Whether you’re taking on the position of Chief Resident in your program, starting a fellowship or residency, or launching your medical career in a new practice, you probably know exactly what you want to accomplish. Or do you?

If you answered no, you have plenty of company. In a recent survey, fewer than 1% of polled residents and fellows have their professional goals in writing. This article focuses on the importance of program goal setting for newly-appointed Chief Residents, but the same lessons and techniques are applicable to every stage of your career from medical training through your entire professional life.

Why do we resist setting goals? Well, while it’s easy to make a list of things we’d like to accomplish, making them happen takes a lot of work. The rewards, however, are huge. How do you, as a new Chief Resident, reach the goals you have for your program? There are three steps to take. First, define the values and goals you have for your program. Second, identify everyone who is directly dependent on your program. Third, find out exactly what these individuals depend on you for, and create a solution that will target and meet each of those needs.

What Values Do You Want in Your Program?

A group of newly-appointed Chief Residents were asked to list the values and goals they had for their program. The list included the following:

  • dedication to academic excellence, scholarship, pursuit of knowledge
  • delivery of quality patient care
  • teamwork with dependable, trustworthy colleagues
  • professional and personal accountability
  • nurturing atmosphere for learning and professional development
  • good business model
  • present professional image to other departments
  • ability to compete with other departments for limited resources

In spite of the fact that all the Chiefs wanted these values in their programs, not one of them felt that their present program actually reflected all these values.

Who Are the Stakeholders?

The next step is to identify all the groups and individuals who are affected by the way your program is run. The Chiefs came up with the following:

  • patients and their families
  • attending physicians
  • hospital administration
  • referring physicians
  • technicians and other support staff
  • fellow residents
  • your own family


Clearly, each of these stakeholder constituencies has very diverse, perhaps even competing, interests when it comes to the way your program operates and how it affects their lives. To be successful in reaching the goals you set for your program, it’s necessary to understand, appreciate and account for how this mix of stakeholders is served by and contributes to your efforts to build a successful and rewarding program.

Identify Needs

Once you’ve identified everyone who depends on you and your program, identify, analyze and list what’s valuable and important to each one of your discrete stakeholder groups. Ask yourself this question for each: what’s valuable to them about what you do?

For example, an Attending Physician depends on you for your labor, scheduling skills, medical knowledge, and professionalism toward patients.

Your family, on the other hand, is more concerned with the time you have available for them, your income to provide for their needs, your overall stress level, and your attitude toward them and to your work.

Your patients depend on you to ensure they receive the highest quality of care possible — and sometimes this need may seem to conflict with the interests of stakeholders like hospital administrators or managed care provider organizations.

Create Solutions

As a Chief Resident, one of your most important duties is to engage the other residents and actively involve them in finding and implementing solutions. Acting as a collaborative group, you should take a hard, analytical look as to whether each of the needs you’ve identified above is being met, making a list of those that are and those that are not.

In the case of your family, for example, how can you assure that you and the other residents have time to spend with family? You may decide to institute a regular “family dinner” program for all residents.

Friction between residents and Attending Physicians may be a more difficult problem to solve. A number of Chiefs commented that, while they had high academic goals for their program, they feel they are only seen as a source of cheap labor to the Attending Physician.

“How can I move from being a laborer to an academic?” asked one Chief.

As Chief, you should delegate the tasks of setting goals and finding solutions to these problems to your fellow residents, requesting them to report back on progress at regularly scheduled meetings.

In many instances, finding the right incentive, motivation and reward is the key to solving a nagging problem. What incentive, for example, does the faculty have to do more teaching instead of just depending on residents for their labor? What’s the reward your family receives for tolerating your long hours away from them? How do you motivate a new resident to comply with hospital policies and procedures while still concentrating on delivering the highest standards of quality care to her patients?

Put It In Writing

As we noted earlier, it’s not enough to just think about your goals. Goals must be specific and written down. Everyone finds it difficult, especially at first, but with practice the process becomes easier and habit-forming once you see the tangible results it it can produce for you and your team of stakeholders.

Be flexible and pragmatic – don’t expect everything to happen at once or to get it all right the first time. Do it now and perfect it later.

As Chief Resident, taking your goals seriously and involving your residents in finding solutions will dramatically affect the quality of your program and set the tone for the entire year and beyond. And these skills, developed and honed during this critical year, will serve you well throughout your professional career.

About the Author:

Wesley D. Millican, MBA, CEO and Physician Talent Officer of CareerPhysician Advisors, LP, and CareerPhysician, LLC, provides comprehensive talent solutions for academic children’s hospitals, colleges of medicine and academic medical centers across the nation. He possesses a longstanding passion for career development of all young physicians and serves as a go to career resource for training program directors and their residents and fellows. In continuing his commitment to the “future of medicine”, Mr. Millican speaks nationally at residency and fellowship programs. His Launch Your Career® Series is a proven resource for today’s residents and fellows and has served as a go to resource for program directors.