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Department of Internal Medicine

Department of Internal Medicine

The Categorical Medicine Track

Research During Residency
Research During Residency

The Categorical Internal Medicine residency is a three-year program that provides a broad experience in inpatient and outpatient internal medicine.  We pride ourselves in the outstanding clinical training that our residents receive.  They also have great opportunities over the three years to do scholarly work.

The Categorical Track has experiences with inpatient critical care, general wards, and cardiology at all three hospital sites (UCDMC, Kaiser, and VA), which provides for great diversity of patients and systems. Residents also rotate on the Neurology inpatient service at UCDMC during their second year. On all of our rotations, the residents work with a single attending of record, which allows easy communication of plans, continuity of teaching, and resident autonomy in the setting of great resident support.

The ambulatory training of our Categorical Residents is also particularly strong.  Residents will rotate through many subspecialty clinics as part of their 8 weeks of Ambulatory training blocks each year (at least 24 weeks total over 3 years).  They also work in subspecialty clinics while on most of their elective rotations.  Residents get Geriatrics and Neurology training experiences during their ambulatory time as well.  We utilize clinics at all of our ambulatory clinical sites (UCD, VA, several Kaiser sites, Sacramento County, Dignity Health System) to get the best training experiences for our residents.

Our continuity clinic experiences are given heavy financial support by our department, and as such residents leave us with strong skills in the practice ambulatory medicine.    As we often point out, much of subspecialty medicine is outpatient-based, and hospitalists are at their best when they understand what can and cannot be done on the outpatient setting. Thus, this training serves the residents well, whatever their future endeavors.

Three years ago, we started block scheduling, which we call 4+1+1. Residents do 4 weeks of an inpatient rotation, followed by two weeks of elective, ambulatory block, or vacation (this is the 1+1 part).  Residents no longer have their continuity clinic during their 4 weeks of inpatient work -- this was always very hard due to the constant pull from the ward rotations.  During the 1+1 weeks, they have 2-3 continuity clinics where they can care for their primary care patients and give them their full attention.  Here is an example of 3 months of the 4+1+1 schedule to give you an idea of its structure:

Week

1

2

3

4

5

6

7

8

9

10

11

12

Rotation

UC Ward

UC Ward

UC Ward

UC Ward

AMB

Vac

CCU

CCU

Kaiser Ward

Kaiser Ward

GI  Elect

GI  Elect

These rich experiences allow residents in the Categorical track to get positions in highly competitive fellowships, and to easily land work as hospitalists, primary care physicians, clinician-researchers, and clinician-educators.

In the sections below, we outline the typical categorical resident experience.  Of note, the TEACH Program residents do categorical R1 and R2 years before moving into that track in their 3rd year.  Primary care residents do a categorical R1 year before moving into the Primary Care Track in their 2nd year.

Please refer to the Rotations and Training Sites page for further details.  

Internship

Intern Orientation Day
Intern Orientation Day

Our internship provides a solid foundation in both inpatient and outpatient care that prepares the interns well for their team leadership roles in the R2 and R3 years. 

In the Spring, all interns participate in a day-long Teaching Skills Retreat, where they learn teaching, team management, communication, and leadership skills to prepare them for their R2 year.

Inpatient Training:

Presently, interns do ward rotations at all 3 hospitals, the MICU, and the Cardiology Inpatient Service. All interns rotate on our highly-regarded Hematology-Oncology Inpatient Service, which is run by the Heme-Onc faculty and fellows. We recently added a hospitalist attending on this rotation who works directly with the Interns in the trenches. Interns do 2 weeks of Emergency Medicine 1- 2 weeks of Night Float at UCDMC, and 2-4 weeks of electives. 

Ambulatory Training:

  • During the first year, each intern spends 8 weeks on Ambulatory Care.
  • Most of the clinics are held at UC Davis Medical Center, but interns also rotate through Sacramento County, Dignity, and Kaiser Hospitals.  One to 2 weeks are spent primarily at the VA on our VA Ambulatory rotation.
  • Interns have their continuity clinic experience throughout the year. Each intern starts with a panel of about 30-40 patients.
  • In addition to the clinical experiences, interns and residents on the Ambulatory rotation meet for one half-day weekly to learn the fundamentals of evidence based medicine through journal club.
  • The second ambulatory block includes an immersion experience in research, the Intern Research Block (IRB) for those interns interested in doing research.
  • Interns complete the Intern Research Curriculum during this year, to get them ready for scholarly work over their next 1-2 years.

