1. Roles Reversed: Resident to Attending
Nina Ahmad, MD
Ruth Deitz, MD
Nancy Ruddy, PhD

2. Introductions Dr. Nina Ahmad Dr. Ruth Deitz Dr. Nancy Ruddy
Resident at MSH-> Assistant Director at MSH
Clinical Director at UMDNJ, Drexel and NYCOM
Clinical Professor at St. Georges
Dr. Ruth Deitz
Advisor-> Colleague
Dr. Nancy Ruddy
Behavioral therapist-> Colleague

3. Environment Changes Expansions Fellowship Hospital being sold?
Attending numbers down
Expansions
6-6-6 residency ->6-6-8 residency

4. The Transition New attending role Supervisor role No orientation
Medical students and left over assignments
From novice to expert (e.g., football game supervision)

5. Challenges in the Transition
Established relationships based on old role
“Friend & colleague” -> faculty
“Safe” person for complaints
Some expectation to side with or advocate for residents and staff
Old issues with individuals still there, but roles different
Become triangulated in conflicts (residents, faculty and staff). Feel “two-faced,” worry about comments being taken out of context

6. Challenges in Transition
Developmentally a “new” doctor, but in supervisory role
Want to project confidence, tempered with reality that role is new
Different levels of developmental differences (working with R1 vs R2 vs R3)
Difficult to ask for back up from colleagues without undermining own position
Supervising medical students

7. Challenges in Transition
Relationships with Residents
May trust new doctor less
Hierarchy issues
Become aware of resident issues
Residents may share more, what stays confidential vs shared with faculty
Residents may feel too comfortable intruding on personal time (friend or attending?)
Residents likely to ask for help – less worried about being judged

8. Challenges in transition
Faculty interface
Some faculty inadvertently undermine
Uncomfortable to be in evaluative role
“Dumping ground” for tasks no one else wants
Hard to say no, ask for help while trying to prove self
From faculty/trainee relationship to colleague/friend relationship
Role definition is murky at time
See other “sides” of formerly idolized people

9. Scenarios
Scenario 1: Front staff, MAs, residents, and attendings complained about issues to the New Faculty about problems in each department and not feeling like they have a ‘voice’. What do you do?
Scenario 2: New faculty was invited into the residents meeting to discuss their conflicts with staff, attendings and the program. Should the new faculty member sit in the meeting and subsequent meetings?
Scenario 3: A resident received critique from faculty and then came to the new faculty member crying and stated, “You didn’t tell me they hate me!” What should the new faculty say?

10. Pros and Cons PROS CONS Quicker transition Extension of learning
Assisted in development of a more well rounded physician
CONS
-Triangulation
-Conflicts of interest
-Being evaluated at the same time as evaluating

11. Conclusion/ Recommendations
Orientation
Awareness of difference between a supervisor, teacher, and friend
Fostering different ways of thinking
Being aware of triangulation

12. Thank you