Making of an Anaesthesiology Chief Resident

​

“I believe in power; but I believe that responsibility should go with power.” - Theodore Roosevelt, 26th President of the United States of America

The title of ‘Chief Resident’ (CR) in SingHealth Residency is one that demands almost-superheroic abilities to multi-task, excel and lead. On top of Residency training, a CR has to shoulder responsibilities in the areas of clinical administration, talent management and conflict resolution. Dr Lie Sui An, a CR in SingHealth from the Anaesthesiology Residency Programme weighs in on this appointment plus the blood, sweat and tears (not forgetting the perks) that come with it.

The Highs & Lows

Like the SingHealth CRs before him, Sui An attended the Accreditation Council for Graduate Medical Education Leadership Skills Training Programme, followed by the Duke Durham Chief Resident Networking Session. He says: “This trip gave me a better understanding of the role of CRs in the United States (US). It was a melting pot, where we learned about the difficulties and struggles faced by CRs from various Residency programs (both medical and surgical sub-specialties) all over the country.” As the only foreign delegate in the training session during the first leg of his study trip, Sui An found the multi-disciplinary exchange of ideas from a vastly different healthcare system to be an eye-opener. He discovered that everyone had similar concerns (like tailoring feedback effectively and dealing with personal stress), which cut across cultural and societal differences. “I am glad I could offer my own perspectives to many common issues in Residency. This definitely helped bridge the gap and forge friendships!”

Sui An also had the opportunity to shadow CRs from Duke Anaesthesiology with different portfolios. He highlights the strengths of the US system, which aims to inculcate in CRs a deeper understanding of how to balance the needs of Residents and the hospital through practical knowledge. The focus is on day-to-day organisation of the training programmes like planning Resident rotations and daily Operating Room schedules, organising Residency events, and more importantly, selecting cases with the greatest educational value and clinical complexity for Resident staffing. This helps to enhance the educational experience for all. “During my time with the Duke CRs, I was humbled by the dedication they showed in serving the Resident body, handling the rigorous administrative demands entrusted to them while still displaying the highest standards of training and clinical performance,” he says.

Unlike Singaporean CRs, US CRs do not undergo any formal Chief Residency training programmes. “I was impressed by the US CRs. Many of them were unprepared for their roles and had to hit the ground running,” Sui An says. In addition to the year-long, nation-wide Singapore Chief Residency Programme that all SingHealth CRs undergo, SingHealth also conducts on-the-job training designed to equip future leaders with advanced practical competencies. Sui An credits all the training he received for his confidence in leading the Resident body now.

“Becoming a CR was not easy at first; leadership did not come naturally to me. There are many expectations to meet, both extrinsic and intrinsic. This puts pressure on us, the CRs, to perform up to professional and personal standards.” Sui An describes CRs as ‘middle managers’ with four directions of responsibility – 1. Upward to the Consultants, 2. Downward to the Residents, 3. Laterally to other middle managers, and 4. Internally to other CRs across SingHealth Residency.

“Sui An observes: “Leadership is about influencing yourself and later, other people to do things outside of their comfort zone, for the greater good.” In this way, the leader’s authority is not the same as the dictator’s mandate. “The opportunity to serve and lead the Resident body has been a rewarding and humbling task. Rewarding, because I got the opportunity to relate to many Residents on a personal level, forging stronger bonds and relationships; humbling, because it is never about self. The work is always about something bigger, be it for the Residents, the program or SingHealth."

The Start of It All

SingHealth Residents have the constant drive to improve things, most notably, care for their patients. Sui An recalls being “thrust into the receiving end of healthcare, becoming a ‘patient’s family member’.” Being on the other side helped Sui An realise that what matters to patients is not the ability of a doctor to quote statistics from the latest journal articles, or to elaborate on treatment plans. He says: “While I am not discounting the need for medical therapeutics, what I am saying is in the midst of the science, we should not forget the art – always remember the human side of things: To cure sometimes, treat often, comfort always.”

While Anaesthesiologists often only encounter patients briefly in the peri-operative setting, Sui An says that they still form an important part of the overall patient experience. Taking the effort to allay patient anxiety, listening to their worries and concerns and providing the necessary reassurance goes far in making a difference for patients. “Seeing my patients ready and confident to face the uncertainties of major surgeries gives me a sense of empowerment. This is what keeps me going at work!”

Even the Smallest Things Count

Inevitably, something has to give so that more time can be devoted to the pursuit of better management, better Residency training, better patient care. Sui An notes wryly: “The hard truth is that we all have only 24 hours a day. Personal time becomes a lesser priority. Rather than viewing this as a sacrifice, I believe in seizing the moment and turning any tiny pocket of time available into something fruitful.” For example, Sui An goes for a run a few times a week to clear his mind and concurrently build up his physical stamina for work. Little things contribute toward the bigger picture. The best advice he has received so far, Sui An shares is: “There are no tasks too menial or small for good leadership. You will have to make that decision to step up, to risk being ridiculed, to fall and to pick up the broken pieces, to dust the dirt off your knees and to carry on. Repeat this often enough, and the fruit of your labour surely will be sweet.”