Three chief residents are selected for their outstanding abilities in patient care, teaching and leadership. They work closely with residents, faculty, the program director and the department chairman to facilitate the clinical and educational programs of the department. They provide on-site leadership at Connecticut Children's Medical Center, at the NICU at John Dempsey Hospital, at Saint Francis Hospital and Medical Center, and in the community. They also provide consultative guidance throughout the program.

The efforts of the chief residents are divided between supervision, service, and scholarly activities. They supervise scheduling, conduct housestaff meetings, participate on the Selections and Promotions Committee and Resident Advisory Committee, and may participate in faculty meetings as well. They conduct chart reviews and morning report. They oversee rounds and management conferences. They maintain a continuity clinic, supervise outpatient activities, may attend on the inpatient service. They are involved in community service and resident social activities. Working together, they are also able to pursue scholarly endeavors, while they arrive at future plans.  The chief residents play a major role in the program, and are provided a management and supervision retreat prior to, and during, the academic year to facilitate their planning and organizational skills. They are available on a rotating basis from home for acute problems, and they have four weeks of vacation. Each chief resident is provided support to attend an academic meeting during the year and they receive the same professional support as all other residents.