How do you describe the patient population at Kaiser San Francisco?
In San Francisco, Kaiser provides care to over one-third of the entire population. Our patients’ demographics mirror those of the local community we serve: 40% white; 34% Asian; 20% Hispanic; 6% African American. Our patients’ socioeconomic demographics are similarly diverse, including: service industry employees and their families; techies; and health care workers such as UCSF physicians and employees. Additionally we are one of the largest providers to Healthy San Francisco, an innovative health access program designed to make health care services available and affordable to uninsured San Francisco residents.
How robust is the volume of patients for residents training at Kaiser San Francisco?
Besides serving the city and county of San Francisco, Kaiser San Francisco is a tertiary referral facility for a diverse population extending from Marin to San Mateo down on the peninsula. Residents find that virtually ALL of our patients are part of the teaching service. These patients provide our residents with ample clinical experience in all aspects of routine Gynecologic and Obstetrical care as well as sub-specialty areas of Reproductive Endocrinology and Infertility, Maternal Fetal Medicine, Gynecologic Oncology, Female Pelvic Medicine and Reconstructive Surgery, and Chronic Pelvic Pain.
At the completion of 4 years of training our graduates leave with exceptional surgical experience. Survey of former graduates consistently finds them well prepared for: full-scope surgical practice, particularly laparoscopic procedures; managing high risk obstetric patients; and providing complete range of family planning services.
Here are preliminary primary surgeon averages for procedures tracked by ACGME for our 2018 graduates (as soon as finalized numbers with national percentiles are available they will be posted):
|Procedure||Program Median/Resident||National Percentile|
|Spontaneous Vaginal Deliveries||426|
|Operative Vaginal Deliveries||37|
|Incontinence and pelvic floor||98|
|Total invasive cancer||76|
Where do your program’s residents typically come from?
Applicants to our program come from medical schools throughout the entire United States. Last year we received over 550 applications for our 4 positions. Applicants came from 125 US Medical Schools in 42 different states. Our current residents attended the following medical schools: UC San Francisco; UC Davis; U Michigan; Northwestern; UC Irvine; Drexel; UC San Diego; U New Mexico; U Vermont; Harvard; U Wisconsin; and Mayo Medical School. A roster of current residents can be found under Our Residents.
Does your program have protected teaching time?
Our training program values and prioritizes educational experiences. Tuesday mornings are protected for didactic curriculum. We assign extra faculty to in-house services to cover L&D, in-patient gynecology and the Emergency Department so that residents can attend. The morning starts off with departmental Grand Rounds or M&M. This is followed by core didactics which include: Gyn-onc; REI; MFM, Urogynecology, Surgical Skills, CETT, Communication Sessions, Clinical Quality Improvement and Patient Safety, and Journal Club.
How are residents evaluated in your program?
We provide comprehensive ongoing evaluation and assessment of residents’ performance in curricular and rotational experiences, and this is reviewed in detail with each individual resident every 6 months at their Semi-Annual review. These evaluations are competency based and include multiple evaluators. Semi-annual reviews include: individual Milestone assessment in 28 areas; semi-annual and rotational faculty evaluations; peer evaluations; medical student evaluations; RN evaluations; Patient evaluations; Focused Assessment of Competency assessment for procedures; simulation and critical event team training assessment; research progress; standardized training exam review; selected self-reflections; ambulatory care performance; Clinical quality improvement and Patient safety project review; management of your patient panel; and performance of mandated training (e.g. Fetal heart rate course).
What are the unique advantages of training at Kaiser San Francisco?
Our ObGyn residency training program fully harnesses the many strengths and advantages that have made Kaiser Permanente a model for health care in this country. We have achieved nation leading quality outcomes as reported by the National Committee for Quality Assurance (NCQA). We are at the cutting edge of technology for health care systems, and our use of technology, particularly video, is the best in the nation. We provide care to almost half the population of Northern California. At Kaiser San Francisco we have earned the confidence and trust of our patients and have a faculty that identifies this as being the best place to work. Our organization has a long history of providing a diverse and inclusive work environment and we are recognized as leaders for diversity in the workplace. Our training program shares our organization’s commitment to helping shape the future of health care and dedication to care, innovations, clinical research, health education and the support of community health. Our expert and caring faculty are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management.
In a recent survey of nearly 300 health care executives, Kaiser Permanente was identified has having the best overall ranking in the domains of quality care at a sustainable cost, healthcare innovation, and thought leadership. Mayo Clinic came in second and Cleveland Clinic came next. The biggest driver for this number one ranking was our reputation around quality care with controlled costs followed by innovation. Our track record of continuous process improvement in a physician led, physician run organization, has helped to bring our recognition to our highest level to date.
What mentorship opportunities are offered in your program?
