As EM Physicians, we have all gone through residency after which some of us went on to community jobs and others decided that they were called to work in academics. Have you ever looked back on your residency years and wondered what was going on in the mind of your program director at the time? Have you ever thought about the things that they may have given up to serve in that role?  In this episode, Andy (Program Director at AdventHealth East Orlando) and John (Program Director at OhioHealth Doctors Hospital) are joined by Mike Kiemeney, MD (Program Director at Loma Linda) to discuss their experiences as program directors, including aspects of the job that they both expected and did not expect.

Things PDs Give Up:

• Relationship with the residents as it was before they were PD.
  • Residents are often on their best behavior around you, but this also means they will be less relaxed around you.
  • You also have to be less relaxed around the residents because, after all you are their boss, so for many PDs, they are not seen as the “cool” faculty members anymore.
• Being able to hang around for social events in the same capacity as before.
  • An example of this is not going out with the residents after graduation.
  • Not only do you as the program director have to be able to have plausible deniability, you also have to allow the residents time to relax, which won’t happen as much if you are there.
• The ability to be the resident’s friend without being their program director.
  • Once you become the program director, while you may still be their friend, you have to be their program director. 
• The ability to be an energy matcher. 
  • If a resident is not giving 100%, you as their PD still have to come at them with 100% engagement into who they are and who they can be.

Things PDs Gain:

• The ability to become way closer to the residents because you know much more about them than you did before.
• The responsibility to protect the public.
  • This can be a blessing and a curse. 
  • This great responsibility can be difficult when it comes time to discipline a resident because you care deeply about them, but it is also a fulfilling responsibility to serve the public. 
• The ability to make a lasting impact on the residents
  • It’s different than being a parent, but it’s about as close of a relationship to that as you can get.
• The buck stops with you on everything.
  • All decisions go through the program director. While this can be exhausting, you gain a lot of say in how the program is run. 
• Perspective
  • You become acutely aware of how much life happens outside of residency for the residents and you often help support them through it,  which can be very rewarding.

Take-home points: 

1. Like with anything in life and leadership, there are pluses and minuses to every job.
2. As PD, your relationship with the residents will change, but not always for the worse.
3. PDs have a responsibility to the public to train excellent physicians and while challenging, it can also be a very rewarding experience, 

Post by Patricia Capone, DO PGY3

About Our Guests:

Mike Kiemeney, MD

Emergency Medicine Program Director, Loma Linda University Medical Center

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