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The UCSF program has a long history of producing leaders in academic medicine, public health, and clinical practice. The program provides all trainees with a broad mastery of knowledge, skills, and attitudes needed as internists. Beyond these competencies, trainees are encouraged to individualize their pathways during residency so that they can pursue more customized educational opportunities that will allow them to enter the next phase of their careers. This also allows residents to track into smaller groups within the large program to maximize the time spent with residents and expert faculty who share similar interests.
PGY1 YEAR
The PGY1 year is identical for all residents in all tracks except for the content of the two block months. Though specifics may change slightly from year to year and vary slightly from intern to intern, below are the current rotations of R1 year:
| Medicine Wards (a mixture of SFGH, Moffitt, VA) | 6-7 months |
| Emergency Department (SFGH) | 1 month |
| Liver Transplant Unit (Moffitt) | 1 month |
| Cardiology at Moffitt ("CCU") and/or SFGH | 1-2 months |
| ICU (SFGH) | 2 weeks |
| Night Float | 1 week |
| Ambulatory Block/Elective | Categoricals: 1 month of ambulatory block + 1 month of elective
Primary Care: 2 months of ambulatory block |
| Elective | 1 month |
| Vacation | 3 weeks (taken during Block or Elective and during the ICU/night float rotation) |
Click here to see some sample R1 schedules.
PGY2 AND PGY3 YEARS
During the PGY2 and PGY3 years, all residents alternate 2 months of inpatient or emergency department experience with 2 months of ambulatory or elective experience. Thus, the program offers residents the flexibility to select at least 12 of 36 months based upon their track and specific interests. The overriding goal is to provide each resident with a smaller group within the large program as a way of facilitating mentoring and career development. Regardless of the track through which a resident enters the program, each resident is provided with the guidance and training opportunities needed to succeed in any facet of internal medicine.
As with the intern year schedule, residents' schedules and specifics may change. Listed below are current examples of rotations for these years:
| Medicine Ward Months (Moffitt, SFGH, VA) | 3 months |
| Cardiology (SFGH) | 3 weeks (other week as Med Consult) |
| Emergency Department (SFGH) | 1 month |
| Float (day and night) | 1 month |
| Medicine Consult | 1-3 weeks |
| ICU (Moffitt) | 2-4 weeks |
| Block (Ambulatory + Elective; for specifics, see descriptions of the three tracks) | 5-6 months |
| Vacation | 4 weeks |
The current rotations for the PGY3 year are listed below:
| Medicine Ward Months (VA) | 2 weeks |
| CCU (Moffitt) | 1 month |
| Emergency Department (Moffitt) | 3 weeks |
| Float (day and night) | 1 month |
| ICU (VA) | 2 weeks |
| ICU (SFGH) | 1 month |
| Block (Ambulatory + Elective; for specifics, see descriptions of the three tracks) | 7 months (with Jeopardy during one month) |
| Medicine Consult | 1 week |
| Vacation | 4 weeks |
Click here to see some sample R3 schedules.
R2* and R3* Schedule Comparison-at-a-Glance (*R1 schedules do not significantly differ)
Please keep in mind that schedules are, of course, subject to change.
| | Categorical | Categorical,
PRIME | UCPC | SFPC |
| Wards, Float, ED Months, Jeopardy | Same for all tracks |
| ICU | Same for all tracks |
| Med Consult | Same for all tracks |
| Ambulatory Blocks | 4 months | 11 months | 11 months | 11 months |
| Electives | 8 months | 1 month | 1 month | 1 month |
| International Electives | Same for all tracks |
| Research | Up to 3 months | Up to 3 months + half to 1 day per week of ambulatory blocks | Up to 1 month + 1 half day per week of ambulatory blocks | Up to 1 month + 2-3 half days per week of ambulatory blocks |
EDUCATION
Residents' Report: Depending on the site, residents' report is either four or five days a week. All are welcome to attend.
Interns' Report: Once a week, there is a dedicated interns' report, run in the style of the daily residents' report.
Noon Conferences: Content of the daily noon conference ranges from subspecialists' and hospitalists' updates in their fields to the famous quiz game "Championship of the World". As well, there is a Morbidity and Mortality conference, and a Medical Grand Rounds.
R2/R3 Conferences: Once a week on inpatient months, an hour is dedicated to upper-level, case-based learning. These sessions are led by hospitalists and subspecialists.
Curricular Half Days
With the educational challenges posed by duty hour requirements, the structure of the day for residents is rearranged so that they can consistently attend educational activities. Major portions of the curriculum has been shifted to dedicated teaching half days for both interns and residents which allow protected time for education. These have also allowed us to further focus material to the various levels of training.
