UHC Internal Medicine Residency

Ambulatory Care

The ambulatory experience includes the resident continuity clinic, ambulatory care rotations in the PGY1 and PGY2 years, and subspecialty clinic experiences. Interns have 1-2 clinics per week, except while in the MICU. The PGY2 and PGY3 schedule separates inpatient and ambulatory experiences by giving all residents discrete clinic blocks. Each residents will complete 12 weeks of clinic block annually, usually organized in 2 week intervals. Please refer to the schedule for more information. The continuity clinic will be at the Parlier Health Center.

Inpatient Care

Inpatient medical teams include a PGY-2 or 3 level resident working with two PGY-1 residents and a dedicated internal medicine faculty member. Medical students on core internal medicine clerkships or 4th year students completing a sub-internship are often part of the medical team.

Inpatient rotations will take place at Community Regional Medical Center and Fresno VA Hospital.

Didactic Schedule Overview

• Intern Summer Bootcamp
• Intern Summer Lecture Series - daily in the summer (July - August) see full schedule in tab below
• Academic half days – protected time from 1-5pm for all residents to focus on education and team based learning:
  • PGY1s Wed PM
  • PGY2/3s Tues PM
  • Team Based Learning didactic over a three year curriculum
  • Rotating: Board Review, Journal Club, Ethics, Wellness, Simulation, Jeopardy, QI, High Value Cost Conscious Care, EBM, other
  • Content is training year specific
• Noon Lectures: M&M twice a month, UCSF Special Lecture Series weekly, House staff meetings 1-2 per month
• Morning Lectures: weekly Grand Rounds, Chest Conference

Academic Half Day

In addition to the summer lecture series, grand rounds, M&M, and our special lecture series, we will offer a weekly protected educational half-day. Residents will be freed from clinical duties for a 3-hour block every week to participate in didactics. Didactics are tailored to the level of the learner: we will offer a separate half-day for interns and another for senior residents.

The typical format consists of 3 sessions:

• Session 1 – Team-based learning didactic
• Session 2 – Morning report-style case
• Session 3 – Rotating Curriculum: Board Review, Journal Club, Ethics, Wellness, Simulation, Jeopardy, QI, High-Value Cost-Conscious Care

Traditional didactics are led by experts in ambulatory medicine, hospital medicine, and all of the medicine sub-specialties.

During the case report, residents will be led through a case with a faculty member. In a large group format, residents are taught key clinical reasoning skills and critical thinking, in addition to building knowledge about disease states.

Evidence-Based Medicine Workshops

Gaining an understanding of evidence-based medicine (EBM) and developing skills in literature searching and appraisal is fundamental to life-long learning in medicine. As part of our core curriculum, we will present interns with the foundations of EBM and prepare them to lead our senior resident journal club.

Intern Evidence-Based Medicine Workshops

Residents will be taught the fundamental skills of EBM in a six-session workshop series. These interactive workshops utilize a team-based learning approach to understanding the medical literature. Based on the Users’ Guides to the Medical Literature, covering topics such as PICO, therapy articles, assessing harm, diagnostics studies, and more.

Interns will learn to:

• Formulate clinical questions,
• Find the best relevant evidence,
• Appraise risk of bias of various study types,
• Assess the results,
• Generalize the results to their patients, and
• Engage patients in making a shared-decision.

Resident- Led Journal Club

During the PGY2 and PGY3 years, residents will lead their peers in an interactive journal club. Residents will choose articles from a repository of the most influential articles of the prior year. Paired with a faculty mentor, the lead large group discussions of assessment and appraisal. Sessions follow a novel peer-reviewed format that incorporates principles of active learning and adult education. The process helps residents learn to draw their own conclusions from the study design and results that are independent of the author’s conclusions, fostering independent critical-thinking skills

Didactic Experience