FAMILY AND COMMUNITY MEDICINE (4 WEEKS EACH PGY-I, PGY-II, PGY-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
FHC Knee Imaging: Nailing it, or Screwing it Up?
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 (10 WEEKS PGY-I; 6 WEEKS EACH PGY-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 (2 WEEKS PGY-I; 4 WEEKS PGY-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 (6 WEEKS EACH PGY-I, PGY-II, PGY-III)
Sunday to Thursday nights, Night Float residents cover admissions, adult and pediatric floor and ICU patients, stand-by for precipitous deliveries, manage laboring patients from our clinics, 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 (4 WEEKS PGY-I)
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. During their rotation at Kaiser-Santa Clara Hospital, residents also receive experience caring for critically-ill patients in the Pediatric Intensive Care Unit with conditions such as life-threatening RSV, pneumonia, and sepsis.
OBSTETRICS AT SANTA CLARA VALLEY MEDICAL CENTER (4 WEEKS EACH PGY-I & II)
During the first year of their training, our residents rotate through 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. This includes assisting on Cesarean sections.
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 the Santa Clara Valley Medical Center-affiliated Obstetrics and Gynecology clinic located in the nearby town of Gilroy, where they work with Family Medicine and Obstetrics faculty.
CLINIC & HEALTH SYSTEMS (2 WEEKS PGY-I; 2 WEEKS PGY-II; 2 WEEKS PGY-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, while senior residents may have the opportunity to engage in a ”Junior Precepting” experience and serve as third clinic consultant with a focus on looking up best practice guidelines, evidence-based medicine, or any other questions that come up during the course of a clinic half-day.
HEALTH EQUITY (2 WEEKS PGY I)
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 (6 WEEKS PGY-I; 4 WEEKS PGY-II; 2 WEEKS PGY-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 asthma, pneumonia, seizures, and sepsis.
SURGERY (4 WEEKS PGY-I)
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. Interns are given ample ward-duties support and assistance to allow for O.R. time as surgical first-assistants. 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.
ORTHOPEDICS (4 WEEKS PGY-I)
During this rotation, residents work with various Orthopedic Surgeons in their private offices and with faculty physicians and the Sports Medicine Fellows in the Sports Medicine Clinic. This rotation focuses on the ambulatory management of orthopedic injuries (e.g., sprains, strains, fractures) and on the inpatient diagnosis and treatment of injured patients (e.g., arthroscopic surgery, fracture reduction, and injury repair). Residents are given the opportunity to strengthen their examination and diagnostic skills of the musculoskeletal system and develop a foundation in ultrasound use. As the Sports Medicine Clinic integrally works with various high school, college, university, and professional sport teams, many other learning opportunities arise. These include pre-participation sports assessments, “on-the-field” handling of acute injuries, and bio-mechanical evaluation of semi-professional and professional athletes. Residents on this rotation also manage a variety of orthopedic injuries at several colleges and universities in the local area, including San Jose City College, San Jose State University, and Stanford University Student Health Center.
EMERGENCY MEDICINE/URGENT CARE (4 WEEKS PGY-II; 6 WEEKS PGY-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 (2 WEEKS PGY-II, 4 WEEKS PGY-III)
Residents on this rotation continue their sports medicine training by spending concentrated time in specialized Sports Medicine clinics in the Stanford-owned faculty clinic (Family Medicine Associates of San Jose), O’Connor Family Medicine Center, and Vaden Student Health Center at Stanford University. 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 (6 WEEKS PGY-II; 4 WEEKS PGY-III)
During the Ambulatory Medicine rotation, residents spend an increased amount of time providing medical care at various outpatient clinics. These clinics may consist of the Family Medicine Center, the San Jose City College Student Health Center, the Santa Clara Valley Medical Center (SCVMC) Allergy Clinic, and SCVMC PACE Clinic (an HIV/AIDS Clinic). Residents also learn how to facilitate group visits (Pain Clinic, Diabetes Group, Smoking Cessation, Chronic Opioid Pain Education, Pediatric Obesity, and Healthy Living classes) during this rotation, as well as learn about Skilled Nursing Facility care under the supervision of our faculty Dr. Frances Sun – an ABFM diplomate with a CAQ in Geriatric Medicine. Additionally, all residents participate in the Continuous Quality Improvement (CQI) curriculum, carrying out their own clinic-based QI projects.
ELECTIVES (4 WEEKS PGY-II, 2 MONTHS PGY-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 Third World Medical Care in Peru, Vietnam, and the Caribbean island of Roatan in the Bay Islands of Honduras.
AMBULATORY PEDIATRICS (2 WEEKS PGY-I & III; 4 WEEKS PGY-II)
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 (2 WEEKS EACH PGY-II & III)
Residents on this rotation learn about the comprehensive management of the older patient across a continuum of sites, including acute care hospitals, long-term care facilities, and individual patient homes. Their clinical assignment is at the Stanford Senior Care Clinic, where they learn about functional assessment, disease prevention and health promotion, and management of older patients with multiple chronic diseases.
AMBULATORY GYNECOLOGY (4 WEEKS PGY-III)
Residents on this rotation work in a variety of outpatient Gynecology clinics in the greater San Jose area and learn to perform basic Gynecological 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.