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 inpatient 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.
Protected time to learn
In September of 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 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.
POCUS CURRICULUM AND SIMULATION SESSIONS
We have a two-tiered POCUS curriculum. All interns are exposed to a longitudinal, hands-on, foundational exposure to the main POCUS skills for Internal Medicine. Our senior residents have the option for a mastery elective during their second or third year that includes self-directed learning and asynchronous feedback on diagnostic studies they have performed.
We also run a ‘code blue 101’ for interns transitioning into their PGY2 year and have noon report sessions dedicated to rapid response and code blue scenarios with a simulation mannequin that occur throughout the academic year.
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 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 and Teacher’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 chart audits 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
Housestaff can rotate through multiple outpatient clinics targeted to specific at-risk patient populations. Electives include our PACE clinic, which cares for HIV positive patients, clinics dedicated to refugee outreach, custody medicine at the county jail, and a TB clinic that treats approximately 100 patients per year. Some senior residents rotate with our Valley Homeless Healthcare Program, working with a close-knit team of doctors invested in advocacy and health equity. Click here to link to interviews with some of our patients who have experienced homelessness. Their stories serve as a powerful and personal reminder of the impact of social determinants of health and reinforce the necessity of safety net hospitals.
We are a core teaching site for Stanford medical students and residents, and Valley interns and residents rotate at Stanford and the VA. We are also affiliated with Geisel School of Medicine (Dartmouth) 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.