Internal Medicine Santa Clara - CHOICE Primary Care

What does this program offer?

This program offers full training in internal medicine and meets all ACGME requirements for board eligibility in general internal medicine, both inpatient and outpatient. A significant reduction in inpatient responsibilities allows far greater proficiency in outpatient medicine than is possible in standard internal medicine residencies.

This program will develop expertise in the following core areas:

• Chronic conditions management
• Health maintenance & disease prevention
• Outpatient subspecialization
• Information technology
• Community service
• Executive skills

In addition, all CHOICE residents will choose an Area of Distinction R2 year and R3 year based on their areas of interest and will graduate the program with additional skills and experience in these areas.

Who is an ideal fit?

• Residents who plan to practice primary care, and would like to develop a particular expertise in an area or areas within primary care.  This might include, among others, diabetes care, lipid management, asthma care, or musculoskeletal medicine.
• Residents planning a leadership career within outpatient medicine.  These residents would be particularly poised to start and/or lead a chronic conditions management clinic, or to advise medical groups on methods for improving chronic conditions management.
• Residents with an interest in working with underserved populations.
• Residents with an interest in population management, public health policy, or medical informatics.
• Residents who plan to practice any outpatient-based subspecialty, including but not limited to Rheumatology, Sports medicine, Allergy and Immunology, Endocrinology, and Geriatrics.

What does the schedule look like?

General principles

R1: R1 year is the same for categorical and choice residents. All R1 residents alternate 2 weeks inpatient with 2 weeks outpatient throughout the year.

R2: Residents have the same number of electives as categorical residents. They have approximately 15 weeks per year in addition to electives which are dedicated to work towards their Areas of Distinction and do additional continuity clinics. Those who opt into doing the Community Medicine Track simultaneously (a popular combination among CHOICE residents) will also use this time to work with the underserved.

R3: The R3 year is heavily outpatient-based. The curriculum is highly individualized and tailored specifically to the individual’s career goals and desired Area of Distinction. Approximately 16 weeks in addition to elective time are dedicated to work toward the Area of Distinction, additional continuity clinics, and (if desired) work in underserved clinics.

What are Areas of Distinction?

CHOICE residents choose an area of outpatient medicine in which they would like to gain additional expertise. Residents engage in additional education in the area as well as clinical experiences, a performance improvement project, leadership role, and individual mentorship.

Some examples of Areas of Distinction that residents have chosen:

• Lifestyle Medicine: Residents fulfill the requirements to become board certified in the American College of Lifestyle Medicine. Learn more about Lifestyle Medicine here.
• Diversity: Additional experience with underserved patients and/or patients of diverse background e.g. transgender.
• Musculoskeletal Medicine: Residents develop focused expertise in sports medicine and orthopedics.
• Leadership: Residents are paired with a mentor involved in Kaiser leadership. They attend meetings and engage in projects with their mentor as well as other leaders within the organization.
• Geriatrics: Although we have had graduates pursue multiple different outpatient fellowships, geriatrics is a popular option, with several opting geriatrics as an area of distinction and going on to geriatric fellowship at Stanford.
• Health technology: Residents are paired with a technology lead within the organization to gain additional expertise in health care technology.

How do CHOICE residents perform on the boards?

ABIM board passage rate among CHOICE residents – since graduation of the inaugural CHOICE class in 2013 – is 100%.

Comparison of Standard vs. Primary Care Schedules

Schedule below is an example of a typical schedule, actual schedules will vary. Schedules are subject to change.