Rotations & Schedules

Ambulatory Focused Learning

Weekly Continuity Clinic Block in the Sr. Mary Philippa Health Center at St. Mary’s
In the 4+1/6+1 -X+Y block system, residents attend their continuity/primary clinic during a dedicated week-long clinic block. Senior Residents return every 5th  week, while categorical and preliminary interns rotate through the clinic every 7th  week. All patients are seen by residents who take on the role of the Primary Care Physician under the supervision of our teaching faculty. Residents are assigned to a team and work in a group practice-like setting. 

All trainees care for an assigned panel of diverse patients: The majority of the clinic population is composed of the underserved working poor, many of whom deal with chronic illnesses that require integrated multidisciplinary care. Patients receive care from a team of healthcare providers that include highly skilled and specialized nurses, medical assistants, social workers, and diabetes educators. Our average preceptor to resident ratio of 1:3 allows for timely and effective personalized teaching.

The Clinic Block Rotation Advantages

  • Learning experience entirely focused on Ambulatory Medicine without the stress of having to return to a busy in-patient ward at the end of clinic.

  • Additional exposure to:
    • Anticoagulation
    • Diabetes education
    • Subspecialties
    • Specialties: Neurology, GYN, Dermatology, Psychiatry
    • HIV primary Care
    • Chronic pain management
    • Behavioral medicine curriculum
    • Quality improvement curriculum
  • Administrative time is allotted for follow up on lab results, ED follow up calls to patients, and quality improvement projects.

  • Following projects are currently ongoing or in the planning phase:
    • Opioid Taper Initiative (interdisciplinary task force), ongoing 
    • HIV-Primary Care Integration (interdisciplinary task force), Ongoing 
    • Human Trafficking Project (planning / implementation phase)  

4 Week Ambulatory Block in the Sr. Mary Philippa Health Center 
The required block rotation exposes senior residents to a vast array of clinical scenarios, including urgent and continuity care as well as specialty and subspecialty care. The ambulatory resident takes on the important role of safe and reliable follow up for continuity clinic patients discharged from the hospital.

Primary Care Experience in Private Practice Settings
The 2-3 week elective gives senior residents the opportunity to learn about private practice in general internal medicine in the community. Patients are seen under one-on-one supervision by one of our general internal medicine private practice faculty, and settings vary from traditional group practices to solo practice and the paperless practice with a state-of-the art fully established EMR. 

Subspecialty Experience in Private Practice Settings
Our sub-specialty faculty offers experience and training in in-patient and out-patient consultative medicine:

  • Gastroenterology
  • Nephrology 
  • Cardiology
  • ID 
  • Hematology-Oncology

Geriatric Medicine
During this 2-3 week rotation, the resident attends nursing homes and assisted living facilities as well as our own geriatric clinic under the supervision of one of our core faculty physicians. The resident will join the attending in his private practice and perform geriatric evaluations in the hospital. The learning experience includes completion of modules of comprehensive online curriculum provided by American Geriatric Society. 

Ambulatory Non-Medicine Specialty Rotations

  • Radiation Oncology
  • Radiology
  • Neurology

Emergency Medicine at UCSF-ZSFGH
This required rotation for PGY-1’s exposes residents to the population accessing care at Zuckerberg San Francisco General Hospital. Residents will encounter a wide spectrum of emergent presentations, including trauma, acute intoxications, cardiovascular and neurological emergencies, sepsis, GYN emergencies and more.

Elective Subspecialty Experience at UCSF – ZSFGH

  • Hematology-Oncology
  • Endocrinology
  • Nephrology

These three elective rotations expose senior residents to a high number of patients in the clinics and on the in-patient service under supervision by fellows and faculty. 

Rheumatology 
This popular ambulatory elective takes place in a private practice setting in Oakland.

In-Patient Focused Learning
ACGME duty hours are consistently enforced and have successfully been implemented without compromising rotations during internship or residency.

Medicine Wards 
Teams are assigned to hospitalist faculty and one team admits with our private teaching faculty. The schedule functions on an alternating morning versus afternoon admitting schedule: For example: Green Team admits from 6:30 AM to noon, Yellow Team admits from noon to 4 PM. This pattern alternates daily. There is daily Morning Report and noon conference Monday through Friday. Sixty to 70% of patients are admitted to our hospitalist service staffed by our UCSF –hospitalist attendings, who form an essential part of our teaching faculty. The remaining 30% of patients are admitted by private medical staff with active in teaching privileges. Residents interact closely with sub-specialty physicians and with consultants in diverse interprofessional fields.
 
Night Float Team 
Our night-float team consists of a senior resident and two interns who cross-cover and admit together 5 nights a week with 2 consecutive days off. Supervision is provided by the UCSF hospitalist faculty and call hours are from 5 pm – 7 am. Residents attend a structured and supervised sign-out at 6:30 AM. 
 
ICU
The ICU team consists of 1 resident and two interns during the day and I resident and I intern at night. Residents are supervised by critical care faculty. Days off are predictable and known well in advance. 

  • Day call: 6:30 am – 7 pm
  • Night Call: 6:30 pm – 7 am 

Pulmonary Medicine 
The 3-4 week in-patient rotation is required of all senior categorical residents and is offered to preliminary residents as an elective rotation. It includes consultations on wards and in the ICU at St. Mary’s.

Neurology 
This required 4 week rotation mostly in-patient rotation is completed at Zuckerberg San Francisco General Hospital.

Anesthesia 
The 2-week in-patient rotation is offered to all residents of all levels of training, and is often chosen by those who wish to improve their procedure skills such as central line placement and intubation.

Physical Medicine and Rehabilitation 
This elective 2-3 week rotation exposes residents to our acute in-patient rehabilitation unit for stroke patients and patients with traumatic injuries. Serves as a formal PMR training site for Stanford University residents.

A Day on Wards

Summary: 

  • 6:30 am: Sign-out rounds with core faculty and chief resident
  • 7:00 – 7:45 AM: Pre-round
  • 8:00 – 8:30 AM: Morning report with house staff
  • 8:45 – 11:00 AM: Teaching Rounds/Work Rounds
  • 11:00 AM: Multidisciplinary Rounds
  • 12:00 – 1:00 PM: Noon Conference with faculty
  • 1:00 – 4:00 PM: Afternoon Call/Work rounds/Additional Teaching time
  • 5:00 PM: Sign out to Night Float