FAMILY AND COMMUNITY MEDICINE (PGYI, II, III)

• Rotate through community alcohol and drug rehabilitation centers, shelters, and other community agencies;

• Study clinically-based statistics and epidemiology, emphasizing the ability to critically evaluate articles in the medical literature;

• Conduct home visits with our faculty licensed clinical social worker;

• Provide health education to high school students through a novel diabetes youth coaching program;

• Carry out a personal research project with the goal of presenting at local, regional, and national conferences. Examples of recent projects include:

  • Childhood Obesity: An Evidence-Based Guideline to Combating Childhood Obesity

  • Digital Healthcare: An Analysis of Utilization and Associated Facilitators

  • Transition Care Management: The Ideal Discharge Visit

  • Improving the Resident Experience in Clinic and Reducing Burnout

  • Building a Smarter Clinic: Balancing Acute Care and Continuity in a Busy Residency Clinic

  • Implementing a Reach Out and Read Site at our Clinic

MEDICINE (PGYI, II, III)

The Medicine rotation provides the bulk of the adult inpatient medicine training for our residents.  The team consists of 1-2 interns and 2 senior residents, and a Family Medicine faculty member.  Initially, as a PGY-I resident, the duties are largely oriented toward direct patient-care.  As the intern progresses to the PGY-II and PGY-III level of training, the resident continues to help in direct patient-care but also assumes a more managerial and educational role of his/her junior colleagues.  The Medicine team admits and manages patients from the Family Medicine Center and from our attending clinic, as well as all “undoctored” patients admitted between 7PM and 7AM.  This includes patients in our Transitional Care Center, a skilled nursing/rehabilitation facility located in the hospital, and ensures an excellent variety of patients in terms of socioeconomic status, demographics, and medical illness.

ICU (PGYI, II)

Starting in 2020, our ICU rotation became a separate rotation, allowing the PGY-I or PGY-II resident to work in an “apprenticeship” format with our intensive care attendings during their dedicated blocks. This 1:1 format allows the residents to become comfortable in managing critical care patients, gain experience in critical care procedures, practice essential POCUS skills, and participate regularly in family meetings under the direct supervision of our ICU physicians.

NIGHT FLOAT (PGYI, II, III)

Saturday to Thursday nights, Night Float residents cover admissions, adult and pediatric floor and ICU patients, stand-by for precipitous deliveries, manage laboring patients, and are first responders to Code Blues and Rapid Responses. During this rotation, residents hone their independent diagnostic and therapeutic skills and build up their professional confidence in an environment designed to provide ample support and backup.

PEDIATRICS AT KAISER-SANTA CLARA HOSPITAL (PGYI)

This rotation is an inpatient pediatric ward experience at the Kaiser-Santa Clara Hospital.  Residents are supervised by Kaiser Permanente Pediatricians.  Along with the common pediatric ward problems (e.g., asthma, pneumonia, seizures, and sepsis), Kaiser-Santa Clara Hospital is a tertiary care referral center for more complicated and often chronic pediatric problems in Pediatric Cardiology, Pediatric Oncology, and Pediatric Pulmonology – such as Cystic Fibrosis (CF), Acute Lymphocytic Leukemia (ALL), and Type-I Diabetes Mellitus. 

OBSTETRICS AT SANTA CLARA VALLEY MEDICAL CENTER (PGYI, II)

During the first year of their training, our residents rotate through the Santa Clara Valley Medical Center (SCVMC) labor and delivery unit for additional obstetrical experience.  This county hospital provides a high-volume obstetrical experience, with low, moderate, and high-risk patients.  Patient care is supervised by various Obstetricians, Perinatologists, Obstetrical Residents, and Family Medicine Obstetrical Fellows.  During this rotation residents learn the treatment of life-threatening antenatal problems, active management of labor, and performance of normal and complicated deliveries. 

During the PGY-II year, residents take evening call on labor and delivery at SCVMC.  During the day they rotate in a variety of outpatient gynecology clinics in the greater San Jose area, including county Family Planning clinics.

CLINIC & HEALTH SYSTEMS (PGYI, II, III)

During this rotation, residents are immersed in their outpatient continuity clinic at the Family Medicine Center. In addition to concentrated time spent in ambulatory training (averaging 6-8 sessions/week), residents also engage in experiential training on Population Health, Billing, Clinic Leadership, Quality Improvement, and Panel Management. First year residents also participate in the Health Equity Curriculum during their initial Clinic & Health Systems Block.

HEALTH EQUITY (PGYI) 

In this rotation, interns are introduced to a range of health equity, policy, and advocacy topics including an overview of the U.S. health system, social determinants of health, anti-racism, implicit bias, privilege, trauma-informed care, housing and health, immigration and health, structural competency, and physician advocacy.   This block is complemented by didactics, workshops, and seminars on additional equity- and advocacy-related topics elsewhere in the residency curriculum.   

