Building a Cohesive Residency Program: Top 10 Strategies to Engage Residents
Welcome to the beginning of the most exciting and terrifying time in your residency — the start to a new year! To help start the year off right a group of chief residents from across the country, through the ALiEM Chief Resident Incubator, have gotten together and compiled a list of ways for chief residents (and other resident leaders) to engage residents early to hopefully make this the best year yet of residency.
1. You don’t have to be a chief resident to be a leader
Every year chief residents are either selected or appointed in every residency program across the country. They take on administrative duties and make the dreaded schedule. Look to engage residents in their interests and give them responsibilities. If someone loves simulation and wants to make it a larger part of your curriculum, help make him/her the resident leader for simulation. If someone was a former high school teacher and loves education, have them draw from their expertise to help revamp conference. Leadership comes from all members of a team and not just the captain!
2. Celebrate the wins
Rather than always focusing on the cases that go wrong, highlight the cases that ran well. Celebrate the wins! While Morbidity & Mortality conference is a necessity and a impactful learning tool, highlighting the great cases can be too. Creating an opportunity to highlight your residents and a job well done can go a long way towards fostering a positive learning environment. Use conference or community-wide residency emails to showcase residents (e.g. utilized effective communication, excellent team work, or displayed excellent patient care). [1, 2]
3. Give them a megaphone
It is important that everyone feels like they have a voice and decision making capacity with regards to their residency. Give your residents a forum to vent, suggest improvements in your program, or utilize it as a brainstorming session for difficult systems issues. Some programs do this by having regularly scheduled, resident-only meetings, designed to give residents a closed forum to discuss sensitive or difficult topics. Other programs have done things with monthly meet-ups at bars/restaurants to facilitate a less formal venue to talk. There should be some type of anonymous suggestion box or Google doc where suggestions for improvement or grievances can be kept up to date. Make sure your residents are being heard! 
4. The good vibe tribe
Create a culture of positivity. Focus on creating opportunities for residents to relax and hang out outside of work. Assign a social event coordinator to engage a resident that enjoys setting up outings. With our crazy schedules, it is difficult to set up a weekly event but try to create an environment where there is a focus on getting together, and doing things everyone enjoys. Whether it is a mountain bike ride, backcountry skiing, or even a simple movie night, create stories and long lasting memories with your residency crew. Focusing on getting to spend time with each other outside the four walls of the hospital creates an atmosphere of positivity and encouragement. Work hard together, and play hard together! 
5. Spark the fire
As chief residents, we can help be the niche pathfinder or the fire igniter. Reach out to your residents and ask them to give you ideas about what interests them outside of the standard curriculum. The more creative the better. We are in the era of a medical education re-vamp, so utilize occasional conference lectures or Grand Rounds to engage residents in their interest such as aerospace medicine, expedition medicine, health care policy, wellness, and global health. There are many ways to encourage residents and help them find their niche, but first you HAVE to ask them! 
6. Vulnerability is a super power
Let your residents see your weaknesses and be vulnerable. Your residents need to see that you don’t have it together all the time and that even as a chief resident, things can still get to you. It’s real life! Being willing to show vulnerability allows people to connect with you and realize that they are not alone in the trials and tribulations of residency. As a team talk about the hard cases. Be upfront with your mistakes and the aspects of the care you gave that you wish you could “do over.” Many times as chief residents we have to be the first ones to open up, hopefully allowing your residents to relax and follow your lead. This can result in a deeper connection with your co-residents. 
7. Be a mentor
Promote a senior mentorship program! Mentorship, especially early on in residency can be transformative. When interns are given early mentorship, there is a decreased likelihood of feeling isolated as they start this exciting but somewhat overwhelming journey. Having near-peer mentorship, rather than just faculty mentorship, during intern year offers several benefits as senior residents are much closer to the pearls and pitfalls of navigating residency. It’s always good to have a seasoned resident to reach out to for help, feedback, or just a pep talk. Creating a peer mentorship program can foster a strong sense of camaraderie. The continued support will hopefully flourish and maintain these relationships beyond residency. [7,8]
8. Let the games begin
Healthy competition is great way to spark motivation and stimulate the minds of your fellow residents. These can be individual or group based. Individual competition can include things such as:
- Trivia-based board review
- Best individual presentation
- SIM Lab Wars
Group-based and longitudinal competitions can tackle a multitude of outcomes, such as the best innovation to improved ED flow or an particular procedure.
Ideally, different competitions would cater to different residents’ strengths and allow for growth across the board. A broad array of competitions also provides an extra motivational push for those who usually shy away from certain topics/situations. A healthy competition can be that extra spark to get residents to engage with the residency community. 
9. Communication and transparency are key
No one likes a brag, but it is important to keep your co-residents updated on the status of your projects! Are you holding meetings to change up to the conference schedule? Are you in the middle of budgeting department funds to get snacks for residents on busy shifts? Even if the fruits of your labor have not yet materialized, sharing your efforts with other residents let’s them know you are working hard for them! These updates can serve as platforms to discuss new ideas as well as opportunities to empower other residents to take on leadership roles. 
10. Close the loop and follow up
What do you do when the opportunity to engage has already presented itself? When you’re sought out to discuss a difficult case or another resident confides in you about a personal issue, make a quick note on your phone or on a notecard (and of course, keep it private!). Addressing something in the moment is easy, but following up gives meaning to your interaction and shows that you care. Be more than just a lip service provider. Prioritize resident concerns and come up with concrete efforts to close the loop. 
- Reid S. Why celebrating your wins can make a big difference for growing companies. Forbes- Entrepreneurs/#StartupLife. June 4, 2016. Accessed July 1, 2017.
- Meyers C. How to creatively celebrate your team’s wins. Forbes-Entrepreneurs/MentoringMoments. December 16, 2016. Accessed July 1, 2017.
- Spicer K. Allow me to get my megaphone. I don’t think you heard me the first six times. Accessed July 1, 2017.
- #Goodvibetribe header is based upon a hashtag utilized by the University of Utah Emergency Medicine Residency to highlight residency camaraderie developed by Sean Slack (@iamseanslack).
- Cooney R. Finding a niche. Better in Emergency Medicine. January 12, 2011. Accessed July 1, 2017.
- Seppla E. What bosses gain by being vulnerable. Harvard Business Review. December 11, 2014. Accessed July 1, 2017.
- Tjan A. What the best mentors do. Harvard Business Review. February 27, 2017. Accessed July 1, 2017.
- Chopra V, Saint S. 6 things every mentor should do. Harvard Business Review. March 29, 2017. Accessed July 1, 2017.
- Gilbert A, Kimberly H. IDEA Series: Applying gamification and competition- based learning to an ultrasound curriculum. Academic Life in Emergency Medicine. March 3, 2017. Accessed July 1, 2017.
- Myatt M. 10 communication secrets of great leaders. Forbes- Leadership. April 4, 2012. Accessed July 1, 2017.
- Metcalf S. Responding to employee feedback. 15Five. Accessed July 1, 2017.
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