FAMILY AND COMMUNITY MEDICINE (1 MONTH EACH PGY-I, PGY-II, PGY-III)

  • Rotate through community alcohol and drug rehabilitation centers, shelters, 
  • Study clinically-based statistics and epidemiology, emphasizing the ability to critically evaluate articles in the medical literature
  • Make “home visits” with the faculty social worker
  • Provide health education to high schools and local community colleges and universities;
  • Plan and organize a personal research project.  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 (3 MONTHS PGY-I; 2 MONTHS EACH PGY-II & III)

The Medicine rotation provides the bulk of the adult inpatient medicine training for our residents.  The team consists of 2 interns, 2 or 3 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 Health Center and from our attending clinic, as well as all “undoctored” patients admitted between 7PM and 7AM.  This includes patients in the ICU and those in our Transitional Care Center, a skilled nursing/rehabilitation facility located in the hospital, and ensures an excellent variety of patients in terms of socio-economic status, demographics, medical illness.

 

NIGHT FLOAT (6 WEEKS EACH PGY-I, PGY-II, PGY-III)

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Night Float comprises a total of six weeks during each of the PGY-I, PGY-II and PGY-III years (always split into three, two-week blocks with other rotations) from Sunday to Thursday night.  Residents cover admissions, adult and pediatric floor and ICU patients, stand-by for precipitous deliveries, and manage laboring patients from our clinics. 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 (1 MONTH PGY-I)

This rotation is a general pediatric ward experience at the Kaiser-Santa Clara Hospital.  Residents are supervised by Kaiser Permanente Pediatricians.  Along with the basic general 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 (1 MONTH EACH PGY-I & II)

During the first year of their training, our residents rotate through Santa Clara Valley Medical Center 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.

As PGY-II’s residents take evening call 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, working with Family Medicine and Obstetrics faculty.

 

AMBULATORY MEDICINE (6 WEEKS PGY-II; 1 MONTH PGY-III)

During the Ambulatory Medicine rotation, residents spend an increased amount of time providing medical care at various outpatient clinics.  These clinics consist of the Family Health 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 Clinic, Healthy Living) during this rotation, as well as provide Skilled Nursing Facility care under the supervision of Dr. Frances Sun – 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.

 

OBSTETRICS/PEDIATRICS, INPATIENT (6 WEEKS PGY-I; 1 MONTH 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, and basic Pediatric admissions at O’Connor Hospital.  During this rotation, residents also learn how to manage basic inpatient Pediatric disorders such as asthma, pneumonia, seizures, and sepsis.

 

SURGERY (2 MONTHS PGY-I)

During the two separate months on the Surgery inpatient service, 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 maximal “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.

 

SURGICAL SUBSPECIALTIES (2 WEEKS PGY-II)

During this rotation, residents learn about several surgical subspecialties by co-managing patient care with private ENT specialists, Ophthalmologists, and Urologists in their offices.  Residents are trained in the management of basic urologic, otolaryngologic, and ophthalmologic conditions family physicians might encounter in their everyday practice of outpatient medicine.

 

ORTHOPEDICS (2 WEEKS PGY-I)

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During their Orthopedics 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).  During this month 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/SPORTS MEDICINE  (1 MONTH EACH PGY-II & III)

The Emergency Medicine/Sports Medicine rotation provides supervised experience in the O’Connor Hospital Emergency Room 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.   Residents on this rotation also spend time twice a week in specialized Sports Medicine clinics in the Stanford-owned faculty clinic (Family Medicine Associates of San Jose), O’Connor Family Health Center, and Vaden Student Health Center at Stanford University.

 

ELECTIVES (1 MONTH 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, to name a few.  These can be arranged at O’Connor Hospital or at other institutions, including Kaiser-Santa Clara Hospital, Palo Alto Veteran’s Hospital, Santa Clara Valley Medical Center, and Stanford University Medical Center.  For one month in their third year, residents may choose to rotate on an “away elective” that is geographically away from the San Jose area – including other states and foreign countries.  Past residents have done such adventuresome rotations studying “Wilderness Medicine” in Alaska, tropical-based rotations studying “Dermatology” in Hawaii, linguistically-challenging rotations studying “Medical Spanish” in Mexico, technically-difficult rotations in “Informatics” at Stanford University, and medically-tough rotations studying “Third World Medical Care” in Vietnam and on the Caribbean island of Roatan in the Bay Islands of Honduras.

 

AMBULATORY GYNECOLOGY (1 MONTH 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.

 

AMBULATORY PEDIATRICS (2 WEEKS PGY-I & III; 1 MONTH PGY-II)

In the Ambulatory Pediatrics rotation, residents work in the Indian Health Center Pediatric Center for Life (a general 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.

 

 

MEDICAL SUBSPECIALTIES (1 MONTH PGY-III)

Residents on the Medical Subspecialties rotation delve into such medical areas as Cardiology, Endocrinology, Neurology, and Rheumatology.  Residents learn the outpatient management of common medical conditions like coronary heart disease, congestive heart failure, diabetes mellitus, stroke, and connective tissue diseases.   Residents see patients in various community clinics and in the private offices of these sub-specialists.

 

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.  This includes the functional assessment, disease prevention and health promotion, and management of older patients with multiple chronic diseases.