Graduating Residents with Chief Resident Positions, 2009-2018

​Kornfeind K, Frintner MP, Powell W 

Accepted for 2020 Pediatric Academic Societies Annual Meeting

Background: Chief residents play important roles in pediatric residency programs but little research has focused on the characteristics of chief residents.

Objective: Examine the proportion and characteristics of graduating pediatric residents who accepted chief resident positions from 2009-2018.

Methods: American Academy of Pediatrics Annual Survey of Graduating Residents was fielded each year to national, random samples of 1,000 pediatric graduates (2009-2018); 57% average response rate, analytic sample=5,560. Cross-sectional responses were pooled across years. Residents were asked both about the position they accepted directly following residency and their future clinical practice goal. Chi-square tests and multivariable logistic regression examined the association of chief resident positions with resident and program characteristics. Chi-square examined position and a) practice goal and b)  satisfaction (would choose pediatrics again). T-tests examined position and starting salary (inflation adjusted to 2018 dollars).

Results: 687 residents accepted chief resident positions (12%); the proportion remained stable across years: 13% in 2009 to 12% in 2018 (p=.52). Overall, chief residents were more likely to be 31 years old or younger (p<.001), be white, non-Hispanic (p<.001), have graduated from a US medical school (p<.001), married/partnered (p<.005) and have graduated from a larger residency program (p<.001) (Table). These results remained consistent in the adjusted model.

Among chief residents 46% reported goals of subspecialty or both primary and subspecialty care, 35% primary care, and 19% hospitalist. They were more likely than non-chief residents to have hospitalist (19% vs 11%, p<.001) and less likely to have primary care (35% vs 41%, p<.01) goals. Most residents, both those accepting chief resident and other positions reported they would choose a pediatrics residency again (98% vs 94%, p<.001, respectively).

Mean salary for chief residents was $76,000, significantly more than those going into fellowship training ($64,000, p<.001) and less than those starting general pediatric or hospitalist positions after residency ($152,000, p<.001).

Conclusion: One in ten pediatric residency graduates accept chief resident positions. They expect to pursue the spectrum of career goals from primary care to subspecialty fellowship training. Chief residents are more likely to be younger, white non-Hispanic, and a graduate from a United States medical school.

Table 1. Characteristics of graduating pediatric residents who accepted chief resident positions