and has witnessed
frequent instances where she feels that Dr. Jansen does not “know what she is doing.” She has
tried to talk to Dr. Jansen about specific patient issues and questions and Dr. Jansen glosses
over the issues and gets defensive. Last night, Dr. Amuzu caught Dr. Jansen in a lie about a
patient situation. Dr. Jansen got upset when questioned and alleged that Dr. Amuzu “was out to
get her” because she is a female resident of color. Dr. Amuzu is one of your most level headed
seniors and you don’t question her judgment. As you think back, you remember occasional
comments from another senior that supervised Dr. Jansen and a comment from one or two of the
interns about Dr. Jansen. While you have no reason to doubt Dr. Amuzu concerns, Dr. Jansen
always seems so personable.

Situation 4: Close Encounters

You are the chief in a very small (3 residents/class) program. Things are going well, but lately
you been hearing gossip regarding one of your PGY4 colleagues, Dr. Jackson, and his romantic
adventures. This colleague is a very personable, bright and accomplished resident that has
socialized with frequently with L & D nurses and other staff in the hospital. It hasn’t been a big
deal, but lately you are hearing bits and pieces about this resident socializing with one of your
new single attendings, Dr. Lee. Dr. Lee is a great teacher, new to the program and the city and
full of great ideas and energy. You reason that they are adults and it isn’t your issue or business.
Several residents in the last couple of weeks approach you individually with concerns about
interactions between Dr. Lee and your colleague, Dr. Jackson. They allege that Dr. Lee is giving
Dr. Jackson preferential treatment and they are upset. Dr. Lee is one of your attendings and
technically your superior as she is also Associate Program Director. You want to ignore this and
hope it will go away, but you realize it isn’t that simple.

Situation 5: No way out

You are the chief resident struggling with a bright and spirited group of PGY1 residents. The year
started off okay, but as the year has progressed, tension has built between the PGY1 residents
and now the PGY2 and PGY3 residents are being drawn into the battle. The latest issue to
present is the issue of a “golden week” in which PGY1 does not have call. These are few and far
between and you try to be very careful about granting these. Dr. Anali, one of the more
outspoken PGY1 residents asks to meet with you and you agree. With your stomach in knots,
you ask Dr. Anali what she wishes to talk about. Dr. Anali tells you that she feels that you are
“picking on her” and “taking sides” with her PGY 1 colleagues because she is “the only PGY1
resident that has not received a ‘golden week.’ As you try to reconstruct 9 months of call
schedules in your head, she tells you that she believes that you are discriminating against her
because she is an international medical graduate and an experienced female physician.” You are
stunned. You know there has been conflict between the PGY1 residents, but you did not realize
that it had escalated to this point. You know that have been as equitable as possible with the call
schedule, but nothing is perfect. You try to explain this to Dr. Anali, but she will not hear your
explanations. You are sick to your stomach. Dr. Anali goes to the program director and
complains about the “golden week” issue and your “siding with the other residents.” The program
director calls you and wants to talk.
 Chief Resident Panel

1. Matt Bunte IM Fairview Chief

2. Lori Ryan Lab Medicine and Pathology Chief
3. Patrick Testerman Anesthesiology Chief resident
4. Sarah Kottke Psychiatry Chief Resident

Questions:

1. Most rewarding aspect of chief role?

2. Most challenging aspect of chief role?
3. Suggestions for handling disagreement/conflict?
4. Tips on dealing with struggling residents
5. Tips on transitioning from “one of the group” to chief?
6. How did you learn to delegate?
7. Top five tips for new chiefs?
 University of Minnesota Medical School - GME
Academic and Well-being Resources

Resident Assistance Program (RAP):

Sand Creek
333 North Main Street, Suite 203
Stillwater, MN 55082
Phone: 651-430-3383 or 1-800-632-7643

RAP services are available to residents and their family members; faculty, attending
physicians; department heads and supervisors who need help in dealing with resident-
related concerns.

o Confidential
o No charge
o 24/7 access

Marilyn Becker, Ph.D., LP, Director of Learner Development:

becke024@umn.edu
B 624 Mayo
612/626-7196

Consultation to residents regarding learning and performance activities

across the GME competencies and residency requirements.
Individual resident contacts [self-referral or department referral]:
o Improving test-taking
o Learning in residency
o Maximizing efficiency
o Problem solving
o Time management
o Organizational skills
o Well-being
o Assistance with preparing for USMLE Step 3, In-Training and Certification
Exams
o Assessment and Referral to other services [i.e. ESL language assistance,
Disability Services, Counseling]
Workshops/presentations to resident department groups [topics
such as effective test-taking, setting up question-based review groups, resident
efficiency, well-being resources, etc.].

