INTERNAL MEDICINE RESIDENCY

Career Planning

Please peruse the relevant section below to better understand how we will help you achieve your career goals. 

SUBSPECIALTY TRAINING

If you plan on pursuing subspecialty fellowship training you will receive individualized support and mentorship to help you achieve your goal. Our residents secure highly competitive matches across the subspecialty gamut, from California to Boston. Click here to see an updated list the past 7 years of Fellowship matches. 

Scholarly activity, which may include quality and safety projects in addition to clinical research, will be an important part of your resume. Annually, we host a subspecialty ‘mentor and mingle’ cocktail hour to make it easy to establish early connections with mentors. Our team will help you navigate the IRB, connect you with existing quality and safety needs and will help you brainstorm interesting projects. Click here to see an updated list of published articles and presentations at national society meetings. 

Many of our fellowship-bound residents participate in our Research ILP to strengthen their skills in statistical software and analysis and in study design.

Below is a sample schedule for the 2-week didactic portion of our research ILP:

Lastly, we provide you with individualized CV advice, a fellowship application guide and hold mock interviews so you can polish your answers before you sit down for your first fellowship interview. 

PRIMARY CARE

Our residency program offers excellent resources to train you for a future in primary care. 

Most importantly, our patients are our best teachers.  Their issues are complex and wide-ranging, from chronic diseases like diabetes, congestive heart failure and cirrhosis, to common dermatologic & musculoskeletal complaints.  You will become well-versed in not only treating these conditions, but because of our integration of social medicine topics into our curriculum, you will also grow into a doctor who treats the whole person. Our patients become quite attached to our residents and vice versa. One resident received cards and baby blankets upon the birth of her child, and patients still ask after former graduates.

Our modified 4+2 block schedule allows concentrated experiences in the outpatient setting. You will spend 2 weeks at a time on the outpatient rotation which allows you to focus on outpatient learning without the distraction of inpatient ward/ICU duties. While on ambulatory block, you learn in small group workshops and didactics, complemented by online modules. Some examples of small group sessions include musculoskeletal workshops, procedure workshops, urgent care topics, medical humanities and topics in social medicine such as implicit bias and social determinants of health including exploration of how zip codes determine health. For interested residents the 4+2 provides the opportunity for longitudinal secondary clinics in various subspecialty clinics. Recent examples include residents who chose secondary clinics in geriatrics, HIV clinic, custody health, and transgender medicine.

Our graduates going into primary care typically choose either our Ambulatory ILP or our Social Medicine ILP. The Ambulatory ILP allows you the ability to tailor your PGY2 and PGY3 experience to specific future practice goals. For example, one resident was set up with a variety of individualized​ experiences: he worked with a nutritionist, practiced motivational interviewing one-on-one with a psychologist, learned musculoskeletal injections at extra procedure clinics, and worked with a psychiatrist. Other opportunities included one-on-one attending coaching on in-basket managing, buprenorphine waiver training, and an opportunity to visit other primary care sites in the community to learn more about other practice settings.    

Other residents interested in primary care pursue a deeper understanding of how social and economic conditions impact health, disease and the practice of medicine and choose our Social Medicine ILP. In this pathway you will have didactic and experiential learning in street medicine, custody and re-entry medicine, the health impacts of poverty, refugee medicine and more. 

When it comes to time to find a job you will receive direct mentorship in CV building and interviewing and you will have a robust referral network of past graduates to reach out to.  Recent graduates have entered into primary care in a variety of practice settings in California and elsewhere. Residents who stayed in the Bay Area currently practice in our own Valley Homeless Health Program, at various Kaisers, the Palo Alto Medical Foundation and at UCSF.

HOSPITALIST MEDICINE

If you are planning on becoming a Hospitalist, you will graduate with exceptional clinical and procedural experience. Many of our graduates become Hospitalists and we know from recruiters what valued colleagues they are. 

As a future hospitalist you want to be certain that your residency training will provide you with the broadest possible exposure to medicine and will help you gain the highest degree of confidence in your skills. At Valley you will be hard pressed to find a disease or illness in Harrisons or MKSAP that you haven’t cared for directly or learned about in morning report. From asthma to Zollinger Ellison you will care for it all. One benefit of our system is that our subspecialists serve as consultants. This means your Wards months will include the full range of Internal Medicine diagnoses including neurological diagnoses like strokes, seizures, AIDP and dermatologic diseases such as SJS-TEN. Our case mix provides you with the exposure and skills you’ll need to practice independently after graduation. We hear from recent graduates about how comfortable and competent they feel handling night shifts, RRTs, undifferentiated syndromes, high volume and code blues. During training at SCVMC you will gain proficiency in a number of procedures like paracentesis, ABGs, central line placement and you will become comfortable managing ventilators. At the end of training you will be ready to practice in any hospital setting including jobs that incorporate ICU co-management. 

Many, but not all our Hospitalist-bound residents participate in our Hospitalist ILP. If you join this ILP you will receive a broader exposure to different Hospitalist practice models and settings and further develop appropriate skills and knowledge. The curriculum is both didactic and experiential and includes lectures, on-line modules, book clubs (Getting to Yes, Being Mortal and others), and trips to other facilities like SNFs, board and care, hospice and other local hospitals. Focused learning topics include ultrasound training, billing and coding, hospital administrative structure, surgical co-management, quality and safety and more. If you want to get more involved in meaningful Quality and Safety work, you will have that opportunity. Recent residents have been involved with sepsis core measures, improving patient experience, rewriting our After-Visit Summaries to ensure greater comprehension, improving interprofessional communication and enhancing hospital flow. 

When it comes to time to find a job you will receive direct mentorship in CV building and interviewing and you will have a robust referral network of past graduates to reach out to.  Recent graduates work as Hospitalists throughout Northern and Southern California and other states including Alaska and Texas. Local practice settings include Santa Clara Valley Medical Center, Kaiser, Sutter, Stanford, UCSF, the Palo Alto Medical, and hospitals in Sacramento and Santa Cruz.  

ACADEMIC MEDICINE

If you are interested in pursuing academic medicine after graduation, we have many experiences that will help you achieve your goal. Throughout your three years you will be exposed to our ‘Residents as Teachers’ lecture series. This series is highly interactive and focused on developing concrete skills in teaching, evaluation and feedback. We do some exploration of learning theory, but the main focus is practical skills that you can immediately employ. Sessions include how to give feedback on presentations, how to assess and teach clinical reasoning, how to recognize and avoid cognitive biases, developing and deploying a shared taxonomy of teaching techniques and more. 

You might also supplement your training with a 2-week Medical Educator elective.  This elective takes a deeper dive into pedagogy with directed reading in concepts of adult learning theory, clinical reasoning, and cognitive errors. The elective then focuses on building concrete, easily adaptable behaviors and skills through direct observation, feedback and coaching.  You will watch videos of teaching, deconstructing what you see and will observe teaching on the wards. After debriefing, self-reflection and goal setting, you will get a chance to teach in multiple settings and will then be given discrete feedback to advance your teaching. Residents interested in medical education are encouraged to participate in curricular re-design or other education-related QI projects. 

Lastly you will have many opportunities to polish your skills by working with medical students. We typically have 2 third year students from Dartmouth and 5 from Stanford rotating on our medicine wards teams. Working with medical students really helps you develop as an educator. 

Over the past few years we have had multiple graduates go into academic medicine in a variety of settings: Hospitalists and Primary Care doctors at SCVMC, and teaching Hospitalists at Kaiser, Stanford, Loma Linda, UCSF and farther-flung locations like the University of Colorado and the University of Wisconsin.