Department of Medicine

Sample Rotations for 2013-2014

PGY1

PGY2/PGY3

Resident Experience


Inpatient Experience


On the inpatient medical services, the intern assumes primary responsibility for all patient care. Each general medical team consists of 1 resident, 2 interns, and 1 to 2 medical students. There is a five day admitting cycle, with the team taking admissions until 7pm.  Nighttime admissions are completed by the night teams.  A jeopardy back-up system provides coverage for residents and interns who must be absent due to illness or family emergencies.

Inpatient Rotations

Outpatient Experience


All residents have the opportunity for several general medicine ambulatory care month-long rotations over the course of the residency, during which they have concentrated experiences in primary care-related areas such as dermatology, ophthalmology, women's health, as well as in general internal medicine. These block rotations include sites at Stanford University Hospital, the Palo Alto VA Medical Center, Vaden Student Health Center on campus, and a Women's Health rotation at offices and clinics throughout the area.   Housestaff on subspecialty rotations also participate in active outpatient clinics staffed by the respective faculty members of the division. In fact, subspecialty rotations truly reflect the practice of that subspecialty; many subspecialty rotations, such as endocrine, rheumatology, and others, have their major experience concentrated in the clinics. All residents participate in both ER and walk-in clinic experiences.

Outpatient Sites

The Continuity Clinics

Housestaff training at Stanford includes experience in all aspects of outpatient care in both primary care and subspecialty clinics. From internship through senior year, residents have a weekly general medicine continuity clinic. Each resident builds a practice of patients for whom he/she will provide care throughout residency. The pre-clinic teaching conferences cover a wide spectrum of ambulatory care topics. These are available on the web for review. In addition, weekly primary care skills sessions offer the opportunity for residents to gain experience in all aspects of general medicine practice in a small-group interactive teaching environment.
 
Continuity Clinic Sites

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Training Sites

Teaching Hospitals

The clinical training of residents occurs at Stanford University Hospital and Clinics, the Palo Alto Veterans Administration Medical Center and the Santa Clara Valley Medical Center, a large county hospital. These three sites provide the Stanford housestaff with diversity and complementary patient populations and experiences. Interns rotate through all three sites.

Stanford University Hospital is a 675-bed teaching hospital which provides experience with both university and community patients who present a broad spectrum of common and rare diseases. In addition to being a tertiary care referral hospital, Stanford University Medical Center is the community hospital for Palo Alto and the surrounding South Bay area. Admissions originate from the Hospital's general medicine and subspecialty clinics, the SUH ER, the Stanford Medical Group (a Hospital-based group of internists), the offices of community physicians, including large HMOs, specialty HIV clinics, and from referrals throughout Northern California and neighboring states and outside the U.S. As the contract provider for Medi-Cal (California Medicaid) patients in the area, Stanford provides care for a large indigent patient population. There is the opportunity to care for general medicine patients for whom you are the primary physician, as well as to diagnose and manage diseases of patients referred for tertiary care.

 

Stanford University HospitalStanford University Hospital and Clinics also has a 60-bed ICU, a 20-bed Compromised Host Unit, and a 25-bed Coronary Care Unit/ Coronary Surveillance Unit. The facilities offer excellent ancillary services and amenities, such as 24-hour online literature searching and computer access and a housestaff gym. Housestaff work with and teach medical students. Patient care is supported by well-trained, highly skilled nursing, case manager, and pharmacy personnel. Pharmacists attend work rounds and provide current literature. These resources help housestaff and faculty to deliver cost-effective care in a busy managed-care environment.

 

Palo Alto VA Medical CenterThe Palo Alto VA Medical Center, located just a few miles from SUH, is one of the largest referral centers in the VA system. A new acute care hospital opened in 1997. It includes 60 internal medicine beds staffed by 5 medicine teams. As a referral hospital in the VA system, the Palo Alto VA also provides housestaff with the opportunity to see both the common diseases of the VA population and unusual tertiary care problems, as patients are referred to the PAVA from the region. At the VA, housestaff provide the primary care for all ward, ER, and clinic patients. In addition, they rotate through the VA ICU.

 

SCVMCThe Santa Clara Valley Medical Center is a 427-bed county hospital in San Jose, about 20 minutes south of Stanford. Members of the medical faculty and house-staff program are affiliated with Stanford. Residents and interns from the two institutions frequently exchange ward and subspecialty rotations. In particular, Stanford interns and residents have active ward rotations at Santa Clara Valley, providing a county hospital experience complementary to that of the Stanford University and VA Medical Centers.

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Conferences

Grand Rounds
Grand Rounds is a weekly conference that seeks to promote excellence and quality in clinical care; introduce clinicians to recent advances in medical care; provide updates on scientific advances that affect the practice of medicine; and provide a forum for discussion of topics that strengthen the relationship of Medicine to the broader community. For more information on the Department of Medicine’s Grand Rounds please visit: http://medicine.stanford.edu/grandrounds/
Morning Report
Interns, residents, students and faculty meet every Monday, Tuesday and Thursday at 10am to discuss interesting patient cases and clinical dilemmas.
Noon Conference
Noon conferences are held every weekday for housetaff. Lunch is provided and conferences are led by faculty members who teach core topics in internal medicine.
Intern Report
Held every Friday morning at 10am, this report is an opportunity for interns to discuss clinical cases amongst their peers with faculty guidance.
Professor’s Report
This is a wonderful opportunity for housestaff to interact with a senior professor who facilitates the case presentation by sharing their expertise in diagnostic skills and clinical decision making.  Professor's report takes place once a month.  
Stanford 25
This special series is held once a month during intern report and is a beside medicine initiative highlighting 25 physical exam skills led by Dr. Verghese.
Journal Club

Journal club is held monthly to discuss and present key articles in medicine by housestaff with faculty guidance. Comprehensive understanding of the statistical analysis of research is reviewed. These meetings are required of all housestaff.

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Vacation

All residents receive 4 weeks of vacation per year (2-two week blocks).  R2 & R3 residents also receive 5 days off during the Christmas or New Year’s holiday. 

Other Benefits

Hospital and major medical insurance for each house officer and his or her dependents are provided. Dental insurance for the house officer and his or her children is provided, with the spouse's dental insurance available at the house officer's expense. Disability insurance, malpractice insurance, and sick leave benefits are also provided to housestaff at Stanford. Lab coats and their laundry, pagers, and some University privileges are available.

Additional benefits include on-call meal cards for residents who must remain in-house overnight at Stanford. A substantial educational allowance is provided by the Hospital. Also, Stanford pays fees for initial state licensure for which you apply at the end of internship, fees for Step III, and it provides a moving allowance.

More specific information regarding these topics, as well as local housing information is available from Ms. Ann Dohn of the Stanford Health Services Graduate Medical Education Office at (650) 723-5948.

Rental housing is available close to Stanford. There are also University rental apartments near the Hospital.

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