SCVMC Internal Medicine Residency Introduction from David Jacobson, MD, FACP,Program Director
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
to see a list of all the diagnoses my team encountered during my first month on the inpatient wards at Valley. The list ranges from “bread and butter” cases to zebras and is 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. Click here
to see the list of postgraduate careers and here
to see a detailed list of fellowships obtained. You can see that our residents are able to stay in the Bay Area for primary care and Hospitalist jobs and those who pursue advanced training successfully match with highly competitive fellowship positions.
Other notable features of our program:
- 4 + 2 block schedule: In 2015 we changed to a “4+2” block schedule for the R2s and R3s. This will likely be the norm for all programs in the next decade because it simply makes sense. The system alternates more “intense” 4-week inpatient blocks with 2-week ambulatory 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.
- Morning Report: This high yield 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 morning report is Chief Resident run and is a safe place to be heard and to be wrong.
- Simulation sessions: Each month a morning 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 offer training in the use of ultrasound to place central lines and we have a central line mannequin.
- Professor EBM: 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 meaningful QI/QA projects in their 2nd and 3rd years. Residents work closely with faculty mentors in the inpatient and outpatient setting. Recent projects with significant impact 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
- Improvements to the EMR resulting in an increase in DVT prophylaxis
- Implementing ‘dotphrases’ in the outpatient setting to aid in implementing best practices
- Targeted ambulatory clinics: Residents have the opportunity to 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 even have a clinic dedicated to refugee outreach. 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.
- Stanford affiliation: We have a robust relationship with Stanford. We are a core teaching site for Stanford medical students and residents, and Valley residents rotate at Stanford and the VA.
Like many of our physicians I was drawn to VMC by the patients and the people. If you learn best by doing
then Valley will help you become an exceptional doctor. You will provide direct care to patients with a high degree of disease complexity and acuity under the guidance of experienced clinical faculty. You will develop strong bonds with your fellow house officers and form life-long friendships. You will be performing essential work. You will be valued and known
at Valley. This is not a place where you will get lost in the shuffle. I look forward to your application and to seeing you on the interview trail.