Sites
All core rotations are completed at one of our 3 teaching sites: Community Regional Medical Center (CRMC), the Veteran’s Affairs Central California Health Care System (VA), and the Deran Koligian Ambulatory Care Center (ACC). We also complete Neurology at Kaiser. Residents are also eligible for more electives offered at UCSF main campus or other programs in the University of California system.
Schedule
The academic year is divided into 4-week blocks. Most rotations span 1 block, though some are 2 or 3 weeks in duration. House staff receive 4 weeks of paid vacation annually. Senior residents take advantage of an X+Y model for the continuity clinic, while interns use a hybrid model. The model increases resident satisfaction with ambulatory experiences, reduces fragmentation of care, and enhances learning.
We utilize a"Golden-Weekend" system for interns while on MICU, CCU, and Wards. Interns have no weekend assignments on electives or clinic blocks.
Interns complete a maximum of 3 weeks of night float, with every 4th night off. With a dedicated night float system at all sites, residents have no 24-hour shifts at any point in the 3 years of training. The longest scheduled shift is from 7 am to 8 pm for MICU call days and CRMC Ward call days.
Below is a sample of the 3-year schedule:
Medical Intensive Care Unit
All residents rotate through the 78-bed intensive care unit at CRMC. These beds are shared between medicine, surgery, & trauma. Two medicine teams are supervised by board-certified critical-care faculty. Teams generally consist of 1 pulmonary/critical care fellow, 1 senior resident, and 2 interns. And Advanced Elective in Critical Care is also available.
Medicine Wards
Over 3 years, residents will have spent approximately 10 blocks on wards. 5 months will be at CRMC and 5 months at the VA. The VA wards include 4 ICU beds and 6 stepdown/telemetry beds which are cared for by the same resident team. The team takes new admissions every fourth day at CRMC. The VA utilize a short call and long call system, with teams taking late call every fourth day.
CCU/Cardiology
Interns and PGY3s each spend 1 block on the CCU service at CRMC. As a leader of cardiovascular services in the central valley, residents will be exposed to a breath of cardiac cases. Teams typically consist of 1 cardiovascular fellow, 1 PGY3 resident, and 2 interns.
Emergency Department
All residents rotate through the VA for experience in emergency medicine. They will gain skills in patient triage, working up undifferentiated illness, and in procedures.
Ambulatory Medicine
All residents complete an ambulatory block at Deran Koligian Ambulatory Care Center during internship. This center features 104 exam rooms, an X-ray room, and three lab drawing stations. In the PGY2 year, residents spend a month at the VA in the Department of Primary Care. They learn to work with the primary care faculty, nurses, pharmacists, social workers, and mental health professionals in a new model of primary care known as Patient Aligned Care Teams (PACT).
The ambulatory experience includes the resident continuity clinic, ambulatory care rotations in the PGY1 and PGY2 years, and subspecialty clinic experiences.
All residents are assigned to a continuity clinic with a panel of patients to manage over 3 years. During clinic weeks, residents will see their continuity panel in the afternoon. Morning are spent rotating through various sub-specialty clinics. at the ACC.
Senior residents have 11 weeks of clinic annually, usually in 1 or 2 week blocks. Interns are asigned 6 weeks of dedicate clinic. In addition, they are assigned 1 half-day per week of continuity clinic while on elective. No clinics are assigned during MICU, CCU, or Wards rotation during any of the years.
Night float
All residents will participate in night float. Interns will join a senior resident to cover the CRMC wards at night, including cross-coverage and new admissions. Senior residents will cover the VA wards at night as well as the MICU.
Neurology
Residents enjoy learning neurology in both the inpatient and outpatient settings at Kaiser Medical Center in Fresno. They also have the opportunity to get additional training in lumbar punctures during their experience.
Research
Each resident is given 2 weeks of protected time for research. The time is taken during either the PGY2 or the PGY3 year.
Subspecialty Elective Rotations
Subspecialty elective rotations are available and provide greater in-depth knowledge and experience. Resident responsibilities include both inpatient consultations and outpatient clinics. By the completion of the three-year program, residents will have completed rotations in most of the subspecialty fields
Electives include:
- Cardiology
- Heart Failure
- Pulmonary
- Nephrology
- Infectious Diseases
- HIV
- Rheumatology
- Dermatology
- Gastroenterology
- Neurology
- Neurocritical Care
- Hematology/Oncology
- Endocrinology
- Diabetes
- Sleep
- Hospice & Palliative Care
- Psychiatry
- Geriatrics
- Toxicology
- Global Health Elective
- Radiology
- Anesthesia
