Welcome to Santa Clara Valley Medical Center. Our Internal Medicine residency has 16 Categorical and 12 Preliminary PGY1 positions. I would like to share a few of the many things that make me proud of our program.
First, we are a safety-net hospital and our patients come from all walks of life and from a variety of backgrounds and cultures. They define diversity. Over sixty languages are spoken by our patients. After English the most common languages are Spanish, Vietnamese, Mandarin and Farsi, but the entire list runs from Amharic to Visayan. Our patients present with all stages of disease, and you will be the doctor who makes many initial diagnoses. Please click here (2015 Cases, 2018 Cases) to see a list of all the diagnoses my team encountered during my first month on the inpatient wards at Valley in 2015 and during a more recent month in 2018. The diagnoses range from “bread and butter” cases to zebras and both are unedited; there is no cherry picking, and no diagnoses were deleted. Another important highlight is how thankful our patients are for the care provided by our residents. Click on the link “From our Residents” to read what our residents value about our program.
I’m also deeply impressed by our faculty. These are highly-approachable, seasoned clinicians who give you full autonomy while providing direct supervision. Our tight-knit group of core faculty care about your development and provide hands-on mentoring. Residents receive assistance and coaching for a wide range of scholarly activity from preparing grand rounds, to writing clinical vignette abstracts for regional medical conferences, to QI and patient safety projects. Click here to link to residents’ scholarly activity. For residents interested in research there are many mentors here at Valley or at Stanford. When it is time to apply for a fellowship these doctors will guide you through the application process, help you prepare for interviews, and pick up the phone and advocate for you. Also, each resident receives more formal, longitudinal mentorship through regular meetings with an Associate Program Director who will help you develop short and long-term goals.
Our residents are a tight-knit, down-to-earth group of doctors who support and learn from each other. Across the board they are motivated by the desire to be outstanding doctors who provide much needed care to an at-risk patient population. Our residents value hard work, camaraderie, and a spirit of inquiry and want a hands-on program that can help them grow. Our accomplished graduates are highly competitive in getting Hospitalist or Primary Care jobs and in matching into advanced specialties. Click here to see the list of postgraduate careers and follow the links on the left of this page for information specific to your intended career path.
David Jacobson, MD, FACP
Other notable features of our program:
4 + 2 block schedule
Categorical interns and residents are on a modified ‘x+y’ block
schedule. Most of the time the more “intense” 4-week inpatient blocks (ICU,
wards, night float) alternate with less intense 2-week ambulatory or
subspecialty consult blocks. This schedule diminishes the tension between
inpatient and outpatient needs and allows for longitudinal QI experience as
well as longitudinal subspecialty clinics. Additionally, we work with residents
to craft ambulatory rotations targeting their specific individual goals.
Individual Learning Pathways
Please see the dedicated page on the ILPs
. These pathways are designed to support and strengthen your chosen career arc. They also offer one more level of mentorship: each ILP has dedicated faculty advisors that will help you hone your career goals.
This high yield, case-based educational session is focused more on how you think than what you know. The focus is on clinical reasoning and problem representation – how do we think through a case? What pitfalls arise from our cognitive biases? Our noon report is Chief Resident run and is a safe place to be heard and to be wrong.
Protected time to learn
In September 2019 we rolled out highly interactive, ‘flipped classroom’ academic afternoons. Interns have protected times on Tuesday afternoons and residents have protected times on Thursday afternoons. These sessions include time to review the previous week’s learning goals, residents teaching residents, and focused, small group directed case review followed by expert subspecialist debriefing. The sessions are mapped to the ABIM blueprint and are intended to increase medical knowledge and evidence-based decision making.
Each month a noon report session is dedicated to rapid response case scenarios and code blue situations with a simulation mannequin. The sessions are led by an Intensivist and nurses trained in simulation. The sessions are highly interactive and high yield. We also run a ‘code blue 101’ for interns transitioning into their PGY2 year. We have a hands-on POCUS session during our boot camp for new interns, have continued training throughout the year and will be rolling out a full POCUS elective during the 2020 academic year.
This curriculum is updated yearly by the Hospitalist group and highlights some of the most important evidence-based literature. Click here to access the both the Learner’s
guides to alcoholic hepatitis. These teaching modules are used on the wards and during weekly EBM noon conferences. Click here
to see the full Professor EBM curriculum.
Quality Improvement involvement
All residents are involved in QI/QA beginning with TOC reviews as interns and continuing with chronic care audits in their 2nd and 3rd years. Some seniors develop more intensive senior QI projects with significant impact. Recent projects include:
- Standardization of note templates to improve documentation
- Reducing unnecessary lab ordering consistent with the Choosing Wisely Campaign
- Improving nursing communication and cutting down on incorrect pages
- Examining sepsis outcomes in oncologic patients
- Examining the needs of transgender patients experiencing homelessness
Diverse ambulatory opportunities
Residents can rotate through multiple outpatient clinics targeted to specific at-risk patient populations. The PACE clinic cares for HIV positive patients, there are multiple clinics for homeless patients including a mobile “backpack clinic”, and we have clinics dedicated to refugee outreach and migrant farm workers. We also have a TB clinic that treats approximately 100 patients per year for tuberculosis and our daily inpatient census of TB is typically 4-5 patients.
We have a robust relationship with Stanford. We are a core teaching site for Stanford medical students and residents, and Valley interns and residents rotate at Stanford and the VA. We also developed an affiliation with Geisel School of Medicine (Dartmouth) in 2018 and host two third year students per block for their Medicine clerkship. Because of these two academic affiliations you will have many opportunities to teach and mentor students during your training at SCVMC.