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 8-10 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 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, and Dignity Health System) to get the strong 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 of 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.

We are in our 4th year of block scheduling, which is a 4+1+1 model. Residents do 4 weeks of an inpatient rotation, followed by two weeks of elective, 1-2 weeks of ambulatory, or 1-2 weeks of vacation (this is the 1+1part).  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, residents rotate with a cohort of residents on the same schedule (thus, we call it cohort time).  During these weeks, they have 2-3 continuity clinics where they 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 (the cohort times are *):

Week

1

2

3

4

5*

6*

7

8

9

10

11*

12*

Rotation

UC Ward

UC Ward

VA Ward

VA Ward

AMB

Vac

CCU

CCU

Kaiser Ward

Kaiser Ward

GI  Elect

GI  Elect

Starting in 2016, we now do Academic Half Days during the 1+1 times.  These are protected time (Monday Afternoon for residents, Friday Morning for interns) where we deliver our didactic curriculum.  No more racing over from the MICU to try to get to the seminars!

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. Some Primary Care residents move over to the TEACH Program in their 3rd 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.

We have a Winter Retreat in Tahoe every year as well.

Inpatient Training:

Presently, interns do ward rotations at all 3 hospitals, the MICU, the Cardiology Inpatient Service, and the Hematology-Oncology Inpatient Service.  The intern schedule also includes 2 weeks of Emergency Medicine, 1- 2 weeks of Night Float at UCDMC, and 2-4 weeks of electives. The intern schedule follows a 4+1+1 model for most of the year, and they rotate in cohorts as well.

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, VA and Kaiser Hospitals.  
  • 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 weekly journal clubs to learn the fundamentals of evidence based medicine and critical assessment of the literature.
  • For Interns that want to participate in scholarly work, they can join the Intern Research Block (IRB) during the second healf of the year. During Ambulatory time in the second half of the year, interns in this track get time for them to find and meed with a mentor, develop a project, submit IRB paperwork(if needed), and essentially set themselves up with an early start on their research. The Intern Research Curriculum prepares them for scholarly work over their next 1-2 years.

Residency - PGY II and PGY III Years

In the PGY-II year, residents take on team leadership roles on the inpatient services at the VA and Kaiser. They also have increased elective time, more time in their continuity clinic, havve dedicated rotations in Neurology and Geriatric, and have a junior resident role on the UCD MICU team.   

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 that started in the PGY-II year, but are now ready to take on the leadership role on our largest academic teams on the UC Wards rotation. They also play a major leadership role on the UCD MICU rotation.  They also have increased amounts of elective time to get varied experiences based on their perceived needs. 

Residents in the Research Track can take up to one month per year of research elective time (8 weeks total over the two years) to work on their scholarly projects.

Residents can select (late in their internship year) if they wish to be part of one of our specialized tracks, including the Medical Educator Track, Hospitalist/QI Track, or Leadership Track (this one is offered only every other year).   Each is a year-long elective track, so residents can more than one if they choose. These are meant to be extra experiences to hone skills in these areas.  They are not incredibly time intensive, so most residents feel comfortable adding them to their busy schedule. As mentioned, residents can also participate in the Research Track throughout internship and residency if they elect to do the Intern Research Curriculum.

Inpatient Training

Currently, all PGYII and PGYIII residents do cardiology inpatient, general medicine, and ICU rotations at the three sites, in addition to a rotation on the neurology inpatient service (PGYIIs) at UCDMC. Residents get significant time on elective consultation services. Our most popular electives are cardiology, endocrinology, gastroenterology, hematology-oncology, infectious diseases, nephrology, pulmonary medicine, rheumatology/allergy, and palliative care. Our residents do electives in 2 week blocks, so over the three years a resident is typically able to rotate on virtually all of these rotations if they desire.

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 8-10 weeks on Ambulatory Care. This time includes training blocks in geriatrics. Resident also get the experience in non-medicine specialties(e.g. dermatology, urology, podiatry, 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. 
  • Electives are often a combination of inpatient and outpatient experiences. So residents on subspecialty electives often rotate through the respective clinic.