OBSTETRICS/PEDIATRICS, INPATIENT (PGYI, II, III)

The residents on the Obstetrics/Pediatrics rotation are responsible for the primary medical care of patients admitted to these services at O’Connor Hospital.  Medical issues presented to the residents include prenatal complications (e.g., hyperemesis gravidarum, pre-eclampsia, and gestational diabetes), labor evaluations, deliveries, routine newborn care.  During this rotation, residents also conduct pediatric and NICU admissions at O'Connor Hospital and learn how to manage common inpatient pediatric and NICU conditions such as hyperbilirubinemia, seizures, and sepsis. While the SCVMC OB rotation gives residents an early exposure to routine vaginal deliveries, the OB/Peds rotation at O’Connor Hospital allows residents to experience continuity deliveries, higher risk vaginal and instrumental deliveries, opportunities for first assisting Caesarean sections, and care of the mother/baby dyad in true family medicine fashion. Residents work directly under the supervision of FM-OB faculty, OB and Pediatric Hospitalists, and NICU attendings, while learning from lactation consultants and social workers.

SURGERY SELECTIVE (PGYI)

During this rotation interns experience “firsthand” the admission, diagnosis, and management of a variety of surgical problems – common (e.g., appendicitis, cholecystitis, pancreatitis), uncommon, and traumatic. Additionally, residents rotate through the private offices of various surgeons to learn about pre-operative and post-operative care and to assist with various minor, office-based procedures, including wound care management.

EMERGENCY MEDICINE (PGYII, III)

The Emergency Medicine/Urgent Care rotation provides supervised experience in the O’Connor Hospital Emergency Room, urgent care clinics, and Stanford Express Care Clinics managing the medical care of a variety of patients: from the simple, acute problems of “urgent-care” patients to the more complicated, life-threatening problems of major trauma patients.  

SPORTS MEDICINE (PGYI, II, III)

Residents on this rotation develop their sports medicine skills by spending concentrated time in specialized Sports Medicine clinics of the Stanford-owned faculty clinic (Family Medicine Associates of Campbell), O’Connor Family Medicine Center, and community sports medicine physicians. There are also numerous opportunities for sideline coverage and pre-participation physicals during this rotation. Point-of-care ultrasound training, casting/splinting, and other common MSK-related procedures are taught during this rotation as well as longitudinally throughout residency.

AMBULATORY MEDICINE (PGYI, II, III)

During the Ambulatory Medicine rotation, residents spend an increased amount of time providing medical care at various outpatient dermatology, cardiology, HIV, and Allergy/Immunology clinics. Residents also learn how to facilitate group visits (Diabetes Group) and participate in the Family Medicine Center Addiction Clinic.

SELECTIVES & ELECTIVES (PGYI, II, III)

Electives allow residents the opportunity to tailor their educational training to fulfill their individual career plans. Available electives include Complementary Alternative Medicine (CAM), Cardiology, Dermatology, Endocrinology, Gastroenterology, Gerontology, Hematology, Homeless Shelters/Community Medicine, Men’s Health, Neurology, Oncology, Pathology, Podiatry, Pulmonology, Radiology, Rheumatology, Urology, and Women’s Health, among others.  Residents see patients in various community clinics and in the private offices of these sub-specialists.  Rotations are also often arranged at O’Connor Hospital and other institutions, including Kaiser-Santa Clara Hospital, Palo Alto Veteran’s Hospital, Santa Clara Valley Medical Center, and Stanford University Medical Center.  During their third year, residents may participate in a one-month “away elective” - either nationally or internationally.  Past away rotations have included: Wilderness Medicine in Alaska, Dermatology in Hawaii, Medical Spanish in Mexico, Informatics at Stanford University, and Medical Care in Developing Countries in Peru, Vietnam, and Roatan in the Bay Islands of Honduras. Residents particularly interested in Global Health may apply to the Stanford/Yale Global Health Scholars Program, which offers a clinically-oriented six-week rotation at one of their mentored sites and a travel award ranging from $3,000-$4,000 based on their site assignment.

AMBULATORY PEDIATRICS (PGYI, II, III)

In the Ambulatory Pediatrics rotation, residents work in the Indian Health Center Pediatric Center for Life (an outpatient pediatric clinic for underserved pediatric patients in the community), the Santa Clara Valley Medical Center Pediatric Urgent Care Clinic, and various other outpatient subspecialty pediatric clinics in the area.  This includes such subspecialties as Pediatric Cardiology and Pediatric Gastroenterology.

GERIATRICS (PGYII, III)

Residents on this rotation learn about the comprehensive management of the older patient across a continuum of sites, including acute care hospitals, ambulatory clinics, long-term care facilities (such as skilled nursing facilities), and individual patient homes. Their clinical assignments are located at the Stanford Senior Care Clinic, On Lok PACE (a full-service healthcare plan for seniors), and ManorCare or Skyline SNF, where they learn about functional assessment, disease prevention and health promotion, and management of older patients with multiple chronic diseases.

AMBULATORY WOMEN’S HEALTH (PGYIII)

Residents on this rotation work in a variety of outpatient gynecology and urogynecology clinics in the greater San Jose area and learn to perform basic women’s health procedures such as colposcopy, endometrial biopsy, and other minor Gynecologic procedures.  During this rotation residents work at sites outside of the VMC system and are not in the Obstetrics night call schedule at the Santa Clara Valley Medical Center.

JEOPARDY/POPULATION HEALTH (PGYII, III)

Residents on this rotation work primarily on a self-directed population health curriculum under the supervision of Dr. Yu and participate in the Continuous Quality Improvement (CQI) curriculum, carrying out their own clinic-based QI projects. Additionally, residents are available to cover for their colleagues in the event of unanticipated illness. This rotation is split into 1-week increments.