As you don your new Chief Resident or Senior Fellow scrubs you should try to remember two things – all eyes will be upon you to set an example, and it’s your job to build and nurture a productivity culture.

Your peers and faculty members will be observing how you interact with other peers, residents, support staff, administrators and above all patients.

They will be watching for and analyzing how you respond to adversity. This may be as simple as how you react to a difficult consult late in the day – to how you handle a busy clinic. And it can be as complex as how you set, measure and reward goals.

The best way for you to set, explain and achieve successful program objectives is to establish a workplace culture based on measurable productivity – productivity that is applauded, promoted and, importantly, rewarded.

Defining and Measuring Productivity

Productivity in the clinical environment can take many forms. Your challenge is to identify the specific areas of performance, production and service delivery you want to improve or maintain and then let everyone know exactly what your key performance indicators (KPIs) will be.

Most studies of productivity in a clinical setting focus on two core outcome measurements: patient throughput and the amount of treatment provided. In many instances simply setting previous baselines and establishing a productivity campaign increases productivity because you, your residents, your peers and your staff all are aware they are being measured.

Other, softer metrics for measuring productivity include:

  • increased patient satisfaction
  • decreased absenteeism
  • increased staff morale
  • raised resident academic levels


The key to success is to make sure everyone on your team understands what the productivity goals are, and how improvement will be measured and the results communicated.

Lead By Example

Remember, productivity should be patient-centric. This almost always translates into doing what is in the best interest of the patient first. Consider every consult as a new opportunity to accomplish three important goals – to heal, to teach and to learn.

Your residents will read your body language if you’re feeling reluctant about performing a consult. First-year residents are impressionable, especially during their first few months. They will be watching you very closely, so display a positive attitude about tough consults or a specific rotation that the rest of your team dreads. And as you aim towards increased productivity, if you identify a problem with a specific rotation or team member, quickly take the necessary steps to find a solution.

As a leader, you should never complain, only fix. You can’t afford the lazy luxury of grousing or whining because that approach to work and problem solving will quickly lower morale in your unit. Be above reproach, leading by your positive example.

During your year as Chief Resident you will encounter many challenges and will most certainly be called on to navigate successfully though difficult times. Remain positive and aggressively promote optimism across your team. Remember to ask for help when needed, and openly praise successful results and speak well of your peers.

It Takes a Team…

…to create a true productivity culture. As Chief Resident or Senior Fellow never try to go it alone, but at each turn take the necessary steps to involve other members of your team. Assess which particular skills and talents each of your team members possess and distribute work assignments and special projects accordingly.

For example, if one of your residents is great with computers, ask that person if he or she would be willing to act as webmaster for the departmental website or organize a patient list for your PDA.

If another one of your residents is very organized, then ask that person to be in charge of organizing the resident call room or creating an on-call phone list.

At times, people on your team may need a reminder about task or project deadlines, so recruit a resident to create and maintain a department-wide e-mail list. Keep team communications timely and shared with all who need to know. Be sure to “cc” the appropriate directors or other department leaders, providing an important level of accountability.

The Rewards of Productivity

During your tenure as Chief Resident or Senior Fellow do your best to involve others in various projects to strengthen their CVs as well. Look for every opportunity to share the credit and benefits – of success with other members of your team. This means letting them take on leadership roles, make mistakes, learn and correct and thus help you drive the team towards measurable success.

If you are always the master of ceremonies (M.C.) for Grand Rounds, offer to let one of your other senior residents emcee on occasion. This will give that person greater decision-making experience, expanded learning opportunities, and offer him or her a chance to shine in front of their peers.

As Chief Resident, it is not your job to do everything. Motivate and encourage others to get involved, make changes and excel. If every resident tried to improve just one thing in their program, imagine the stellar programs we would all be proud of in 5 years.


About the Author:

Wesley D. Millican, MBA, is CEO and Physician Talent Officer of CareerPhysician, LLC, the national leader in child health faculty and executive search and leadership development. In partnership with the Child Health Advisory Council, a diverse group of emeritus and current national thought leaders in academic pediatrics, Mr. Millican provides critical career and professional development content to residents and fellows to help foster their effective transitions from training into academic and/or private practice roles. For more than 20 years, Mr. Millican and CareerPhysician’s Launch Your Career® Series has served as the trusted go to career training and ACGME Competency resource for U.S. residency and fellowship program directors, and most importantly for residents and fellows seeking to maximize their return on the personal, professional and economic investments and sacrifices made during training. Through Launch Your Career® Series onsite and visual programs and associated web-based content, Mr. Millican believes that residents and fellows are the future of academic pediatrics and that meaningful early investments in their career journey will have a monumental positive impact on their long-term professional satisfaction and their service to children.

For more information about the Launch Your Career® Series and/or to schedule a program for your residency or fellowship program, contact us.

Updated 1-16-24