Internal Medicine Residency Program
Unique Aspects of Our Curriculum and Work Environment
We believe that unique aspects of California Pacific Medical Center’s Internal Medicine Residency place it at the cutting edge of Internal Medicine training in the United States. Below are some of the features that we think will interest you.
Evidence Based Medicine Course and Journal Club
Given the voluminous amount of new medical knowledge published these days, it is vital that residents receive good teaching in how to read and evaluate the medical literature. This weekly 2 hour seminar occurs during residents' ambulatory rotations during their 2nd and 3rd years of residency. Taught in a highly-interactive format that is individualized to residents' learning needs, this course covers study design; how to evaluate articles on diagnosis, therapy, screening, prognosis, and meta-analysis; searching the medical literature, and medical statistics terms. During their elective rotations, residents apply these skills to choose and present an article for our monthly journal club. Journal club takes place over dinner at a faculty member's home.
Residents As Teachers Curriculum
This bimonthly session was created in 2016 to improve the teaching skills of 2nd and 3rd year residents. Topics addressed include team leadership, conflict resolution balancing supervision with autonomy, bedside and didactic teaching, clinical reasoning and working effectively in interdisciplinary teams.
Neurocalisthenics is a teaching technique developed at CPMC to aid in rapid recognition of word and symptom patterns in Board Review questions as well as in teaching sessions and patient care. It is utilized regularly by Chief Residents to teach at Residents' Report.
Images in Medicine
Images in Clinical Medicine are used regularly in Residents' Report to emphasize clinical training. Our clinical photo library contains a wealth of patient clinical findings, radiology images, blood smears and pathologic specimens at CPMC.
Residency and Faculty Shared Drive
The Shared Drive is available on most computers in the hospital and allows sharing of articles, files, talks, clinical photos, handouts and photos of fun house staff events, such as retreats, journal clubs and the end of the year graduation party. It has been invaluable in storing presentations done at noon conference and Residents' Report for residents and interns on off-site rotations, vacation or night float rotations so that they can easily review talks of interest to them.
"Common Things Are Common Core Collection"
This collection of articles is based on the most common diagnoses seen in most American hospitals. In theory, if a resident reads one of the core Internal medicine articles in the "Medicine" folder, he/she will see that disease within the week on the wards (e.g., cellulitis, community acquired pneumonia, upper GI Bleed, sepsis.) There are also multiple choice question sets written by the program directors for some of the articles which can be used to reinforce important learning points and to make reading the article more interactive.
This collection received a Commendation from the Residency Review Committee at our last ACGME site visit in 2006.
Quality Improvement (QI) Curriculum
Numerous interns and residents have participated in Quality Improvement projects over the last 2 years. They are educated about Quality Improvement by our QI Department and then focus in on areas of the hospital or patient care that they feel should be improved. We feel it is important for our residents to feel empowered to participate in change rather than feel like passive spokes in the wheels of patient care. Examples of these projects include: retrospective evaluation of PORT criteria and pneumonia admissions at CPMC. VTE prophylaxis compliance performance improvement plan, sliding scale insulin and blood sugar control on 2 selected nursing units at CPMC and addressing barriers to efficient patient flow in the outpatient clinic. Residents have presented these projects at regional and national meetings as well as at noon conferences.
Global Health Elective in Haiti
In 2014, we will initiate a two-week global health elective for 3rd-year residents at Hôpital Albert Schweitzer (HAS), a 130-bed hospital located in Deschapelles, in central Haiti, that provides integrated hospital and community-based healthcare. Established in 1956, HAS is the only full-service hospital serving more than 350,000 people in the region. It has 500 employees, 98% of whom are Haitian. The hospital has a staff of Haitian physicians who treat infectious diseases such as malaria, dengue fever, TB, HIV, and malnutrition, trauma, strokes, peripartum cardiomyopathy and congenital heart diseases. Visiting specialists from all over the world fly in throughout the year to expand the breadth of care and help with the workload in the wards, clinics, and outreach community health centers. Our internal medicine residents will attend morning report, hospital rounds and consultations and outpatient clinic. They will experience the challenges of delivering healthcare with limited resources.
Enhanced Palliative Care Program
We are excited to announce that our Palliative care curriculum will be enriched thanks to a gift from a generous donor. A variety of Palliative care experiences will be integrated into the program throughout the three years of training. These include formal didactic sessions beginning during internship, multidisciplinary rounds, a Palliative care consultation service experience, small group sessions devoted to physician wellness and a series of dedicated noon conferences, including prominent guest faculty. The ultimate goal of this enhanced Palliative care program is to increase awareness about the importance of Palliative care and acquisition of skills in addressing shared decision making in chronic disease and end of life care.
Internal Medicine Subspecialty Rotations
We offer the following core Internal Medicine Subspecialty experiences:
- Infectious Diseases consult service
- Ambulatory Hepatology
- Renal Medicine(including a one week outpatient rotation at the San Francisco VA Hospital)
Increased Ambulatory Care
In 2014, we have increased categorical residents' ambulatory time. Each resident year has gained two weeks of outpatient elective that can be done at a participating clinic in a variety of specialties including endocrinology, sports medicine, San Francisco Free Clinic, allergy, rheumatology, and others. We are continuing to expand the opportunities to pursue ambulatory care clinical experiences during residency.