Internal Medicine at Kaiser Santa Clara

1. How frequently are residents on call? Is there a night float system?

Internal Medicine inpatient wards services take long call every 5th day. The 5 day cycle is made up of one long call, one short call, and 3 non-admitting days. Long call teams admit up to 10 patients and short call teams up to 4 patients on their respective days. Long call teams take their last admission by 7pm and leave the hospital by 9PM. There is a night float system to admit overnight and cover the hospital, allowing long call teams to sleep at home.

The ICU rotation is the only rotation with overnight call. Residents leave first thing in the morning post-call and then have the rest of the day and the following day off.

There is no call on AC or elective rotations. Weekends and nights are generally free during these rotations.

2. Will I get days off? How much vacation do I get?

Each resident will have one day out of seven off when averaged over any four-week rotation during inpatient months. During outpatient months (AC and elective) weekends are generally off. All residents receive three weeks of paid vacation per year.

3. How much autonomy will I have in this program?

Each resident receives as much autonomy as he/she is capable of handling in our program. Our system puts an emphasis on resident independence and responsibility. An HBS staff is assigned to each team to supervise resident patient care and to teach the team.

Resident teams generally admit patients on their own while on long call, although at least two HBS are in the hospital at all times to assist when needed. Residents then present the cases to their team HBS post-call.

4. What choices exist for elective rotations?

Electives can be chosen in any subspecialty area including Allergy, Anesthesia, Cardiology, Dermatology, Endocrine, Gastroenterology, Hematology/Oncology, Infectious Diseases, Nephrology, Neurology, Pulmonology, Rheumatology and Sports Medicine.

Residents take most of their electives at Kaiser Permanente Santa Clara. Electives can also be taken at other Bay Area hospitals including Stanford University and Santa Clara Valley Medical Center. Off campus rotations can be arranged during each post graduate year (limited to one/year), with the approval of the program director.

5. How successful have recent graduates been in finding jobs after residency?

Our residents are very competitive for Internist, Hospitalist, and Fellowship positions. Many residents who complete our program join Kaiser Permanente as internists with The Permanente Medical Group, or return to join us as specialists after completing fellowship. As the largest single employer of physicians in Northern California, Kaiser Permanente offers many opportunities for Internists in both inpatient and outpatient settings. Our residents see this as a great benefit of doing a residency within the Kaiser Permanente system.

6. Can I get into fellowship after residency at Kaiser Permanente?

Graduates interested in pursuing fellowship training have all secured competitive positions. Recent matches include Cardiology, Hematology/Oncology, Gastroenterology, Infectious Disease, Pulmonary/Critical Care, and Rheumatology.

7. What are the opportunities for research?

All of our categorical residents complete a clinical research project or publishable case report before graduating. Each Spring, the program sponsors its Annual Resident Research Symposium, where residents present their research project to the faculty. The faculty judges evaluate projects and awards are given at graduation. Our program is very well represented in The Western Regional American College of Physicians (ACP) Resident Poster presentations. Our residents typically present four to five different posters, and in 2007 the winning poster was presented by a Kaiser Santa Clara resident.

8. What is the pass rate of graduates on the American Board of Internal Medicine certifying exam?

95% of residents over the past 5 years have passed the ABIM on the first attempt.

9. What medical schools do current residents come from?

Please check out where our current residents come from by clicking on the "Our Residents" link.

10. What does HBS stand for?

HBS stands for Hospital Based Specialist. The hospitalist system is a growing trend nationwide and within Kaiser Permanente. (To learn more about the hospitalist movement, go to the Society of Hospital Medicine website). Our HBS program was implemented in April 1997 and has led to improvements in teaching and patient care. Our hospitalist program has also been recognized as a model for Northern California Kaiser Permanente. In addition to Internal Medicine responsibilities, HBS physicians also care for non-Internal Medicine patients on non-teaching services.

11. How is Kaiser Permanente different from other HMOs?

Kaiser Permanente, unlike many other HMOs, is a nonprofit organization. Kaiser Permanente protects physician decision making from the oversight and approval of insurance administrators. We are committed to the needs of our members and our social obligation to provide benefit for the communities in which we operate, rather than by the needs of shareholders.

12. Are there restrictions on ordering diagnostic tests?

Kaiser Permanente physicians are free to order the laboratory, radiographic, and other tests deemed necessary without seeking pre-approval from health plan administrators. As in any residency training program, there is education as to the utility and cost of evaluations in the framework of evidence-based medicine.

13. How stable is Kaiser Permanente?

The California Division of Kaiser Permanente has been fiscally solvent and growing for more than 50 years. Kaiser Permanente in Northern California is composed of three different organizations in close partnership: The Permanente Medical Group (the physician group practice), the nonprofit Kaiser Foundation Health Plan (insurance plan), and the nonprofit Kaiser Foundation Hospitals (hospital operations). Kaiser Permanente has medical centers and medical offices nationwide, including California, Colorado, District of Columbia, Georgia, Hawaii, Kansas, Maryland, Missouri, Ohio, Oregon, Virginia, and Washington. California is the largest of the Kaiser Permanente organizations and the only one that has residency training. Despite uncertainty and instability in the healthcare industry, Kaiser Permanente remains strong and able to provide high-quality, effective care.

14. Can I afford to live in Silicon Valley on a resident's salary?

Though rents are expensive, all of our residents live comfortably. In addition to your salary, meals are covered when on duty, your medical license is paid for, and there is an educational allowance through the GME Office. Please see our Salary and Benefits page for more information on our salaries.

15. Are there medical student clerkships?

Yes. 4th year medical student rotations on the General Medicine Ward rotations are available. Please complete the online application. You may also contact Susan Krause, our Student Clerkship Coordinator.

16. How can I contact one of the Program Directors or Chief Resident?

Contact the Residency Coordinator for Internal Medicine, Michelle Beyda. She will put you in touch with one of the program directors, the chief resident, or one of the residents.

17. What is the accreditation status of Kaiser Santa Clara?

Kaiser Santa Clara was recently (2007) accredited for a full 3 year cycle.