The Primary Care (PC) Internal Medicine Residency Program was started as a separate track within the UC Davis Internal Medicine Residency Training Program in 1979. As categorical medicine residency programs are traditionally quite adept at training residents for subspecialty and inpatient medicine, the initial goal of the PC Program was, and remains today, to train physicians to provide comprehensive inpatient and outpatient primary care. It accomplishes this goal through combining the strengths of the categorical training program with an intensified and diverse ambulatory care experience. A second major goal is give residents a solid clinical and didactic background in evidence-based general internal medicine.

The PGY1 year is identical to the categorical intern schedule, which already has a solid base of outpatient training with its general medicine continuity clinic and 8 weeks of Ambulatory rotations. 

Academic Forum Poster Presentation

In addition to the clinical rotations, each Primary Care Resident is expected to complete an annual scholarly project. The scope and content of the project can be quite variable. In the past, projects have ranged from scholarly literature reviews to clinical research studies. Residents are urged to work with faculty mentors (many are available, especially from our Center for Healthcare Policy and Research) who will assist with their projects. Each resident is expected to present his or her project to their resident colleagues at the end of the academic year. Residents are encouraged to submit their project for publication and/or for presentation at regional and national meetings.

UC Davis serves a diverse ethnic and socioeconomic group.  Residents work with this diverse group in all of the clinics that they work in. Additionally, they get to work with the wonderful VA, County medically indigent, and Kaiser patient populations, which rounds out the experience even more.  

The residents’ continuity clinic also serves this diverse population, and residents learn the ins and outs of dealing with many payer types (HMO, PPO, Medicaid, Medicare, medically indigent), which is invaluable for future work.   It is a very rewarding population to work with.

Primary Care for the Underserved

The General Medicine Clinic is a very nice clinical setting with excellent support staff and nurses.  It has received awards in 2007 and 2008 for excellence based on patient perceptions – a rare achievement for resident clinics. The Clinic has a top notch Full EMR system (inpatient and outpatient) that allows access from home and other hospital sites, as well as online secure communication with continuity clinic patients.  We have outstanding triage nurses, and a pharmacist-run refill system that cuts down on busywork for the physicians. Pharmacists run a Hypertension Clinic and a Medication Consultation Clinic (especially helpful on educating patients, reviewing medications, and assisting with getting expensive medications) that can really help care for patients in a multidisciplinary manner.   There is also a Wound Clinic run by an outstanding nurse wound specialist.  We have a Psychiatry Clinic within our clinic two half-days per week to optimize the psychiatric care of our patients, particularly those who have poor access to mental health services. The General Medicine Clinic Attendings are a carefully selected group of outstanding clinician-educators dedicated to our residents.   Endocrinology, Geriatrics, and Rheumatology clinics often run simultaneously with the resident clinics to allow for “on the fly” consultations and advice for our patients. This is a wonderful resource.   Overall, the clinic experience will definitely train you well for practice after you complete your training.

A. Continuity Clinics and Primary Care Program Specialty Clinics

• General Internal Medicine Clinic (UC Davis): average of two ½ day sessions per week.
• Geriatrics Clinic (UC Davis): one ½ day session per week.
• CARES (HIV) Clinic: one ½ day session every 2 weeks.

B. Specialty and Subspecialty Clinics:

• Cardiology (UC Davis)
• Women's Cardiovascular Health Clinic (UC Davis)
• Pulmonary Clinic (UC Davis, VA)
• UC Asthma Network (UCAN) Clinic (UC Davis)
• Gastroenterology Clinic (UC Davis)
• Hepatology Clinic (UC Davis)
• Endocrinology Clinic (UC Davis)
• Nephrology Clinic (Sacramento County Health System)
• Neurology Clinic (UC Davis)
• Rheumatology Clinic (UC Davis)
• Dermatology Clinic (VA Medical Center and UC Davis community clinic in Elk Grove)
• Urology Clinic (UC Davis)
• Breast Cancer Clinic (UC Davis)
• Hematology Clinic (VA Medical Center )
• Infectious Diseases Clinic (UC Davis)
• Adolescent Medicine Clinic (UC Davis)
• Urgent Care/Procedure Clinic (UC Davis)
• Allergy Clinic (UC Davis, Mercy Health Care)
• Pre-Op Clinic (UC Davis)
• Podiatry Clinic (Mercy Health Care)
• Sports Medicine Clinic (UC Davis)
• Gynecology Clinic (Sacramento County Health System)
• Medicine-Psychiatry Clinic (UC Davis)
• Pain Medicine/Psychiatry (UC Davis)
• Wound Clinic (UC Davis)

We can also help arrange for residents to go to a myriad of other clinics that run at UC Davis on ad hoc basis, based upon individual residents’ desires (e.g. occupational health, physical medicine and rehabilitation, ENT, etc).