- Intern Half Day (IHD)
Interns attend a monthly half day during which they receive four uninterrupted hours of a core curriculum while the residents cover the interns' inpatient responsibilities. The topics are high-yield and practical, and include small group workshops and simulation training.
- Core Ambulatory Conference Series
During their block months, PGY2s and PGY3s participate in a bimonthly core ambulatory conference series every other Friday afternoon (the alternating Friday afternoons are filled with "Track-Specific Didactics"). The curriculum focuses on important aspects of ambulatory medicine, including primary care, preventive medicine, chronic disease management, and urgent care. In order to support all of the residents pursuing scholarly projects during the residency, didactics in clinical epidemiology and critical review of the literature have been embedded into the curriculum. (Residents who wish to acquire more methodological training may enroll in the extended curriculum offered by the PRIME track and the Primary Care tracks and/or a one-month elective in clinical research and epidemiology offered by the Department of Epidemiology.)
- Track-Specific Didactics
Each track has bimonthly teaching sessions specifically designed to address the interests of that group.
- Categorical Seminar Series: The goal of these sessions is to deliver customized curriculum based on the residents' interests, including selected clinical topics, career development seminars, and journal club. Each block group creates lists of topics, speakers, field trips for this seminar series.
EKG Class: Residents supplement their clinical experience reading EKGs with a series of classes based on the curriculum established by one of UCSF's most beloved cardiologists, Dr. Tom Evans.
AOD-Specific Didactics. During the outpatient/elective months of the R2 and R3 years, residents have dedicated time for didactics in their Area of Distinction. (AOD). See AOD descriptions for further details.
Journal Clubs: Residents will facilitate 1-2 journal club session(s) over the year. There are a total of 3 journal clubs in each block, two during core seminar series half day and one in the evening. The purpose of the evening journal club is to bring together all core categorical residents in a more relaxed setting, enjoying dinner at a colleague's house while discussing the literature. PRIME, UCPC, SFPC also have designated times for their track-specific journal clubs, to which all residents are invited.
Intern Retreat: We recognize that the transition from intern to R2 can feel more intimidating than the step from medical student to intern. In the spring of intern year, all the interns spend a day reflecting on their year and planning for the R2 year. Small and larger group sessions are designed to cover team management and leadership skills, tips at incorporating teaching into the daily routine, organizational strategies, and a few practical clinical pearls (e.g., running the first few minutes of a code).
UCSF GLOBAL HEALTH PROGRAM/ELECTIVE
In response to resident interest in international training opportunities, a Global Health Elective Program was launched in July 2003. All Residents may participate in this elective and train abroad. Roughly 60% of R3s go abroad each year.
Listed below are the current sites:
Uganda
The most well-established site is in Kampala, Uganda in association with Makerere University. Residents spend 4 weeks in a clinical elective, dividing time between Mulago Hospital, Makerere's main teaching hospital, and ReachOut, a comprehensive urban clinic and home visit program for patients with HIV infection. Over 50 residents have traveled to Uganda since 2003.
China
A residency exchange program with Peking Union Medical College (P.U.M.C.) in Beijing was begun in 2004. Residents participate in a one month clinical rotation at P.U.M.C.. Residents spend 2 weeks on the inpatient general medicine ward, and 2 weeks on the subspecialty ward of their choice. UCSF residents are actively involved in the teaching of P.U.M.C. residents by conducting morning report, delivering didactic sessions, and conducting round table discussions on medical education.
Saipan
During the 2005-6 academic year, the site in Saipan was added. Residents from pediatrics, internal medicine and nephrology fellows can elect a four-week rotation in Saipan.
Kenya
In 2006, a new site in Kismu, Kenya was added. Residents spend four weeks at the FACES clinic learning to evaluate and manage HIV patients.
RESEARCH OPPORTUNITIES
Our program encourages residents to engage in a research or scholarly activity during residency. To facilitate this activity, categorical residents may dedicate up to 3 months during their R2 and R3 years for research only. PRIME residents may take up to three months (while still attending block didactics) and have half to one day per week during ambulatory block months. Residents in the UCPC program have a half day per week during ambulatory blocks and may take an additional 1 month. SFPC residents have 2-3 half days per week during ambulatory blocks and may take an additional one month as well.
At national conferences throughout the year and at the annual Floyd Rector Resident Research Symposium, residents are given a chance to present their projects. Approximately 60% of presentations at the Floyd Rector symposium result in publication in peer reviewed journals.
Examples of projects from the last several years are provided at noon conference or Primary Care Grand Rounds.
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