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UC Irvine Department of Medicine

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Presentation on theme: "UC Irvine Department of Medicine"— Presentation transcript:

1 UC Irvine Department of Medicine
Internal Medicine Residency Training Program Welcome Bindu Swaroop, MD Program Director

2 Internal Medicine Residency Training Program University of California, Irvine
We are very pleased that you are considering our Internal Medicine residency, and we look forward to meeting you. In this presentation, we have highlighted the most salient information about our Program. More extensive information is available on our website: Please also feel free to me with questions at Bindu Swaroop, MD, Program Director Welcome and Introductions Please refer to the packet. This packet contains a number of important documents including our curriculum document, samples of our web site, information on our residents and our graduates, and information on our Research Pathway. One of the most important enclosures is a copy of the RRC Program Accreditation Requirements for Internal Medicine. I would suggest that you review this document because it sets forth the standards for Internal Medicine Residency training. As you work through your choices for residency programs, it would be important to have a knowledge of this document and understand its implications.

3 UCI Internal Medicine Residency Core Philosophy & Goals
Our Mission To provide outstanding training that is comprehensive, innovative and prepares residents to be exceptional providers and life-long learners. To foster a love of knowledge, altruism and the highest respect for intellectual integrity and curiosity. Our Vision To continue as a premier Internal Medicine training program, enhance our pledge to academic training and foster the highest commitment to individual patients and our community Department of Internal Medicine|

4 UCI Internal Medicine Core Philosophies & Goals
By the end of training our residents will be: Clinically astute Academically rigorous Committed to the highest professional standards Able to access the broadest range of career options The core training of the internist should prepare him or her for any of the possible internal medicine career tracks. Clinical skills and knowledge are key, but the internist must have a grasp of the precepts of research, population health, and professionalism. These areas enhance the spirit of intellectual inquiry and commitment which are core to the practice of internal medicine. In addition, we wish to foster those individuals who are committed to academic or research career tracks through our Research Pathway. We are offering the Research Pathway, however, not just to benefit the few who might participate directly but because we believe that these individuals will enhance the academic milieu of the entire program.

5 Defining Program Characteristics
Diversity of Training Experiences Our residents train in diverse environments and with unique patient populations. Our hospitals include the primary teaching hospital of the University of California, Irvine; the Long Beach Veterans Health System Hospital; and Long Beach Memorial Medical Center Our outpatient clinics range from indigent care sites to faculty private practice to our NCI-comprehensive Chao Cancer Center We believe now and have always believed that the core of an outstanding residency training program is outstanding house staff. We consistently recruit and matriculate these excellent individuals. Our residents generally come from the top 25% of their classes. But beyond class standing, we look most especially for individuals who are team players and who enjoy taking care of patients. We believe in the less than 80 hour work week. We believe in at least one day off per week because it is the right thing to do. We value resident input into policy and curriculum. When people do have problems, we believe in supporting them to the fullest and avoiding a punitive approach to Program Management.

6 Broad experiences at three hospitals
UC Irvine Medical Center – 45% (diverse population) Long Beach VA Medical Center – 45% (“bread & butter”) Long Beach Memorial Medical Center – 10% (ICU) Internal Medicine Residency |

7 UCI Medical Center (UCIMC)
University hospital with 400 active beds 100 total IM Beds General medicine Hospitalist and consult team experience ICU/CCU Oncology As the faculty’s and community’s hospital we attract a wide range of ethnicity, disease and social status Uniquely a student and resident hospital: No “private patients” UCIMC is an academic health center. About 70% of the patients are departmental patients and another 30% are private patients of the faculty. Faculty patients are cared for on the ward services in exactly the same way as departmental patients, and residents write the orders on all patients. Patients of the general medicine faculty and oncology division are cared for by single hospital-based physicians so that residents are not required to contact many different attendings. The patient population of UCIMC is diverse and interesting. Because we sit a a hub for many different ethnic groups, we regularly treat patients with diseases not generally seen outside of the third world: leprosy, tuberculosis, congenital or rheumatic heart disease, malaria. We have 24 hour access to translators for most of the major groups we care for.

8 Long Beach VA Healthcare System
Recently updated and refurbished Great depth of common Internal Medicine illnesses Exceptional academic faculty, full members of the Department of Medicine Outstanding clinical and basic science research Resident & student oriented health system Important resource in geriatrics training The Long Beach VA is one of the largest institutions in the VA system. It serves an active inpatient and ambulatory patient population. Most common at the VA are diseases which would be common in the practices of most internists: cancer, heart disease, diabetes, COPD. Because of amount of pathology, it provides a great opportunity to treat patients with a the full spectrum of manifestations of each of these entities. The VA is clean, modern, recently renovated and fully staffed.

