St. Mary Medical Center, UCLA-Affiliated Internal Medicine Residency, Long Beach, CA

PGY-1's

Categorical PGY-1's get a balanced experience by rotating through the Medicine Wards, ICU, Cardiology service, and Harbor-UCLA Medicine Wards.  Additionally, 3 months are dedicated to a combination of E.R. rotations and outpatient clinics.

Preliminary PGY-1's spend more time in the ICU and have the option to rotate through Harbor-UCLA.

On wards, interns take day call every fourth day until 8pm and about 2 overnight calls per month on either Friday or Saturday.  Both categorical and preliminary interns rotate on night float for 2 weeks at a time, working an 7pm-8am shift with Friday and Saturday off.  In the ICU, interns are overnight every fourth night.  ER and clinic rotations are call-free.

PGY-2's have roughly 3 months of inpatient rotations divided between Medicine Wards and ICU.  The remaining months are spent in subspecialty consultation or outpatient clinic rotations.  Cardiology, combined Neurology and Nephrology Consult service, and Pulmonary rotations are based at St. Mary Medical Center.  Pulmonary Consult, Cardiology Consult, Infectious Disease, General Medicine Consult, Endocrinology, Hematology-Oncology, and Gastroenterology are based at Harbor-UCLA.  Overnight call is typically once a week.  Residents also rotate through the night float service 2 weeks at a time, once or twice each year.

Outpatient months are spent at a variety of clinics in the South Bay area including: St. Mary Medicine Clinic, Harbor-UCLA Outpatient Clinics (Rheumatology, Dermatology, Diabetes Clinic, Women's Health), Kaiser-Permanente (Ophthalmology, Dermatology), and Private Practice Offices (Allergy and Immunology, Endocrinology, Psychiatry, Adolescent Care).

PGY-3 schedules are very similar to PGY-2 year with the addition of an elective month.  In the past, residents have rotated at hospitals and clinics around the world to take full advantage of this opportunity.

OUTPATIENT CLINICS

St. Mary Medical Center Internal Medicine Clinic is located on the seventh floor of a medical office building adjacent to the hospital with a nice view of Long Beach. All residents have a weekly continuity clinic at this location, which has five patient rooms and large resident workroom.

Residents care for a diverse patient population that is representative of the broad socioeconomic mix seen in Long Beach  Medical cases vary from skin rashes and routine check ups to complex diabetes management and unstable angina requiring hospitalization.  We have a full-time staff supporting our clinic with rotating attendings each day, as well as a social worker, pharmacist, and nutritionist who work in conjunction with our physicians.  Our close proximity to the main hospital allows us quick access to radiology, ER, and the laboratory.

In addition to our general internal medicine patient population, we have on-site subspecialty clinics in rheumatology, pulmonology , endocrinology, and travel medicine.  In this private practice-like setting, residents also learn about practice management, billing and coding, quality assurance, and managed care. The clinic prepares our residents well for "real-world" medicine after graduation.

INPATIENT CURRICULUM

Internal Medicine Wards consist of 2 teams, each headed by a PGY-2 or PGY-3 resident.  Morning report is run by the Chief Resident with core faculty co-moderating.  Full-time teaching attendings run daily bedside rounds and private attendings provide guidance on specific issues concerning patient care.  A typical day on the ward consists of:

   1. Morning report, with weekly award-winning cardiac physical exam sessions

   2. Resident and intern rounding on patients

   3. Didactic teaching/bedside rounds with the attending for the month

   4. Noon conference

   5. Patient care

   6. Sign out

The Intensive Care Unit also consists of 2 teams, each headed by a PGY-2 or PGY-3 resident.  Bedside ICU rounds are conducted by intensivist attendings.  New patients from the call team are presented with management and teaching points discussed in-depth.  A typical day in the ICU would consist of:

   1. Resident and intern rounding on patients

   2. Bedside rounds with the ICU attending

   3. Noon conference

   4. Patient care

   5. Bedside sign out rounds