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Rotations & Schedules

 

In the 6+1 (interns) / 4+1 (residents) rotation block system, residents attend their continuity/primary care clinic during dedicated week-long clinic blocks. Residents return to clinic every 5th week, while categorical and preliminary interns return to the clinic every 7th week. All patients are seen by interns or residents who take on the role of the Primary Care Physician under the supervision of our teaching faculty. Residents are assigned to a clinic team and work in a group practice-like setting. 

Clinic experience includes continuity clinics as well as all sub-specialties and specialties as listed below. 

All trainees care for an assigned panel of diverse patients: ur clinic population is multi-ethnic and represents the underserved working poor, many of whom deal with chronic illnesses that require integrated multidisciplinary care. Our goal is to afford equal access to comprehensive care for all patients regardless of immigration status, health insurance status, or ability to pay. Patients receive care from a dedicated team of healthcare providers that include highly skilled and specialized nurses, medical assistants, social workers,  diabetes educators, podiatrists, general internists, subspecialists, surgical specialists, neurologists, dermatologists, optometrists and mental health professionals. Our average preceptor to resident ratio of 1:3 allows for timely and effective personalized teaching.

Why a Clinic Block Rotation? 

Your learning experience is entirely focused on Ambulatory Medicine without the stress of having to return to a busy in-patient ward after clinic.

  • Additional exposure includes: 
    • Anticoagulation
    • Diabetes education
    • Subspecialty clinics:
    • Specialty clinics: 
      • Neurology
      • GYN, Breast
      • Dermatology
      • Psychiatry 
      • Orthopedics
  • Administrative time is allotted for follow up on lab results, ED follow up calls to patients, quality improvement projects as well as directed studying 
  • Weekly Behavioral medicine curriculum
  • Academic Half Day in Friday morning for protected team learning time :
    • Quality improvement curriculum and workshop
    • Medical documentation review 
    • Procedure lab
    • Sim code lab
    • Team bonding time  

2-4 Week Ambulatory Multispecialty Block Sr. Mary Philippa Health Center 

This required block rotation exposes senior residents to a vast array of clinical scenarios, in the specialty and subspecialty clinics. The ambulatory resident takes on the important role of safe and reliable follow up for continuity clinic patients discharged from the hospital and serves as the clinic liaison for the assigned rotation period. 

Primary Care Experience in Private Practice Settings

This 2-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 general internal medicine private practice faculty, and settings vary from traditional group practices to solo practice. 

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
  • Endocrinology 
  • Infectious Disease 
  • Hematology-Oncology
  • Pulmonary
  • Rheumatology

Geriatric Medicine

During this 2-3 week rotation, the resident visits 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 and on home visits. The learning experience includes completion of comprehensive online curriculum modules provided by American Geriatric Society. 

Non-Medicine Specialty Rotations

  • Radiation Oncology
  • Radiology
  • Neurology

Emergency Medicine at UCSF-ZSFGH

This required rotation for PGY-1s exposes residents to the population accessing care at San Francisco General Hospital, our county hospital and Level 1 trauma center. Residents will encounter a wide spectrum of emergent presentations, including trauma, acute intoxications, cardiovascular and neurological emergencies, sepsis, GYN emergencies and more.

Elective Subspecialty Experiences at UCSF – SFGH

  • 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 UCSF fellows and faculty. 


Other off-site electives:

Rheumatology

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

Inpatient Medical Wards 

Two teams of one senior resident, 2 interns, and 1-2 medical students are assigned to UCSF hospitalist faculty and a resident-only team admits with our private teaching faculty. The hospitalist teams’ schedule functions on an alternating admitting cycle, admitting from 6 am to 4 pm every other day. A Swing Service hospitalist attending admits from 4 to 6 pm, and the Night Float resident team admits from 6 pm-4 am, signing out to the Day teams at 6:30 am daily.   Morning Report and noon conference are schedules Monday through Friday.  75% of patients are admitted to our hospitalist teaching service staffed by our UCSF hospitalist attendings, who form an essential part of our teaching faculty. The remaining 25% of patients are admitted to a Private Teaching Service staffed by a senior resident, supervised by a core faculty and private medical staff with active inpatient  teaching privileges. Residents interact very closely with sub-specialty physicians and with consultants in diverse interprofessional fields.  There are no medical fellows at St. Mary’s, so residents interact directly with our outstanding subspecialty consultants.

Night Float Team 

Our night-float team consists of a senior resident and two interns who cross-cover and admit together for 5 nights a week, with coverage by our Day Gloat system to enable 2 consecutive days off. Supervision is provided by dedicated UCSF hospitalist faculty 24/7 and work hours are from 5 pm – 7 am. Residents attend a structured sign-out supervised by the Program Director at 6:30 AM.