Rotations and Clinics
Below, you will find information about many of our inpatient and outpatient experiences at UC Davis.
Clicking on these links will bring you to the section on the page where you can learn more about our rotations & clinics.
A robust ambulatory experience is provided to train residents to care for patients from many backgrounds with a goal of working toward delivering high-quality outpatient care. There are 3 different continuity experiences offered so trainees have an opportunity to tailor their training experience to best align with their career goals.
- Diverse continuity clinic options: Sacramento County Clinic, Kaiser Permanente, or UC Davis Health.
- True continuity experience:
- All three clinics provide the opportunities for continuity of care in a structured training environment throughout 3 years of residency. The continuity experiences emphasizes true continuity in patient care.
- Emphasis on intra-professional teams:
- Each site has a focus on patient centered care and integrating ancillary staff into your medical practice.
- 4+1+1 structure:
- Two dedicated ambulatory weeks allows the provider ample time to care for their ambulatory panel without competing interests.
- Range of sub-specialty clinics in various health systems:
- All residents have the opportunity to rotate through a broad range of clinics in varying subspecialties. See list of ambulatory site rotations for more information.
- Mentorship opportunities:
- Access to a variety of outpatient general medicine and sub-specialty physician educators lending itself to opportunities to develop mentoring relationships throughout residency.
- Journal Club:
- Monday afternoons have a dedicated journal club every week, led by residents, and supervised by our key faculty.
- Wellness time:
- The ambulatory schedule includes Wellness half days, which can be used for catching up or wellness activities, such as going to the doctor, dentist, or gym.
- All primary care, TEACH, Combined Internal Medicine/Psychiatry, and categorical residents have at least 130 half-day clinic sessions as mandated by the ACGME.
- We use a 4+1+1 schedule.
- Residents do four weeks of an inpatient rotation, followed by two weeks of elective, ambulatory block, or vacation (the 1+1 part).
- Residents do not have ontinuity clinic during their four weeks of inpatient work.
- During the 1+1 weeks, they have 2-3 continuity clinics.
- We use a 4+1+1 schedule.
- We have 3 continuity clinic sites: UC Davis, Kaiser, and Sacramento County.
- The majority of the residents have their continuity clinic at the UC Davis General Medicine Clinic.
- This clinic comprises 32 exam rooms and over 40 staff supporting 70+ residents in the residency clinic, our general medicine faculty practice, and endocrinology, infectious disease, rheumatology, anticoagulation, and allergy clinics.
- Residents learn to practice with patients who have HMO, PPO, and Medicare insurances.
- Four to 12 residents are in clinic each half-day with outstanding general medicine faculty.
- Residents work in small groups called Firms, and every resident has a dedicated Firm Attending who helps out at any time with any clinical questions about the resident’s patients.
- Each intern is paired with an upper level resident “buddy” to help out with clinic issues.
- Our residents work in a multidisciplinary environment that help them provide excellent care. Some features of our clinic are:
- An outstanding telephone nurse triage system
- A pharmacist-run medication refill system
- A pharmacist-run controlled-substance management program (for safe opioid prescribing!)
- Pharmacist-run hypertension and medication management clinics
- Procedure clinics
- Psychiatry clinics
- Wound care clinics
- In-person and over-the-phone interpreters
- Social work and care coordinators
- Epic EMR platform
- When you leave UC Davis, you will be ready to care for the sickest patients in any ambulatory setting.
- 10 residents have their continuity clinic at Kaiser Clinics.
- Here, each resident sees patients with a single faculty doctor within that doctor’s practice, over their entire three years.
- Residents love this apprentice model due to its close mentoring and role modeling.
- Residents also like working in the highly efficient, patient-centered Kaiser closed-HMO model.
- Epic EMR platform
- 16 residents have their continuity clinic at the Sacramento County Clinics—we call it the TEACH Clinic.
- This clinic cares primarily for low income Medi-Cal patients and undocumented residents of Sacramento County. Residents love caring for this very underserved population.
- Interns who have expressed a desire and have shown committment to working with this population are placed at this clinic.
- The third year TEACH residents also have their continuity clinic here during their third year.
- All of these residents work as a group practice to care for their patients.
- Epic EMR platform
- Most of our electives are at the UC Davis Medical Center.