9 Long Beach Memorial Medical Center
Outstanding facility with an IM Associate Program Director Long-standing commitment to teaching with programs including IM, Surgery, Pediatrics, Ob/Gyn, EM, PM&R, cardiology, pulmonary medicine and radiology Cardiology, Neurology, and ICU Teaching Services with dedicated, supervising teaching faculty Excellent practice-based ambulatory and subspecialty experiences in areas such as women’s health, cardiology, allergy, oncology, & emergency medicine One of the top centers in the country for cardiac care Long Beach Memorial Medical Center is one of the premier community hospitals in California. Memorial provides another window into the world of “private” medicine and a more middle class working population. This 700 bed facility is perhaps best known for its cardiology and critical care services which are the 2 areas we currently take the most advantage of. We also have community-based rotations at LBMMC as well as some ancillary disciplines like Women’s Health and Sports Medicine.

10 Community-based Sites
UCIMC Continuity Clinic with a unique practice model VA Continuity Clinics with a novel team based approach to care (Patient Aligned Care Team- PACT) UCIMC Faculty Practice Sites Continuity clinic protected without back-up responsibilities Dedicated ambulatory curriculum on clinic rotations In 1998, the NEJM reported on the workings of 5 of the most successful managed care medical groups in the country. One of those was Bristol Park Medical Group in Orange County. Each of our residents spends a block at Bristol Park, seeing patients in a managed environment and getting a first-hand view of the world of managed care medicine. We also have elective rotations which allow residents to work with Medical Group Medical Directors and to get an inside view of the medical managers world.

11 Defining Program Characteristics
Diversity of Patient Populations We serve an extraordinarily diverse patient population including long established and recently immigrated communities. We serve patients across the economic spectrum. More than 50% of our patients are economically disadvantaged. Neighborhoods in our area include persons from China, the Middle East, Southeast Asia, Latin America, Persia and many others. We care for patients with conditions like leprosy, TB, rheumatic heart disease and HIV as well as the breadth of diseases seen in the general US population.

12 Defining Program Characteristics
We present unique, longitudinal curricula in clinical skills, EBM, Quality, and Palliative Care. Each house officer has at least 9 months of elective time for clinical, research, externship, or international experiences, with 2 elective blocks (6 weeks) in the first year. We are committed to our mission of education and measure service in the context of educational value.

13 Defining Program Characteristics
Our flexible curriculum allows residents to tailor their experience to their career track. We encourage couples matching. We offer coordinated acceptance for IM & Occupational Medicine. We offer career pathways in research, hospitalist medicine and primary care.

14 Curriculum Development: Recent Innovations
Doctoring Skills Rotation Fellowship & Career Mentoring from the first day of orientation The Science of Decision Making Conference Business of Medicine and Career Development A longitudinal curriculum in Teaching Skills for all residents An experience in Palliative Care Hospitalist and Consult Service Curriculum Resident-Driven Process Improvement Programs A Curriculum in Life-Long Learning Skills to enhance commitment to knowledge and skills after graduation Resident Morale Project to continuously identify ways to improve the well-being of our residents Academy of Internal Medicine

15 Doctoring Skills Rotation
Patient-Centered, Learner-Driven Focused on: History taking and communications skills Physical diagnosis Real patients and patient simulation technology Decision-making skills Life-long learning skills Clinical teaching skills Direct Feedback from Specially Trained Teaching Faculty

16 The Academy of Internal Medicine
Weekly protected 2.5 hour conference All residents on elective or outpatient rotations are required to attend Focuses on: Clinical cases and unknowns Basic clinical science review Board review

17 UCI Institutional Distinctions
Among the School of Medicine’s distinctions: The University of California with all its programs and resources An outstanding medical school with diverse and accomplished student body One of a handful National Cancer Institute Comprehensive Cancer Centers in the US Diverse Centers of Excellence for research in basic clinical sciences Top 20% of NIH Research dollars per Faculty Member UCI Medical Center: A Leapfrog Group designated top hospital for quality, safety and outcomes Our curriculum defines our core competencies. You can see these in the curriculum document in your packets. You can look to this document to find what we feel is important and where we teach it. All residents participate in the core curriculum rotations and conferences. Where appropriate, we believe in innovation that enhances the learning experience.

