Internal Medicine at Oakland

Internal Medicine Curriculum

Inpatient Rotations

We have eliminated overnight "call” so residents can maximize their daytime education goals and ensure the highest level of quality patient care.

Residents assume primary responsibility for their patients in the critical/coronary care unit and the general medicine wards.

Ward Teams

There are 4 ward teams consisting of 2 interns and 1 resident. Each team caps at 16 general medicine ward patients, 8 per intern. The ward attendings are selected for their interest in teaching and are from both our hospital and general medicine departments. Acting interns (4th year students from a variety of medical schools) give our residents additional opportunities to teach and mentor.

Intensive Care

The teams for the ICU/CCU patients are supervised by an intensivist and a cardiologist. The residents particularly enjoy the teaching from our intensivists who have been honored with many teaching awards over the years.

Our resident night float system begins at 8PM so that none of our inpatient services have long or overnight call.

Residents desiring a career in Hospital Medicine can do additional electives to prepare them for the critical leadership roles of hospitalists. These include but are not limited to:

• Peri-operative care including Spine Surgery
• Emergency Room Consultation
• Hospitalist block (focusing on Patient Safety, Quality Assurance etc.)

Subspecialty Experience

Outpatient Experience

Our graduates are in very high demand for positions in the Bay Area. We excel in training primary care physicians in evidence-based medicine and culturally sensitive care. All of our residents have a ½ day continuity clinic and are the primary care physicians for their patients. The resident clinic will move to our new state-of-the-art building in 2008. Categorical residents have 6 blocks of ambulatory medicine over the 3 years of training.

These blocks include:

Primary Care Medicine

Residents interested in primary care can spend as much as 40% of their training in the outpatient setting. Residents are exposed to one of the strengths of our organization: evidence-based care of patients with chronic medical problems while emphasizing preventive care for all of our patients. Our faculty mentors in primary care are selected for their teaching and clinical excellence. These mentors shepherd residents through their primary care training and many form a life long mentorship/friendship with the residents as they proceed into clinical practice.

Research and Other Electives

We have a very generous number of true elective blocks. In addition to the core subspecialty consultation and ambulatory medicine blocks, each resident has 6 blocks of elective time. This time can be spent doing off campus rotations in preparation for fellowship training. In addition, four weeks a year for both preliminaries and categoricals can be spent on a research project/scholarly activity. Additional elective rotations in Allergy and Immunology, Radiology, Anesthesia, Psychiatry, Gynecology and other specialties are available. There is no call and no weekend responsibilities on these rotations, which allows ample time for reading and an active lifestyle.

Educational Funds

All interns and residents are given an individual UptoDate account to be used both on campus and at home. ACP Associate membership including subscription to Annals of Internal Medicine is provided to all categorical interns and residents. We also buy the MKSAP for Board Review for all R3’s. All of our categorical residents are given textbooks in both primary care medicine and hospital medicine. Other educational funds include $500/year for R1’s and R2’s and $750/year for R3’s. (to be used for books, software and other educational purposes).

We financially support our residents presenting at regional and national meetings.We also cover the cost of USMLE Step 3 ($655), California Medical License ($900) and DEA license ($551) for all categorical residents.

Conferences

Daily Teaching Conferences

Case Based Daily Report:
Residents present cases followed by an evidence-based medicine discussion. The inpatient and subspecialty focused daily reports are led by medicine and subspecialty faculty. All residents may attend daily report and this time is protected to minimize distractions to learning.

Noon conferences:
Daily conferences given by our onsite and visiting faculty keep you up to date on the rapidly expanding field of medicine. There are weekly subspecialty conferences as well as monthly Morbidity & Mortality and Quality Assurance conferences.

Teaching Rounds:
Critical care: These very popular daily small group teaching sessions are led by the intensivist.

Cardiology: Small group discussions focus on active cases or core cardiology topics. There is an additional weekly cardiac catheterization conference.

Ward Teaching rounds: These include bedside teaching and small group sessions. In addition, there is a hospital medicine curriculum based on the Hospital Medicine textbook.

Weekly Conferences

Board Review:
A MKSAP Board review meets weekly and is led by a sub-specialist. In conjunction with the resident’s excellent clinical experience, this conference contributes to our 100% board pass rate for the past 4 years.

Journal Club and Chief Rounds:
A recent groundbreaking journal article is actively debated or an in-depth review of an unusual or complex case is presented.

Outpatient Clinic Conference:
These occur before continuity clinic and are based on topics taken from the Primary Care textbook which is provided to all categorical interns at the start of residency.

Special Teaching Sessions

Pathology Rounds:
A very popular session of interesting pathology/biopsy findings that are reviewed with an attending pathologist.

Resident Peer Review:
Residents review cases with unanticipated outcomes or “near misses”. Human factors and ways to minimize errors are emphasized in each case.