- We have electives in GI/Hepatology, Rheumatology/Allergy, Inpatient Nephrology, Outpatient Nephrology Pulmonary, Inpatient Cardiology, Outpatient Cardiology, Hematology-Oncology, Infectious Diseases, Endocrinology, Palliative Care, Toxicology, CHF, Physical Medicine and Rehabilitation, Psychiatry, and Sleep Medicine.
- Some residents create custom electives for areas not represented.
- Most are a mix of inpatient and outpatient experiences.
- Under the 4+1+1 schedule, residents do electives in 2 week blocks (1+1 time), but they can repeat electives to get more experience, when desired.
North Kaiser Wards
- North Kaiser is a hybrid rotation, where residents spend half of their time on the floors and half of their time in the MICU. This is a large community hospital, and most of the patients are admitted by the large hospitalist and ICU services. Given the size of the Kaiser system in our area, the hospital admits an incredible variety of medical patients.
- Residents take a distinct minority of the admissions to medicine (the rest go to a non-teaching service) – so the admitting hospitalists cherry pick the best cases for the housestaff teams. Kaiser has a long history of supporting our residents so that they receive optimal educational experiences.
- The Academic Floor Team is staffed by a subset of hospitalists who are dedicated to resident education.
- The Academic ICU Team has ICU attendings who are dedicated, experienced intensivists that have a track record of winning teaching awards.
- There are four teams at Kaiser at a given time: two teams of one resident, one intern, and one 3rd-year medical student that manage the ICU; and one daytime floor team of one resident, two interns, and two third-year medical students, and one night team comprised of one resident.
- The night resident cross-covers on the housestaff patients in the ICU and on the floors Monday through Friday. They admit patients overnight to the floor and ICU. There is no night resident on weekends, when the hospitalists and ICU staff at Kaiser provide cross-coverage.
- The daytime floor team admits daily on Monday through Saturday (Sunday is the resident day off.
- The ICU teams take call during the daytime every other day. The night resident covers at night, except on Saturday and Sunday when the intensivist faculty cover the unit without residents.
UC Cardiology Inpatient Service
- We have an active and outstanding group of cardiologists practicing at the cutting edge, including an advanced heart failure program, interventional, and structural heart disease program (mitral-clip service, TAVR, etc).
- This is a combined CCU and cardiology floor rotation--residents admit to the floor and the unit. There are two teams of two upper level residents, two interns, one fellow and one attending.
- Each resident takes overnight call (24 hours) every 4th night, going home after presenting the next morning.
- Interns take call with the resident for 16 hours and go home. There is a night intern that comes in to relieve the day intern, provide cross-cover and help with overnight admissions.
- There is a cardiology attending in-house until 11 PM every night to teach and assist with new admissions and sick patients. The attending is also available to come in after 11 to assist with sick patients.
UC Emergency Medicine
- Residents work for two weeks per year in our state-of-the-art Level-1 emergency department. This is a very busy ED and residents play a key role as the first evaluator of many common and complex patient problems.
- During this rotation, residents have ample opportunities to perform procedures and get experience with bedside ultrasound with our ER faculty.
- The two weeks during their second year is in the Rapid Care ambulatory urgent care clinic. They get great experience at seeing many urgent ambulatory problems, including fractures, abscesses, and common ambulatory complaints.
UC General Medicine Consult Service
- Upper level residents (two at a time) provide consultation to non-medical services under the supervision of the general medicine faculty.
- This team co-manages many of surgery patients, performs many preoperative evaluations, and helps manage many common post-operative problems.
- We have a set curriculum that all residents finish during their training.
- After this experience, residents are well-prepared to perform perioperative consultation and management.
- UC Davis is one of only 41 nationally recognized National Cancer Institute Comprehensive Cancer Centers.
- The inpatient Heme-Onc service cares for patients seen at the Cancer Center, patients admitted through the ER with new cancer diagnoses or complications of cancer, and transfers from other facilities for our extensive services (e.g. acute leukemia patients). For educational reasons, interns do not care for our bone marrow transplant patients or routine chemotherapy patients. These are handled by the fellows and faculty separately.
