Rotations & Schedules

 

Clinic and Ambulatory Medicine Block in the Sr. Mary Philippa Health Center at St. Mary’s

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 the 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: our clinic population is multi-ethnic/multi-lingual 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 includes highly skilled and specialized nurses, medical assistants, social workers, diabetes educators, podiatrists, general internists, subspecialists, surgical specialists, orthopedists, 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: all subspecialties on site
    • Specialty clinics:
    • Neurology, GYN, Breast, Dermatology, Psychiatry, Orthopedics, Spine Surgery, Podiatry
  • Administrative time is allotted for follow up on lab results, self-study and Quality improvement projects
  • Weekly Behavioral medicine curriculum seminars
  • Academic Half Day on Friday mornings for protected team learning time :
    • Quality improvement curriculum and workshop
    • Medical documentation review
    • Procedure lab
    • Sim code lab
    • Team bonding time
    • POCUS Image Review and Training

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, in addition to rotating through a variety of specialty and subspecialty clinics. 

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 subspecialty faculty offers experience and training in both in-patient and out-patient consultative medicine:

  • Gastroenterology
  • Nephrology 
  • Cardiology
  • Endocrinology 
  • Infectious Disease (HIV clinic)
  • Hematology-Oncology
  • Pulmonary
  • Rheumatology

Geriatric Medicine

During this 2-week rotation, the resident visits nursing homes and assisted living facilities 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
  • Physical Medicine and Rehabilitation
  • Dermatology

Emergency Medicine at UCSF-SFGH

This required rotation for categorical and preliminary anesthesia PGY-1s exposes residents to the diverse population accessing care at San Francisco General Hospital, our UCSF-affiliated 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 (senior residents only)

  • Hematology-Oncology
  • Endocrinology
  • Nephrology

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

Other off-site electives: 

Rheumatology                                                                                                                

This popular ambulatory elective takes place in an academic  private practice setting in Oakland or at St. Mary’s

Inpatient Medical Wards 

Two teams, each consisting of one senior resident, 2 interns, and 1-2 medical students, are assigned to the onsite UCSF hospitalist faculty at St. Mary’s. The hospitalist teams’ schedule functions on an alternating admitting cycle, admitting from 6 am to 2  pm every other day. A Swing Service admits from 2 to 6 pm, and the Night resident team admits from 6 pm-6 am, signing out to the Day teams at 6:30 am daily.  Morning Report and noon conference are scheduled Monday through Friday. 75% of  acute medicine ward patients are admitted to our hospitalist teaching service at St. Mary’s, staffed by our UCSF hospitalist attendings, who form an essential part of our teaching faculty. The remaining 25% are admitted to the direct care attending services. 

Residents interact very closely with sub-specialty physicians and with consultants in diverse interprofessional fields.  There are no medical fellows onsite at St. Mary’s, so residents interact directly one-on-one 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 Float 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.