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Department of Internal Medicine

Department of Internal Medicine

Transforming Education and Community Health (TEACH) Track

Started in 2005, the Transforming Education and Community Health (TEACH) Program Track is a highly successful primary care training track for residents interested in caring for the medically underserved and becoming leaders in academic General Internal Medicine. The long term goal of the TEACH Program is to improve access to high quality health services by training General Internal Medicine physicians who provide well-coordinated, evidence-based, culturally humble care to underserved adults.

In partnership with the County of Sacramento Department of Health and Human Services, this community-based collaborative aims to reduce health disparities and increase the number of primary care physicians in medically underserved communities.

Of note, our TEACH program philosophy was expanded to our UC Davis Medical School.  Medical students who share this aim are joining the TEACH-Medical Student Program for their medical school training and work with our TEACH residency team.

 Our Patients and our Community

Sacramento is one of the most racially and ethnically integrated major cities in the United States, providing a unique setting for teaching culturally humble care.  The TEACH Program is centered in Oak Park, a vibrant, historic community just steps from UC Davis.

Oak Park Community
Oak Park Community

 

The TEACH Clinic is located in the County of Sacramento Primary Care Center, a 100,000 sq ft comprehensive ambulatory facility that provides nearly all out-patient services to the region's medically underserved. The patient population is approximately 30% Hispanic, 30% Caucasian (of which a substantial proportion is Russian speaking), 25% African-American, 10% Southeast Asian, and 5% other ethnicities. One in eight patients require an interpreter. The primary languages spoken include: English, Spanish, Vietnamese, Hmong, Russian, Mien, and various Chinese dialects.

County clinic
TEACH Clinic, County of Sacramento Primary Care Center

 

Our program was featured in an article within the Sacramento Bee

 

Curriculum

The TEACH program is a yearlong experience that replaces the traditional third year of residency. Residents rotate in one week blocks on the TEACH inpatient service, where they care for primarily uninsured or underinsured patients admitted to UCDMC. They work with an attending and two third-year medical students.

When not on wards, TEACH residents spend three afternoons per week in their county-based continuity clinic (at the Sacramento County Primary Care Center) and rotate through other university specialty and sub-specialty clinics as well as county-based clinics including the Gynecology Clinic, Dermatology Clinic, Nephrology Clinic, and the Sacramento County TB/Chest Clinic.

The UC Davis Internal Medicine residency program uses a 13-block schedule for the academic year. A typical TEACH resident annual schedule includes:

  • 8-9 blocks on TEACH
  • 1 block on wards
  • 1 1/2 blocks on the MICU/CCU
  • 1 block on elective
  • 1 block on vacation

Whenever possible, hospitalized TEACH in-patients are followed up by their personal resident physician in the TEACH clinic. TEACH continuity clinics are held at the County of Sacramento Primary Care Center, and the inpatient component occurs at the UC Davis Medical Center. This experience allows the resident physician to care for patients during their acute illness, during their recovery, and in follow-up care.

A typical TEACH block ensures ample opportunity for outpatient follow-up and inpatient independence. A sample four-week block is below:

 

 

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Week 1

AM

TEACH Wards

TEACH Wards

TEACH Wards

TEACH Wards

TEACH Wards

TEACH Wards

TEACH Wards

PM

TEACH Wards

Academic Conference

TEACH Wards

TEACH Wards

TEACH Wards

TEACH Wards

TEACH Wards

Week 2

AM

TEACH Wards

TEACH Wards

TEACH/PC Conference

Specialty clinic

Specialty clinic

Specialty clinic

 

PM

TEACH Wards

Academic Conference

TEACH Clinic

TEACH Clinic

TEACH Clinic

TEACH Clinic

 

Week 3

AM

 

Specialty clinic

TEACH/PC Conference

Specialty clinic

Specialty clinic

Specialty clinic

 

PM

 

Academic Conference

TEACH Clinic

TEACH Clinic

TEACH Clinic

TEACH Clinic

 

Week 4

AM

 

Specialty clinic

TEACH/PC Conference

Specialty clinic

Specialty clinic

Specialty clinic

 

PM

 

Academic Conference

TEACH Clinic

TEACH Clinic

TEACH Clinic

TEACH Clinic

 

TEACH residents continue to attend the residency academic conferences and also join the TEACH/Primary Care weekly conferences.

TEACH residents
TEACH Residents

Other unique features of the program include: on-site mental health services supervised by a dual-trained IM-psychiatrist (Dr. McCarron) to help residents manage patients with comorbid medical and psychiatric illness; and, an on-site chronic kidney disease management specialist (Dr. Morfin) focusing on improving the care of patients with kidney disease.

TEACH residents are also involved in teaching second year medical students in the Introduction to Clinical Medicine course and precepting at one of the seven UC Davis School of Medicine's Student Run-Free Clinics.

Applying to the TEACH Program

The TEACH Program is for third year residents. We have residents apply for one of the five TEACH resident positions during their second year of residency. Both categorical and primary care residents are welcome to apply.

Reference

Fancher TL, Keenan C, Meltvedt C, Stocker T, Harris T, Morfín J, McCarron R, Kulkarni-Date M, Henderson MC. An academic-community partnership to improve care for the underserved.
Acad Med. 2011 Feb;86(2):252-8.