C.  Inpatient Rotations:

Residents will have 13 blocks of a combination of these rotations over their final two years.

• UC Davis General Medicine Wards
• VA General Medicine Wards
• VA ICU/CCU
• North Kaiser Wards (NKW)
• North Kaiser ICU
• UC Davis Medical ICU
• UC Davis Cardiology Inpatient Service
• UC Davis General Medicine Consultation Service - a combination of outpatient urgent care and inpatient general medicine consults. 
• UC Davis Subspecialty Elective Consult Services
• UC Davis Emergency Room

During their last two years, PGY2 and PGY3 residents alternate betweeen inpatient and outpatient rotations every block (each block is 4 weeks in duration).  Here is a sample schedule:

The PC Outpatient time is entirely ambulatory.  Residents on the PC Outpatient blocks have continuity clinics in General Medicine Clinic twice weekly and Geriatrics Clinic once weekly.  They rotate through the local HIV Clinic (CARES) once every two weeks. Residents also rotate through a large number of medicine subspecialty clinics and non-medicine specialty clinics. Residents are able to choose most of these elective clinics (list of available clinics below) based upon their own perceived educational needs, with a core of them being required.  Residents can also create their own clinic experiences in other clinics if desired (e.g. refugee clinic).  During non-PC blocks, residents rotate through inpatient medicine wards, Medical ICU (MICU), Cardiology Inpatient Service (CIS), ER, general medicine consults, and subspecialty consultation or research electives.

Each resident has another PC resident partner that is on an opposite schedule (i.e. one is always on PC Outpatient time when the other is on more “inpatient” months).  This pair of residents shares in the care of a small panel of Geriatrics Clinic patients.  With the new 4+1+1 schedule, residents do not have their continuity clinic while on Ward, CIS, or MICU rotations. Their clinic partner helps to manage their outpatients during this time, if necessary. They will have their continuity clinic 2 half-days per week during elective or research months. Please also refer to the Categorical Medicine Track description for details on inpatient rotations and the intern year rotations.

PC residents on PC Outpatient Blocks meet every Tuesday morning (8 to noon) for interactive seminars.   In addition, PC residents attend the Department academic seminar series on Monday afternoons.

Internal Medicine Academic Conference

This weekly seminar series is for the entire medicine residency program, and meets each Monday from 1:30 to 3:30 (or so) for Residents and 10:30-noon for Interns. It takes the place of the more conventional noon conferences, and attendance is dramatically higher than classical noon conferences. Residents from all clinical sites attend these seminars, which cover a broad internal medicine curriculum over the course of the year.  It is a great opportunity for socializing among residents and faculty.

Morbidity, Mortality, Quality and Safety Conference

We have a monthly Morbidity, Mortality, Quality and Safety Conference (MMQS) on Monday at noon.   Here we do M&M cases with faculty and residents over a great lunch, and we add in topics relating to quality improvement and patient safety.

Internal Medicine Grand Rounds

We also have Grand Rounds every Thursday at noon, which is videocasted to all hospital sites.  One quarter of these Grand Rounds are dedicated to clinical topics, such as Clinical Solving Problem Cases, where expert clinicians work through an unknown case presented by our chief residents.  Once a month, we have our Clinical Grand Rounds, where one of our residents presents an outstanding case from our service, with experts discussing the complexities and learning points from the case.

Other Internal Medicine Conferences

When on subspecialty rotations (consults or CCU), residents can also attend the subspecialty conferences, which are regularly held. While at the VA, residents attend noon conferences on a daily basis.

Psychiatry in Primary Care Seminar Series (monthly, Tuesday PC Seminars)

This seminar series is run in concert with faculty from the Department of Psychiatry. It includes a series of seminars covering common psychosocial topics pertinent to primary care. Topics include: somatization disorder, depression, anxiety disorders, bipolar disorder, competency assessment (forensic psychiatry), eating disorders, psychiatric emergencies, the psychotic patient, personality disorders, delirium, and dementia.