A sample intern schedule is as follows (subject to change) **: 

Block

1

2

3

4

5

Rotation

VA Ambulatory (2)

VA Wards (2)

Cardiology (2)

Pulm Consult (2)

UC Wards (2)

Vacation (2)

Night Float (1)

Ambulatory (1)

ER (2)

VA Wards (2)

Core Ambulatroy (2)

Block

6

7

9

9

10

Rotation

VA ICU (2)

Heme/Onc (2)

Heme/Onc (2)

Vacation (1)

Ambulatory (1)

MICU (2)

Core Ambulatory (2)

Kaiser Wards (2)

UC Wards (2)

UC Wards (2)

Neph Consults (2)

Block

11

12

13

Rotation

Cardiology (2)

Heme/Onc (2)

Vacation (1)

Ambulatory (1)

Cardiology (2)

Kaiser ICU (2)

MICU (2)

** : number in parentheses indicates number of weeks on that rotation

Residency

In the PGY-II year, residents take on team leadership roles on the inpatient service and their clinic panel expands. They also have increased elective time and can take Research elective time to work on scholarly projects.

All PGY-IIs participate in a full-day teaching retreat in the Fall.  This course is based on the Stanford Faculty Development program that is used commonly for medical faculty, and is taught by graduates of this program.

The PGY-III resident continues the supervisory role practiced in the PGY-II year with increased training in consultative and research activities.

Residents can select (late in their internship year) if they wish to be part of the Medical Educator Track or Hospitalist Track.   Each is a year-long, so residents can do both.  They can be in the Research Track throughout internship and residency if they elect to do the Intern Research Curriculum.

Inpatient Training

Currently, all residents do cardiology, general medicine, and pulmonary-critical care rotations at the three sites, in addition to a rotation on the neurology inpatient service at UCDMC. Much more time is spent on elective consultation services. Our most popular electives are cardiology, endocrinology, gastroenterology, hematology-oncology, infectious diseases, nephrology, pulmonary medicine, rheumatology/allergy, and palliative care.

All residents do at least 4 weeks of the General Medicine Consult Service over their last 2 years. This rotation teaches residents to do preoperative evaluations on complex medical patients and how to manage common perioperative problems.  An outstanding structured curriculum reinforces the patient care experiences.

Ambulatory Training:

  • During each of the R2 and R3 years, residents continue to get 8 weeks on Ambulatory Care. This time includes training blocks in geriatrics and neurology, as well as experiences in non-medicine specialties(e.g. dermatology, urology, podiatry, gynecology, sports medicine) and medicine specialty clinics.
  • Residents rotate through the best clinics at UCDMC, Sacramento County, Dignity, VA, and Kaiser systems. 
  • Residents have more continuity clinic sessions, and their panel expands to maximum of about 75 patients for an R3. 
  • Residents continue to meet for one half-day weekly to learn the fundamentals of evidence based medicine and participate in journal club.
  • Four weeks per year are spent on our Core Ambulatory rotation, where interns and residents have 2 half-days per week of core topics on clinical reasoning, EKG interpretation, medical error reduction, evidence-based medicine, musculoskeletal medicine, and quality improvement projects.
  • Electives are often a combination of inpatient and outpatient experiences. So residents on subspecialty electives often rotate through the respective clinic.

In the second and third years, we allow residents to do electives in 2 week blocks, so over the three years a resident is typically able to rotate virtually all of these rotations if they desire.

Many residents take Research Elective time (up to 8 weeks over the 2 years) to work on their scholarly projects that they developed in their internship year.

Sample schedules for R2 and R3s are outlined below (subject to change):

R2 Schedule **:

Block

1

2

3

4

5

Rotation

GI Elective (2)

VA ICU (2)

Ambulatory (1)

Vacation (1)

UC Wards (2)

Cardiology (2)

Core Ambulatory (2)

 

MICU (2)

Research Elective (2)

UC Wards (2)

Kaiser Wards (2)

Block

6

7

8

9

10

Rotation

ID Consult (2)

Neurology Wards (2)

ER (2)

Vacation (1)

Ambulatroy (1)

Geriatrics (2)

Kaiser ICU (2)

VA Wards (2)

Core Ambulatory (2)

Ambulatory (1)

Vacation (1)

VA Wards (2)

Block

11

12

13

Rotation

GenMedConsults (2)

UC Wards (2)

Ambulatory (1)

Vacation (1)

Rheum elective (2)

MICU (2)

UC Wards (2)

R3 Schedule **:

Block

1

2

3

4

5

Rotation

Core Ambulatory (2)

Endo Elective (2)

MICU (2)

Kaiser Wards (2)

GI Elective (2)

Cardioogy (2)

UC Wards (2)

Ambulatory (1)

Vacation (1)

GenMed Consult (2)

Neph Consult (2)

Block

6

7

8

9

10

Rotation

VA Wards (2)

ER (2)

Vacation (1)

Ambulatory (1)

Kaiser ICU (2)

Core Ambulatory (2)

Cardiology (2)

Ambulatory (4)

UC Wards (4)

Block

11

12

13

Rotation

Ambulatory (2)

Vacation (2)

Wards (2)

Ambulatory (2)

MICU (2)

Rheum Elective (2)

** : number in parentheses indicates number of weeks on that rotation