PGY 3 Chief Residents in a 4-Year Emergency Medicine Residency Training Program: A Unique Paradigm

Emergency medicine (EM) chief residents are traditionally drawn from the most-senior class of residents. Our training program's chief residency structure is, to our knowledge, unique in that it is the only 4-year EM training program to select PGY 3 residents as chief residents. This structure allows PGY 4 residents enrolled in a 4-year curriculum to focus their final year of residency training on their professional development and on laying a foundation for a career in academic EM while unencumbered with the responsibilities of chief residency. Conventional thinking holds that the most senior individual is the most capable of serving in a leadership role as chief resident; our experience has shown, however, that selecting chief residents from the PGY 3 class of a 4-year residency program is not only feasible and well received by our residents, our residency training program, and our department, but is invaluable to the development of all individuals in the PGY 4 class regardless of whether or not they served as a chief resident. We recommend that 4-year EM residency training programs in development as well as 4-year programs that currently use-or plan to incorporate-longitudinal academic development or track systems consider this model.