Medical Interviewing and Communication Skills Seminar (quarterly, Tuesday PC Seminars)

This seminar series entails reviewing both basic and advanced interviewing skills, including motivational interviewing techniques.  Residents also videotape patient encounters in clinic, which we review as a group. We concentrate on interview techniques, patient-physician communication skills, and psychosocial aspects of patient care. It is an eye-opening and valuable experience for the residents and is a great hands-on opportunity to discuss these important topics.

PC Resident Journal Club (2-3 times monthly, Tuesday PC Seminars)

PC Residents meet together during their Tuesday morning sessions with faculty members and critically review articles from the medical literature with their colleagues, applying the basic tenets of Evidence Based Medicine.

Outpatient Morning Report (weekly, Tuesday AM)

PC residents attend UCD morning report and present educational cases from clinic, to allow focused discussion on common outpatient problems.

General Medicine Pre-Clinic Huddle (weekly)

Every week, we have a preclinic huddle, where physicians meet for 20 minutes before clinic to discuss many aspects of ambulatory care, including some quality improvement, and practice management techniques.  The clinic nurses and staff often participate.  We supplement this with the excellent web-based Ambulatory curriculum (developed and maintained by Johns Hopkins) that residents complete on their own time.

Teaching-Residents-to-Teach Seminars (Tuesday PC Seminars)

Residents are taught by faculty the skills and techniques for more effective teaching of fellow residents and students.

Health Care Policy Seminars (Tuesday PC Seminars)

Common policy topics are reviewed and discussed in depth, including healthcare financing, health system structure, and how we as physicians can affect health care policy and be true advocates in our current health care system. We also discuss issues of population health, universal vs. non-universal health care and insurance systems.

Clinical Reasoning/EBM Seminars (Tuesday PC Seminars)

PC residents run these interactive seminars to elucidate the fine points of clinical reasoning, with the help of faculty facilitators 

Leadership Seminars (Tuesday PC Seminars)

This is a new seminar series begun in 2010 designed to develop physician leadership skills in the primary care and TEACH residents. The plan is to repeat it every other year.

Healthcare Disparities Seminars (Tuesday PC Seminars)

This seminar series began in Winter 2011, with plans to be be repeated every other year.  This series of seminars will teach primary care and TEACH residents about healthcare disparities in the US, and how they can combat them.

Intern Resident Research Block

All UCD interns participate in the Intern Research Block during the second half of their internship year. This is an excellent introduction to assist in the annual Scholarly Project that each PC resident completes each year.  These seminars are used to share progress on the scholarly project for each resident.  Research technique and resources are reviewed, and problem-solving on individual projects allow group learning.

The proposed schedules for Primary Care PGY2 and PGY3 years are outlined below. Please note that these numbers are subject to change, depending on a variety of factors.   

PGY2 Schedule (13 blocks total):

PGY3 Schedule (13 blocks total):

Primary Care residents work very closely with UC Davis faculty in a wide range of specialties. Our General Medicine faculty are dedicated clinician-educators and care for their own primary care panels. They are great clinicians and role-models for doctor-patient relationships.

For the 2013 Match, there will be four positions for the Primary Care Internal Medicine Training Program in the National Residency Match Program, available to incoming interns. The remaining two PC Program positions that remain after the Match will be filled from the intern class the following winter.  This allows those medical students who are less certain of their career goals at match time to get six more months of experience as interns. After this experience, these interns can make a more informed decision on whether to pursue a primary care career.

The applications for the slots to be filled from our active interns are sent out in November, and final selection takes place in late January each year. Preference is given to those residents interested in pursuing primary care internal medicine as a career, or those who plan to do subspecialty training in fields that involve significant ambulatory practice. 

Any questions about the Primary Care Internal Medicine Residency Program can be directed to the Program Director, Dr. Zach Holt, at zachary.holt@ucdmc.ucdavis.edu.

Class of 2013

Class of 2014

Class of 2015

**indicates resident is doing 3rd year in TEACH track 

Class of 2012

Class of 2011

Class of 2010

Class of 2009

Class of 2008

Class of 2007