Our residency training program offers strong mentorship that starts prior to arriving for intern orientation. Newly matched residents are paired with a faculty mentor who reaches out to the new interns in the weeks before starting residency. This four year relationship focuses on growth, educational, and career development. The mentor is both and advocate and advisor. It is expected the mentor-mentee meet regularly outside of the hospital.
Residents who are considering fellowship training will also have a sub-specialty mentor to help advice and guide the resident in their pursuit.
Each resident will have a separate research mentor for their primary research project. The program director will work closely with each resident through the initial stages of selecting a research project and will help each resident select an appropriate research mentor.
Residents also establish big sib-little sib mentoring relationships. Each intern is paired with a third-year resident to act as an advisor for their initial two years.
How affordable is San Francisco?
Imagine great weather year round; amazing food and drink scene; gorgeous beaches and forests within a short drive or hike; progressive; truly diverse; beautiful; stylish; illustrious sports teams; technology and transportation hub; Napa, Sonoma, Santa Cruz, Pacific coast northward and southward – how could you turn down the opportunity to live and train in San Francisco?!
Besides a highly competitive resident salary that increases each year, we offer significant subsidies over the 4 years of residency:
- San Francisco Housing Allowance: $3500 / year
- Moving Stipend: $1000
- Educational Stipend: PGY 1 & 2 – $1250 / year; PGY 3 & 4 – $1500 / year
- Bridge tolls and travel stipend for WCR rotation (PGY 3): $1000
- Travel/gas stipend for Clinic-SSF Rotation (PGY 4): $250
- Board Review Course for PGY 4: $1500
- Gym membership subsidy: $720 / year
- Licenses fully paid, including renewals: California Medical License; DEA License
- USLME Step III fully paid
- Daily Parking: fully paid
- ABOG Junior Fellow Dues: fully paid
- ABOG Written Exam fee: significantly subsidized
- Meals: daily lunch, as well as Night Float and weekend call
How does your Medical Center and Residency Program support physician Well-Being?
Physician Well-Being is a major priority of the leadership at our Medical Center. Our training program works in partnership with our faculty leadership to take advantage of many resources for wellness. Every week the Wellness Report outlines activities that can be taken advantage of (e.g. game challenges, bike to work day, women’s health month, workplace safety fair, lunchtime lecture series, cancer survivor’s day relay, lunchtime call-in meditation, on-site farmer’s market, bean sprouts family days). A major priority at our Medical Center are efforts to proactively prevent and combat burnout and depression.
Our training program works with the San Francisco Medical Center Faculty Wellness Committee on joint programs, planning and initiatives. Efforts include making the hospital environment reflective of our values for wellness and fostering inter-collegiality between departments. In addition to a gym stipend, there is free access to a fitness center at the French Campus. Each year the residents select one of their own to champion and organize monthly resident social events. Chiefs often organize rotational end of rotation events for Gyn/Gyn-Onc and Ob services. The night float team frequently has end of rotation breakfast with the nurses off-site. Regional events include attending Warrior’s basketball games and A’s and Giant’s baseball games.
Within the OBGYN Department we have faculty and resident Wellness Champions. Joint faculty-resident activities include yoga, local service events, and international medical missions. We recognize that working in a small training program requires close support and collaboration between faculty and residents, particularly when dealing with unpredictable circumstances in which residents may be unable to attend to work, such as fatigue, illness and family emergencies. We have a long history of strong support from faculty for this.
Here is how our current residents responded when asked how they attended to wellness:
- Group exercise classes at Soul cycle, Barry’s boot camp or running Lyon street steps
- Sending gratitude thank you letters through Dohje
- For wellness I rent vespas and scoot around San Francisco with my husband, go to the beach, and do Pilates in my living room
- hang out with classmates/friends
- workplace mentorship from attendings, fun events with attendings
- workplace support from other residents – team events, gratitude rounds
- local spa services
- I ride my bike to work. It gives me a half-hour to wake up in the morning and wind down in the evening, especially helpful on intense rotations. Bonus – I can spend all my off time playing with my kid instead of worrying about getting to the gym!
- Free sporting events
- Free massages on the mezzanine in hospital
- Resident retreat
- Research half days
- Getting coverage for graduation
- Having wonderful co-residents and attendings who don’t make it feel like work most of the time 🙂
- Monthly resident socials to check out new restaurants, bars, activities around the city
- Monthly team events (mini golf at UrbanPutt, trivia night, happy hour, Nightlife at Academy of Sciences or Exploratorium)
- Meet up with residents in my year for drinks/meals to talk through stuff
- Group text with my year of residents essentially everyday
- Plan vacations during which I have plenty of time to relax
- “gratitude rounds” in which we go around and say what we’re grateful for
- Talk to EAP when I need an emotional sounding board who understands my situation but isn’t directly involved
- Hip hop dance class with co-resident
- Go on “city hikes” to explore different areas of sf
- Write a gratitude journal
- Talk to family on the phone or FaceTime