- This service is staffed by four interns, two fellows, one hospitalist attending and one Hematology-Oncology attending. The interns share admissions daily until 4 PM under the supervision of the hospitalist. There is no overnight call, as patients are covered by the UC Night Float intern. There is a separate teaching attending that teaches a didactic curriculum through several seminar sessions each week.
- The MICU is probably the favorite rotation for most of our residents. This is because of the incredible medical pathology, the great fellows and attendings that supervise this service, and a true multidisciplinary care team of nurses, nutritionists, physical therapists, and respiratory therapists.
- There are two “mega-teams” comprised of two R3s, one R2, two day interns and one night intern. Each mega-team takes call every other day.
- The R3s take overnight (24-hour) call every 4th night, admitting with the day interns during the day and the night intern during the night. They go home after presenting the patients on rounds in the morning.
- Intern shifts are less than 16 hours.
- The R2 admits with the day interns. We devised this schedule to have junior residents have MICU experience during daylight hours, doing admissions and procedures with the pulmonary fellow and/or attending. By the time you are an R3 on an overnight MICU call, you are more than ready to run the ship. Even so, there is an in-house pulmonary fellow to help supervise the overnight intern and resident.
- All residents do two weeks on our inpatient Neurology Services.
- Here they learn the basics of acute inpatient stroke care, secondary prevention measures, management of seizures, and neurologic examination skills.
UC Night Float
- All interns do 1-2 weeks of night float, where they cross-cover on UC floor patients on the medicine and hematology-oncology services.
- They have on-site backup from more senior medicine residents on ICU, Cardiology and General Medicine services who are also present in-house overnight. They also have phone back-up from fellows and attendings.
- This is our flagship rotation, with an amazing patient population and disease mix.The majority of patients admitted on this service come through our very busy Emergency Department, but we also get tertiary referrals from other hospitals in the Central Valley and Northern California areas.
- There are four teams, each comprised of an R3, two interns, one attending, two 3rd-year medical students, and usually a 4th-year medical student.
- The interns and residents work days only on this rotation, and take Day Call every 4th day – admitting up to 4 patients before 4 pm.
- A team of two R2s admit patients overnight and do after-hours general medicine consultations. These R2s present the new admissions to their team in the morning during bedside rounds, before they go home. So there is built in bedside teaching for the teams and the night residents get excellent teaching after their long night’s work.
- No shift is longer than 16 hours for any member of the team and there is always a senior resident to lead the team during the day.
- Discharge planners are assigned to each team, which is very helpful.
- The supervising faculty are primarily hospitalists and general internists who are very experienced at inpatient care. They are wonderful clinical mentors and great role models of clinician-educators.
- The VA ICU admits cardiology and ICU patients to the 10-bed unit.
- This is a one resident, two intern team that admits ICU and cardiology patients daily.
- There are cardiology and pulmonary fellows on the service as well.
- Night admissions and cross-cover are provided by the overnight floor medicine team.
- The team rounds with the ICU team at 8 AM and the CCU team (cardiology fellow and faculty) at 10 AM every day.
- The attending for the ICU team is one of our UC Davis pulmonary faculty who rotates at the VA. The CCU attending is one of several outstanding VA cardiology faculty. The night ICU attending in-house helps housestaff with complicated patients and procedures after hours.
- There is a small Surgery Service at the VA, but for the most part this 60-bed hospital is run by the Internal Medicine Service. This allows for our residents to see what it is really like to work in a community hospital and see virtually everything that comes their way. Add to this the wonderful VA patients, with their “bread and butter” medical problems and their great spirit, and this becomes a great rotation.
- The floor at the VA is covered by four teams with one resident, two interns, and one third-year medical student. One of these teams is a Family Medicine team.
- Residents take call overnight every fourth day and will admit to the floor over the 24 hour shift, and covering the VA ICU Team patients and admissions after 5 PM.
- The interns do not work overnight shifts.
- The team also takes short call every 4th day until 2 PM.
- There is an in-house hospitalist 24-7 to assist the residents when needed.
- All interns and residents get four weeks of vacation per year. These are taken in one- to two-week blocks over the course of the year. We do our best to meet the requests of our residents.
- Of course, all residents get one day off per week on average when on inpatient rotations per ACGME guidelines.
- On electives, residents are not required to work weekends, except when they are covering night shifts or providing backup services to other residents who are unable to work.