Categorical and Preliminary interns have similar rotation schedules. They rotate through various inpatient rotations, including general medicine, critical care, cardiology (telemetry and CCU patients), and night float. The categorical interns and Anesthesia preliminary interns do a one month rotation in Emergency Medicine at Zuckerberg SF General Hospital.

In addition to the rotations listed above, second and third year residents also rotate on the Hematology Oncology service and have autonomy managing complex patients.

For an inpatient rotation, a team usually consists of two interns, one second year or third year resident, and a teaching attending. We frequently have medical students from Dartmouth and UCSF Medical School on our inpatient services. We work with a group of hospitalists, intensivists, cardiologists, and oncologists that make our education a priority, providing dedicated teaching time.

Interns and residents do not work shifts longer than 16 hours in length.

All our categorical residents have their own panel of primary care patients and work in a team with a designated supervising preceptor, providing continuity of care over their three years of training.  Our categorical interns have 4 weeks of concentrated ambulatory training (divided into 2 blocks) while second and third year residents have 8 weeks of concentrated ambulatory medicine embedded in their modified block schedule.  We focus on evidence-based care of diverse patients and include exposure to in a variety of primary care subspecialties including orthopedics, otolaryngology, geriatrics, HIV medicine, rheumatology, allergy, podiatry and travel medicine. Including outpatient-based electives and clinic time during inpatient electives, approximately 33% of a resident's time is devoted to ambulatory care. Residents with a particular interest in primary care can customize their schedules and electives to create a three-year experience that is almost 40% ambulatory.

Sample Ambulatory Medicine Block Schedule

Evidence Based Medicine Course and Journal club

Given the voluminous amount of new medical knowledge published, it is vital that residents receive training in the critical analysis of the medical literature. Our weekly 2 hour seminar occurs during categorical residents' ambulatory rotations and provides a highly-interactive, individualized program tailored to resident learning.  We review study design, evaluation of various types of studies (diagnosis, therapy, screening, prognosis, and meta-analysis), review efficient literature searches, and medical statistics.  Our residents apply these skills at our lively, attending-hosted, monthly journal club.  We also have great catered dinners to enhance the learning!

Quality Improvement (QI) Curriculum

Our outpatient education includes a quality improvement curriculum that introduces residents to QI tools and puts them into practice.  Residents work on a QI project during their 3 years of training to help them improve the quality of healthcare delivery.  Examples include: safe opioid prescribing, improving patient transitions of care, reducing VTE, and removing barriers to efficient patient flow.  We are proud of our residents who have presented their QI projects locally and nationally. 

Our Patient Clinic

We provide up to date, state of the art, primary care for adult patients from a wide variety of backgrounds through a team-based approach.  A variety of specialty services are offered to improve our patient care and expose residents to the latest advances.  Our wonderful staff include an on-site advice nurses, a social worker, a physician assistant, and amazing medical assistants. We are located in a newly constructed, expanded office at 2100 Webster in Pacific Heights. 

Our Internal Medicine Residency Program affords excellent inpatient and outpatient elective experiences. Because of our strong academic affiliation with UCSF, electives are offered both at CPMC and at UCSF. Here is a list of some of our offered electives:

Our residents participate in scholarly activities, which include submitting peer reviewed articles and case reports to journals as well as giving oral and poster presentations at major conferences.

Every year we attend the Northern California chapter of the American College of Physicians Conference with residents winning the clinical vignette or QI abstract/poster awards as well as the Jeopardy competition. We also attend the National American College of Physicians Conference.

Interns and Residents also attend national subspecialty conferences including American Association for the Study of Liver Disease Conference, American College of Gastroenterology, American College of Cardiology, American Thoracic Society, Infectious Disease Week Conference, and more.

We have a Quality Improvement (QI) Curriculum as part of our outpatient education, as well as a QI elective that residents may select, during which residents receive one on one mentoring by an attending. Residents have presented their projects at national conferences as well.

Unique aspects of our curriculum and work environment:

• Resident As Teachers Curriculum — Our bimonthly seminars were created to improve the teaching skills of 2nd and 3rd year residents. Topics addressed include team leadership, conflict resolution balancing supervision with autonomy, bedside and didactic teaching, clinical reasoning and working effectively in interdisciplinary teams.
• Global Health Elective in Haiti — We have an established, funded, two-week global health elective for 3rd-year residents at Hôpital Albert Schweitzer (HAS), a 130-bed hospital located in central Haiti, that provides integrated hospital and community-based healthcare. HAS is the only full-service hospital serving more than 350,000 people in the region. Residents help treat infectious diseases such as malaria, dengue fever, TB, and HIV while seeing the impact of malnutrition, trauma, strokes, peripartum cardiomyopathy and congenital heart diseases. This allows our residents to experience some of the challenges of delivering healthcare with limited resources.

• Internal Medicine Subspecialty Selectives — We offer the following core Internal Medicine Subspecialty experiences in infectious diseases, hepatology, nephrology, endocrinology, hematology-oncology, stroke neurology, HIV medicine, and transplant care.
• Enhanced Palliative Care Program — Our Palliative care curriculum is enriched by a gift from a generous donor. A variety of palliative care experiences are integrated into the program throughout the three years of training. These include formal didactic sessions, multidisciplinary rounds, palliative care consultation, and small group sessions devoted to physician wellness. We also have a series of dedicated 12:00 pm conferences, including prominent guest faculty.

California Pacific Medical Center is a community and university-based institution focused on providing the experience, commitment, and a rigorous and balanced approach to training of future physicians. We provide an intensive exposure to the practice of internal medicine and aim to train highly skilled and compassionate physicians in a diverse and supportive environment, fostering growth of the individual physician and their talents.

Our resident-driven primary care clinic (known as Pacific Primary Care) is the focus of the residents' outpatient experience. This HMO-model clinic serves a panel of 10,000 patients representing the diverse spectrum of the San Francisco community.

Our hospital serves its community and also serves as a major referral center from other healthcare providers and facilities throughout Northern California, Nevada and Oregon and are sent for our superb sub-specialty and sub-sub-specialty care. This population of patients provides the same challenging diagnostic and therapeutic dilemmas one would see at any tertiary/quaternary care university hospital in the United States but with a greater degree of house staff autonomy.