Building Your Leadership Team

Abstract

To successfully navigate the complexities of running a residency program, a program director must create a team of individuals to ensure all necessary functions are fulfilled. But creating an effective team consists of more than just assigning several people to fulfill specific roles. Identifying, recruiting, and motivating key team members along with creating a culture and atmosphere to facilitate strong teamwork lead to the development of a high-functioning team that can successfully navigate the challenges associated with running a residency in a dynamic, ever-changing environment. This chapter will cover the leadership team roles, skills and attributes that are important for leaders, and qualities and characteristics that produce a high-functioning team.

Glossary of Common Leadership Titles

Title	Alternate Titles	Duties
Program Directora	Residency Program Director; Residency Training Director; Fellowship Director; Fellowship Program Director; Fellowship Training Director	At the meta level, the Program Director is responsible for ensuring the educational environment allows residents/fellows to successfully complete all the program requirements and successfully pass the Board Certification exam. Some key responsibilities include:  Ensuring quality didactics  Ensuring quality clinical experiences and supervision across all clinical sites  Approving and evaluating faculty  Approving local directors for each clinical site  Ensuring appropriate documentation is collected and stored at the local level as well as submitting required information to appropriate agencies  Creating and implementing policies to ensure compliance with ACGME requirements  Selecting, evaluating, promoting, and disciplining residents/fellows
Vice Chair of Education	Vice Chair for Education; Associate Chair for Education	Duties vary widely for this role and will be defined by each department who utilizes a Vice Chair of Education. Generally, this person develops, oversees, and advocates for most or all of the educational programs within the department—such as medical student, resident, fellow, allied health professionals, faculty development, continuing medical education (CME), or continuing professional development (CPD). This individual provides mentorship to leaders of each of these educational programs, and educational leaders may even report to the Vice Chair of Education. The role may include oversight and advancement of educational scholarship. They may have fiduciary responsibility for educational programs
Associate Program Director	Associate Training Director	This individual(s) assists the Program Director in the administration of the residency/fellowship program. They may have defined duties (such as oversight of the program’s didactics) and will often flex responsibilities based upon mutual agreement with the Program Director depending upon the needs of the program at the time
Program Coordinatora	Program Administrator	Duties can vary based upon division of duties between the Program Director and Program Coordinator. They manage the day-to-day operations of the residency/fellowship. Typically, they collect resident/fellow-specific and program level data and input that data into internal and external data management systems. They assist with resident/fellow schedules and with communication between the program and faculty, clinical sites, and other departments where residents/fellows rotate. They assist with residency recruitment—often by communicating with applicants, scheduling and organizing interviews, and coordinating the development of the rank order list. They are occasionally involved in the selection of which residents/fellows are invited to interview or screened for interview by program leadership.
Core Facultya		These are faculty designated by the Program Director who dedicate a significant amount of time and have a significant role in the educational experience of residents/fellows. The ACGME Psychiatry Residency Program requirements currently require at least five core faculty members associated with the residency program
Course Director		This individual creates the didactic curriculum covering a topic area, which could be broad (Psychotherapy) or more narrow (Interpersonal Psychotherapy). They identify faculty to teach the curriculum and ensure both the curriculum and the teaching methodology aligns with the goals of the program. The role may include providing feedback to the faculty on their teaching evaluations and effectiveness, though this task may also be accomplished by the Program Director or Associate Program Director
Clinical Supervisors		These are faculty who provide supervision to the residents/fellows on their required and elective clinical rotations. These faculty are also responsible for providing feedback to residents/fellows, providing written evaluations of the residents/fellows, and ensuring the residents/fellows receive the appropriate clinical experiences as defined by program leadership
Department Chair	Chairperson, alternatively known as a Chief in some health systems	Most academic institutions have a Department Chair who is responsible for hiring and firing of faculty; oversight of the medical school’s missions of education, research, and service; and managing the operational, financial, and personnel resources of the department. In community-based programs, there may be no Department Chair associated with the training programs. Instead, the Department Chair may be a hospital-based role responsible for defining and approving hospital privileges for psychiatrists wishing to provide clinical care within the hospital
Division Chief		Within an academic institution, a Division Chief reports to the Department Chair and is responsible for a defined area of the department—usually delineated by clinical areas or programs. The Division Chief will often be the supervisor for faculty and staff who work in that area and, as such, is responsible for advancing educational, research, and clinical care. In community-based programs, the Division Chief often oversees the clinical area for a specialty or subspecialty, working with hospital or institutional leadership to define what clinical programs are offered, oversee quality assurance programs, and manage the resources related to that clinical area
Educational Site Director	Clinical Site Director; Site Director	This individual coordinates with program administration to ensure an optimal learning environment for residents/fellows and that the educational mission of the program is accomplished at a given clinical site. They ensure clinical supervisors comply with expectations and requirements of the residency/fellowship program. They also coordinate with leadership at that clinical site to make changes in structure, organization, expectations, etc. to ensure residents/fellows have a good clinical learning environment and function in compliance with program goals and expectations as well as accreditation requirements. They may assign the clinical supervisors for that site and may also provide feedback to clinical supervisors at the site on their evaluations and effectiveness at meeting program goals, though this task may also be accomplished by the Program Director or Associate Program Director
Designated Institutional Officiala	DIO; Associate/Assistant Dean for Graduate Medical Education (GME); Vice Dean for GME	This individual is responsible for ensuring ACGME institutional, common, and program-specific compliance of the institution, all residency and fellowship programs, and all sites where residents/fellows rotate
Chief Resident		The role of the Chief Resident is to serve as an intermediary between the residents/fellows and the program administration. As such, Chief Residents represent the residents/fellows when interacting with the program administration and represent the program when interacting with the residents/fellows. Some programs may have one Chief Resident at a time while other programs have multiple Chief Residents simultaneously. There is a lot of variability in the specific tasks the Chief Resident is responsible for. Examples include: creating call or rotation schedules; organizing and leading residents on specific clinical services; organizing residency recruitment activities; organizing and running wellness programs; organizing and delivering teaching/instruction to learners (students, residents, fellows); organizing research or quality improvement activities; etc.

1. ^aACGME required role