From the Chair

It’s a remarkable time to be embarking on a career as a physician – at once thrilling and unsettling. 

New therapies for conditions as diverse as cancer, obesity, diabetes, sickle cell anemia, and heart failure have massively expanded the physician’s toolbox. Our deepening understanding of the immune system, genomics, molecular biology, and the socioeconomic determinants of health opens tremendous possibilities. And, of course, AI offers breathtaking opportunities to free clinicians from unproductive paperwork and allow us to be better versions of our professional selves.

Yet Americans are unhappy with the state of healthcare, and they’re right to feel that way. Our healthcare system is unwieldy, inconvenient, inequitable, and backbreakingly expensive. The threats to science and expertise are growing, trust in physicians has fallen, and patients are increasingly seeking care outside traditional pathways. Many clinicians are burned out. 

In the face of these opportunities and threats, medical education will need to evolve. It’s important that you look for a residency that has a tradition of excellence, but also has an eye toward training you for a world that is quite different from the one your faculty trained in.

I believe you’ll find that UCSF’s internal medicine residency fits that description. Our department typically ranks among the top handful in areas as diverse as NIH funding and primary care delivery. Our graduates have gone on to leadership roles in government, entrepreneurship, medical education, research, and clinical care. And we have a long tradition of innovation – in everything from the founding of the biotechnology industry to the creation of the hospitalist field.  

I’m immensely proud of our extraordinary faculty and their commitment to medical education. I also prize our three-hospital training program, which offers a variety of patient populations and settings that I believe are unsurpassed. Our mentoring program – already a strength – recently received a major gift from one of our own graduates, a testament to how much this place means to the people who train here. 

But, while our curriculum and structure are important, it is really our culture that sets us apart. It's culture that determines whether one intern will help a colleague in a pinch at 3 in the morning. It's culture that shapes whether a prominent faculty member will make time to counsel a resident struggling with a career choice or that first research paper. And our culture celebrates diversity, animates our commitment to caring for the underserved, honors teamwork, tamps down unhelpful hierarchies, and prizes work-life balance without sacrificing professional excellence or passion.

It was that culture that drew me here for my residency four decades ago. While I thought I’d come to San Francisco for three years of training and return to the Northeast, I’ve not found another institution that could match the attributes that drew me here, nor a set of colleagues I admire and enjoy as much. And so, I became living proof of the old quip that UCSF stands for, “U Can Stay Forever.” You truly can.

Robert M. Wachter, MD
Chair, Department of Medicine