University of Minnesota Medical School – Disability Services/UReturn

DS/UReturn is the designated Disability Services office that serves residents and fellows with
any disability or medical condition requiring accommodation or adjustment.
As a neutral and confidential resource, DS/UReturn works with residents and fellows, with a
disability or medical condition that, in some way, interfaces with their job/productivity.
DS/UReturn provides assistance such as: confidential provision of medical documentation,
determining and implementing reasonable accommodation/adjustment, and referral.
DS/UReturn also provides consultation with and training for faculty and staff to ensure access
to their programs, facilities, and services. All services are confidential and free. For more
information or to arrange reasonable accommodations/adjustments, contact the DS/UReturn
office, in the McNamara Alumni Center, Suite 170, (612)626-1333 (voice or TTY).

On-Line Resources:
http://www.mentalhealth.umn.edu/ - Student Mental Health, Twin Cities Campus
http://www.med.umn.edu/gme/residents/wellness/home.html - GME Well-Being Tools
 Academic Incivility:
Resources for Dealing with Harassment
The University of Minnesota is committed to a working and learning environment that is respectful, collegial, and free
of harassment. Harassment can include offensive, intimidating, or hostile behavior that interferes with a student’s
ability to work or study, such as, but not limited to, threatening or demeaning language.

If you or someone you know has experienced offensive, intimidating or hostile behavior that interferes with your
ability to work or study, you don’t have to face these challenges alone. There are services here to support you.

First Step Contacts for Personal, Academic or Career Concerns

Contact: Contact: Contact: Contact:

Jan Morse Mary Tate Marilyn Becker (RAP) Resident
Student Conflict Minority Affairs and Learner Development Assistance Program
Resolution Center (SCRC) Diversity and Medical Phone: Phone:
Phone: School EOAA Unit Liaison 612-626-7196 651-430-3383 (local);
612-626-0689 Phone: Email: 1-800-632-7643 (toll-free)
Email: 612-625-1494 becke024@umn.edu Web:
morse005@umn.edu Email: tatex001@umn.edu Office: www.sandcreekeap.com
Web: Office: B624Mayo
http://www.sos.umn.edu B608 Mayo

Primary sources of assistance include:

Your Program Director or Faculty Advisor. They are your essential partners in a successful educational
experience. If you encounter a problem and feel comfortable approaching them, do it and do it early.
Student Conflict Resolution Center (SCRC). If you want to talk to someone outside of your department,
you can contact the SCRC. Consultations are confidential - no one will know you contacted SCRC without
your permission. SCRC works with hundreds of students and offers information, coaching, and intervention.
You can reach them by phone 612-624-SCRC, by email sos@umn.edu or in person (211 Eddy Hall).
Mary Tate. The Director of the Medical School Office of Minority Affairs and Diversity is the Equal
Opportunity and Affirmative Action liaison. For questions or concerns regarding matters of allegations of
mistreatment, sexual harassment, or discrimination, the Office of Minority Affairs and Diversity may assist in
finding solutions. You can reach her by phone 612-625-1494, by email tatex001@umn.edu, or in person
B608 Mayo.
Marilyn Becker. The Medical School Director of Learner Development. Dr. Becker assists residents and
fellows with learning/performance concerns across the GME competencies and residency/fellowship
requirements; provides assessments and referrals for special services [disability evaluation, ESL tutoring,
personal/couple counseling, health/wellness assistance]; and is available for consultation on
academic/training process difficulties. You can reach her by phone 612-626-7196, by email
becke024@umn.edu, or in person B624Mayo.
Resident Assistance Program (RAP). The Resident Assistance Program (RAP) is a confidential counseling
service designed to offer residents and their immediate family members a professional, external resource to
address a variety of stressors, at no cost to the client. In many cases, these stressors are affecting personal
lives and impacting a resident’s ability to meet professional expectations in the workplace. You can reach them
by phone 651-430-3383 (local) OR 1-800-632-7643 (toll free); or the web www.sandcreekeap.com.

For more information on campus resources, visit http://www.sos.umn.edu/stafffaculty/academic_civility.php

Delaying or avoiding a situation can make it worse. Don’t put off addressing a problem until you’re falling behind in
your coursework or considering leaving your program or job. You don’t have to face it alone.

See also Resident Dispute Resolution Policy at:

http://www.med.umn.edu/gme/residents/parta/disciplresdisputeresolpol.html

As always, if you believe there is imminent danger to a student or others, please call 911.