Continuity Clinic Block in the Sr. Mary Philippa Health Center at St. Mary’s
In the 6+1 (interns) / 4+1 (residents) 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 rotate 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 for each year and work in a group practice-like setting.
All trainees care for an assigned panel of diverse patients: the majority of our clinic population is composed of the multi-ethnic underserved working poor, many of whom deal with chronic illnesses that require integrated multidisciplinary care. We provide access to comprehensive care for all patients regardless of immigration status, health insurance status, or ability to pay. Patients receive care from a team of healthcare providers that include highly skilled and specialized nurses, medical assistants, social workers, diabetes educators, podiatrists, surgical specialists and medical sub-specialists in addition to our primary care internal medicine faculty. 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:
- Diabetes education
- Subspecialty clinics: s
- Specialty clinics: Neurology, GYN, Dermatology, Psychiatry, Breast, Urology, Orthopedics, Podaitry
- 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.
- Quality projects ongoing or in the planning phase:
- Opioid Taper Initiative (interdisciplinary task force)
- HIV-Primary Care Integration (interdisciplinary task force
- Human Trafficking Project
- Hepatitis C and Cirrhosis Project
- Advance Directives Implementation Project
4 Week Ambulatory Block in the Sr. Mary Philippa Health Center
This 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 and serves as the clinic leader for the month.
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 one of our general internal medicine private practice faculty, and settings vary from traditional group practices to solo practice and apaperless practice with a state-of-the art EMR.
Subspecialty Experience in Private Practice Settings
Our sub-specialty faculty offers experience and training in in-patient and out-patient consultative medicine:
- Infectious Disease
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.
Ambulatory Non-Medicine Specialty Rotations
- Radiation Oncology
Emergency Medicine at UCSF-ZSFGH
This required rotation for PGY-1s exposes residents to the population accessing care at Zuckerberg 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 – ZSFGH
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.
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 Gloat 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 residenr, supervised by 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.
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 dedicated critical care-pulmonary and cardiology faculty. Days off are predictable and known well in advance.
- Day call: 6:30 am – 7 pm
- Night Call: 6:30 pm – 7 am
This 3-4 week elective rotation includes consultations on wards and in the ICU at St. Mary’s as well as outpatient clinics. Dedicated time is devoted to learning pulmonary function test interpretation.
This required 4 week , senior resident rotation is completed at Zuckerberg San Francisco General Hospital with teaching and supervision by the UCSF Neurology ptogram (rated #1 in the country).
This 2-week in-patient rotation is offered to residents of all levels of training, and is often chosen by those who wish to improve their procedural 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 or recent neurosurgery. Our Acute Rehabilitation Unit is a required training site for Stanford University PM&R residents.
A Typical Day on Wards
- 6:30 am: Sign-out rounds with program director and chief resident
- 7:00 – 7:45 AM: Pre-round
- 8:00 – 8:30 AM: Morning report
- 8:45 – 10:30 AM: Teaching Rounds/Work Rounds
- 10:30 -11:00 AM: Multidisciplinary Rounds
- 12:00 – 1:00 PM: Noon Conference with UCSF and St. Mary’s faculty
- 1:00 – 4:00 PM: Afternoon Work rounds/ Teaching time
- 5:00 PM: Sign out to Night Float
- Admitting cycle: 6 am – 4 pm every other day
- Interns have Tuesday or Wednesday off (coverage provided by Day Floar interns)
- Residents have Saturday or Sunday off