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J Grad Med Educ. 2009 Sep;1(1):150-4. doi: 10.4300/01.01.0025.

Demographic and work-life study of chief residents: a survey of the program directors in internal medicine residency programs in the United States.



Chief residents play a crucial role in internal medicine residency programs in administration, academics, team building, and coordination between residents and faculty. The work-life and demographic characteristics of chief residents has not been documented.


To delineate the demographics and day-to-day activities of chief residents.


The Survey Committee of the Association of Program Directors in Internal Medicine (APDIM) developed a Web-based questionnaire. A link was sent in November 2006 by e-mail to 381 member programs (98%). Data collection ended in April 2007.


Data collected include the number of chief residents per residency, the ratio of chief residents per resident, demographics, and information on salary/benefits, training and mentoring, and work life.


The response rate was 62% (N  =  236). There was a mean of 2.5 chief residents per program, and on average there was 1 chief resident for 17.3 residents. Of the chief residents, 40% were women, 38% international medical graduates, and 11% minorities. Community-based programs had a higher percentage of postgraduate year 3 (PGY-3)-level chief residents compared to university-based programs (22% versus 8%; P  =  .02). Mean annual salary was $60 000, and the added value of benefits was $21 000. Chief residents frequently supplement their salaries through moonlighting. The majority of formal training occurs by attending APDIM meetings. Forty-one percent of programs assign academic rank to chief residents.


Most programs have at least 2 chief residents and expect them to perform administrative functions, such as organizing conferences. Most programs evaluate chief residents regularly in administration, teaching, and clinical skills.

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