Leadership in Medical Education: Teaching Senior Residents

By Michael Gisondi (@MikeGisondi)

I recently had the honor of presenting a faculty development lecture at Kaiser Permanente Medical Center San Francisco, entitled, “Teaching Senior Residents.”

My learning objectives for this talk were two-fold:

  • Distinguish between junior resident and senior resident competencies
  • Describe several techniques for clinical supervision and teaching of senior residents

Why are senior residents unique?

I believe there are two halves to residency training, with two distinct learner types: junior residents and senior residents.

Residency training is not a gradual progression of learning across a several-year continuum… residency is bumpy and erratic. It has starts and stops.

There is a point where one starts being a junior resident and stops being a junior resident. Similarly, at some point one starts being a senior resident. That transition from junior to senior is challenging, as the time of promotion is generally driven by an academic calendar rather than a competency assessment.

Starting over is never easy. Just when a trainee is successfully achieving ‘junior resident competencies,’ we push them into new roles and responsibilities – we make them novice learners of ‘senior resident competencies.’


Senior residents are, therefore, a special cohort of learners. Teach them differently.

But how? In anticipation of my presentation at Kaiser SF, I reached out to #MedTwitter to crowdsource some sage wisdom and help.

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#MedTwitter never disappoints. I’m grateful to the 100+ individuals who responded with their teaching expertise in just 24 hours. I collated all the posts into 7 general themes, with a few illustrative Tweets below.

TIP: Teach the Senior Resident Competencies

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TIP: Develop Senior Residents to be Great Teachers

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TIP: Be Vulnerable with Your Senior Residents

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 TIP: Observe Your Senior Residents at the Bedside

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TIP: Give Your Senior Residents Space to Grow

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TIP: Challenge Your Senior Residents, Safely.

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TIP: Treat Your Seniors as Your New Colleagues.

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Summary: 7 Tips for Teaching Senior Residents

  • Teach the Senior Resident Competencies
  • Develop Senior Residents to be Great Teachers
  • Be Vulnerable with Your Senior Residents
  • Observe Your Senior Residents at the Bedside
  • Give Your Senior Residents Space to Grow
  • Challenge Your Senior Residents, Safely
  • Treat Your Senior Residents as Your New Colleagues

Header photo via Pexels


About the Author: Michael A. Gisondi, MD is an emergency physician, medical educator, and education researcher who lives in Palo Alto, California. Michael currently holds a position as Associate Professor and Vice Chair of Education in the Department of Emergency Medicine at Stanford University. Twitter: @MikeGisondi

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