18 Philosophy of Program Governance
Our philosophy of governance is inclusive and progressive. Residents are included on the Curriculum Committee and on the ROC (policy committee). They have equal voting power with the faculty and Program Director. We regularly survey residents about every aspect of the Program including rotations, faculty, teaching, educational resources, and resident satisfaction. And as always, residents are a big part of the process.

19 Curriculum Development and Oversight
The Curriculum Committee reviews every aspect of the curriculum on a regular basis: - clinical rotations - conferences - goals and materials Residents have creative input into the Committee, are members of the Committee and participate on a regular basis. Many enhancements emanate from residents’ suggestions or requests.

20 Curricular Elements: Conferences
The Core Lecture Series is regularly updated and maintained in concert with subspecialties. Innovative Morning Report at the VA and Afternoon Report at UCI Teaching Rounds on all inpatient rotations. Rotation-based, web-based curricular outlines are available on our website. Weekly Grand Rounds with more than 50% of speakers recruited from across the nation for their expertise and experience. Daily or twice daily conferences at all our sites.

21 Conferences- Sample Schedule

22 Curriculum: Rotations Year 1
Ward blocks ICU/CCU 3 blocks Doctoring Skills Rotation 1 block Geriatrics 1 block Electives 2 blocks Women’s Health 1 block Night Medicine 1 block Vacation 4 weeks Continuity/Ambulatory 2 blocks Palliative Care 1 block

23 Curriculum: Rotations Year 2
Wards 3 blocks ICU/CCU 2 blocks Neurology 1 block Electives/Research 5 blocks Vacation 4 weeks Night Float/Medicine 2 blocks Continuity Clinic/Ambulatory 2 blocks Doctoring Skills Rotation-2 1 block

24 Curriculum: Rotations Year 3
Ward/ICU/CCU 5 blocks Hospitalist/consult 2 blocks Ambulatory Oncology 1 block Emergency Medicine 1 block Community-Based Clinic 1 block Geriatrics block Night Float/Medicine 2 blocks Electives blocks Vacation weeks

25 Preliminary Intern Year- Curriculum
Ward blocks* ICU/CCU 5 blocks Electives 5 blocks Vacation 4 weeks ** *Each block is 3 weeks long **Prelim interns are given 5 additional days off at the end of the academic year in order to help you end earlier and transition to your next program

26 Working Conditions & Duty Hours
Our structures and schedules are fully compliant with ACGME regulations. Ward rotations do not have overnight coverage requirements Our ward teams cap at 15 patients We admit patients through a drip protocol every 4th (VA) or 6th (UCI) day free of admissions. We have arranged our rotation schedules so that each time-intensive rotation like wards or ICU is followed by a much less intensive rotation like ambulatory clinic or an elective.

27 Team Structure A typical ward team consists of : 1 attending 1 senior resident 2 interns 2-3 medical students A typical day on Wards : 6:30AM –Arrival 8-9 AM – Morning report 9:30AM – Rounds 12 – 1 PM – Noon conference 6:30 PM – Sign-out to night float

28 Faculty 160 Full Time Faculty and several hundred active volunteers
Representing the full range of subspecialties, including Epidemiology and Occupational Medicine Accomplished and distinguished Researchers Chosen for & committed to teaching Available to residents for clinical rotations, research and mentoring

29 Clearly our most important asset
Housestaff Clearly our most important asset Excellent Match performance, representing US Medical Schools from across the country Supportive, collegial, accomplished, diverse Excellent Access to Fellowships, Primay Care & Hospitalist Jobs We have several parties per year, and we try to make the residents aware of each others interests so that friendships and collaborations can form.

30 Where our Residents Went- 2013
Chief Resident: 5 IM Fellowships: 14 Primary Care in CA: 3 Hospitalist in CA: 2

31 Resident Positions & Salary
Number Level/Year Salary Preliminary PGY $51,289 Categorical PGY $51,289 Categorical PGY $53,218 Categorical PGY $55,218

32 Detailed descriptions of our institutions
Other Information on Our Website: Detailed descriptions of our institutions Location College of Medicine Our fellowship programs Core curriculum Rotations Policies and Procedures Salaries Department of Internal Medicine|

33 University of California Irvine
Thank you for taking the time to review this presentation. Please feel free to contact us with further questions. Bindu Swaroop, MD Program Director Our Program provides outstanding clinical training in an academic and supportive environment. We believe in a culture of participation and collegiality. We offer a diverse patient population, outstanding faculty, and most importantly, a committed, skilled, and engaging bunch of residents. If there are any burning questions, I can take a couple right now. However, you will have a chance a little later to sit down in small groups with one of the Program Directors who will answer all of your questions so you can save questions up for that forum if you prefer.


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