This report describes a survey that explored the selection, training, duties, skills, and evaluation of chief residents as perceived by the program directors of the 381 family medicine residencies in the United States in 1989. A response rate of 79% (300 programs) was achieved. In 70% of the programs the chief resident received no formal training, and in 41% no formal evaluation. The program directors believed the most important duties and skills of a chief resident were acting as a liaison and advocate for residents, scheduling, and leadership. The directors thought that the most exciting aspects of being a chief resident included the development of leadership skills and the ability to influence curriculum; the aspects that caused the most concern included time pressures and demands that detract from clinical learning. The authors suggest that more attention should be directed to the nurturing and development of chief residents, who are the future leaders in academic medicine.
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