Continuity Clinics | Outpatient Primary Care and Subspecialty | Urgent Care | Geriatrics
Neurology | Owen Clinic | Kaiser Endocrinology | Psychiatry
Residents in the Categorical, Physician-Scientist Training Program (PSTP) and Medicine/Pediatrics training tracks have a continuity clinic that spans the duration of their training and occurs, on average, one afternoon per week, with more clinics in the second and third years. Residents are assigned to one of approximately nine primary care clinic sites for the duration of their training.
At the majority of the sites, each resident has his/her own patient panel and is the primary doctor for these patients. The continuity clinic sites include Federally Qualified Health Center (FQHC) sites, Kaiser Permanente® (one of the largest health maintenance organizations) sites as well as multiple UC San Diego Health and VASDHS locations.
The Medicine/Pediatrics residents have their continuity clinic at a community clinic, where they see both medicine and pediatrics patients and are precepted by a medicine/pediatrics board-certified attending; or they have alternating clinics in medicine and pediatrics, with the medicine clinic experience at either a UC San Diego Internal Medicine Group practice or one of the community clinic sites.
Research (PSTP) residents also maintain a general medicine continuity clinic during their clinical years of training. There is a primary care conference at the beginning of clinic at each site based on the Yale Primary Care Curriculum and all residents complete specified ambulatory modules online (Johns Hopkins curriculum) for each year of their training.
Outpatient Primary Care and Subspecialty Rotations
House staff rotate through a variety of outpatient rotations which focus on exposing residents to issues commonly seen in outpatient primary care and subspecialty settings. Each rotation has several focused clinical experiences including outpatient cardiology, pulmonary, neurology, endocrine, nephrology, orthopedics, dermatology, gastroenterology, rheumatology, hematology/oncology, infectious diseases, allergy and immunology, hospice, psychiatry, rehabilitation and sports medicine, and head and neck surgery, ophthalmology, urology and vascular surgery.
There are also dedicated 2- to 4-week outpatient blocks for residents at all levels of training in a variety of outpatient primary care settings. Ambulatory rotations in underserved medicine and global medicine are also available serving a broad range of patient populations.
Interns and residents rotate through ambulatory blocks in the Emergency Department at the VA San Diego Healthcare System hospital in La Jolla, where they see patients with a wide range of urgent medical problems and work closely with experienced clinical faculty.
Residents work with Geriatrics faculty to see patients in a wide variety of clinical settings, including a comprehensive outpatient multidisciplinary Alzheimer's facility, skilled nursing facilities, assisted living facilities, home visits and hospice. They also participate in multidisciplinary rounds on the inpatient geriatrics service.
Residents rotate through a variety of general and specialty neurology clinics at the VA San Diego Healthcare System hospital, UC San Diego Medical Center in Hillcrest, and Thornton Pavilion (part of Jacobs Medical Center in La Jolla). They work with the neurology faculty to evaluate new and returning patients and develop diagnostic and management strategies for these patients.
Owen Clinic is a primary care clinic for patients with HIV disease. All residents have the option of rotating through this HIV clinic for 2- to 4-week blocks.
Kaiser Endocrinology is a 4-week elective rotating through endocrinology clinics at Kaiser Permanente, a large health maintenance organization. This rotation is an option for PGY-3 or 4 (Medicine/Pediatrics) residents.
The outpatient psychiatry rotation at the VA psychiatric emergency clinic affords residents with the opportunity to work one-on-one with a psychiatry attending to learn to diagnose and manage acute and chronic psychiatric conditions such as depression, anxiety, bipolar affective disorder, and schizophrenia. Residents learn to perform an effective psychiatric interview, respond during a psychiatric crisis, assess suicidality, and identify when patients require psychiatry or psychology referrals and how these sub-specialties contribute to the overall healthcare of patients.
Residents also have the opportunity to practice brief motivational interviewing and learn about the use of psychotropic medications.