VAMC - Department of Medicine

San Francisco Veterans Affairs Medical Center

History & Background

The San Francisco Veterans Affairs Medical Center (SFVAMC) is closely affiliated with the University of California San Francisco. That relationship is especially evident in the VA Medical Service, the academic partner with the UCSF Department of Medicine. In fact, the concept of a close, mutually beneficial and formal affiliation between a medical university and a VA medical center was created in the 1960's at UCSF, later spreading to other parts of the VA system as its substantial rewards became clear.

UCSF medical students, residents and fellows rotate through the VA which provides nearly one third of all of the University's medical training. The SFVAMC has no free-standing training programs of its own; every aspect is fully integrated with UCSF. In addition, each VA staff physician in the Medical Service is a full UCSF Department of Medicine faculty member, following the same process for appointment and promotion as those based in other campus sites. The VA Medical Service Chief serves as the Vice Chair of the Department of Medicine, coordinating academic affairs at the VA with those across the broader Department.

Overview of Activities

The VA Medical Service addresses the three overarching missions of the University and the Department of Medicine: patient care, medical education, and scholarship. In each, the highest standards are expected. As might be expected, the specific activities and focus are influenced by the VA patient population and available resources as well as faculty interest.

Patient care is a key focus of the national VA system. The VA patient population of US military veterans is typically, but by no means always, older than in many other hospitals. Most are men and they come from the large geographic region served by this facility, as far as Nevada and the California-Oregon border. Patient care at the VA is dramatically enhanced by the most advanced, completely paperless, electronic medical record system in the country. All patient information is readily accessed locally or remotely through secure means allowing efficient care that is a model in increasing patient safety by reducing medical errors.

Medical education at the VA is also enhanced by the electronic medical record and by the reduced need for billing documentation in this subsidized national health care model. Attending physicians have the time to devote to individual patient-based medical education and to role-model the career of academic specialty trained internal medicine as an investigator, educator, and care provider. The VA is also an active participant in developing novel educational models including longitudinal third-year medical student clerkships and will host the first Chief Resident with a full focus on resident training in ambulatory medicine.

Research is also a key aspect of the VA Medical Service. Facilitated by a VA-based non-profit research organization, SFVAMC-based faculty members are supported by more NIH grants than any other hospital in the VA system and also have access to research funding from the VA and other external sources. VA research ranges from laboratory to clinical and outcomes in focus. The VA is also playing a leading role in the UCSF Clinical and Translational Research Institute, an ambitious NIH effort to stimulate the translation of basic scientific findings to improve individual and population health.