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Internal Medicine San Francisco - FAQs

What will the 2023-24 interview season look like?

All interviews and recruitment activity for the 2023-24 recruitment season will be conducted in an entirely virtual format. We anticipate sending out initial interview invitations on Monday, October 16. Subsequent interview invitations will be sent out in a rolling fashion throughout the season as space permits. We plan to interview Categorical and Internal Medicine/Public Health Track applicants from mid-October 2023 through mid-January 2024 and Preliminary Track applicants from mid-October 2023 through early December 2023.

I’m interested in the Preliminary Track. What do I need to know about applying to this track?

For applicants to our Preliminary Track, we strongly prefer but do not require a Department of Medicine Summary Letter of Evaluation as one of your letters of recommendation. Because of the ACGME-mandated transition of all ophthalmology programs to either a joint or integrated program format, we unfortunately are no longer able to consider applicants applying to ophthalmology.

I’m interested in the combined Internal Medicine/Public Health and General Preventive Medicine (IM/PH) Track. What special considerations should I be aware of?

Invited applicants to our combined IM/PH Track will have two separate interview days, one with each residency program. We will interview you on a Categorical Track interview day, and the UCSF Public Health and General Preventive Medicine program will conduct their interview on a separate day. Each interview is scheduled independently with each program.

What is the size of the program?

There are 44 residents and interns in our program plus 2 chief residents. Each intern class has 10 Categorical positions, 2 combined IM/PH positions, and 7 Preliminary positions.

What are some of the strengths of the program?

The program size fosters a close-knit, family-like community and a supportive, safe learning environment. Our “hybrid” program incorporates the best qualities of both university and community-based programs. Residents benefit from a balanced rotation schedule, strong mentorship, and ample opportunities for research. Graduates of our program consistently enjoy remarkable success in finding post-training career opportunities.

How often will I be on call?

We do not have a traditional on-call system. For the wards, we have a system of Admitting and Rounding teams as described below. There is a Night Float system for both Wards and ICU.

Are there ‘caps’ on the number of patients on the medicine wards?

Yes. We have a strict census cap of 14 patients per ward team, or 7 patients per intern. The hospitalist ward team with one attending and one resident has a cap of 12 patients. There is also a limit to the number of new admissions during a 24-hour period: no more than 3 new patients per intern (6 per team) for conventional ward teams, and no more than 3 new admissions for the hospitalist ward team.

Is there a night float system?

Yes. Overnight admissions to ward teams and the ICU are handled by the Night Float resident and Senior Medical ICU Resident, respectively, both with back-up from the in-house hospitalist and ICU attending. Two interns on the Night Float rotation handle overnight cross-cover responsibilities for both wards and ICU patients.

What ancillary services are available to residents?

Kaiser Permanente San Francisco offers 24/7 coverage for phlebotomy, respiratory therapy, radiology services, patient transportation, and clerical support. Residents also benefit from a multidisciplinary team approach, working with pharmacists, medical social workers, patient care coordinators, case managers, and unit assistants.

Why are there separate Admitting and Rounding roles on the inpatient teams?

This system was implemented to simulate more closely the admitting systems typically seen in hospitalist practices and to avoid “boluses” of new admissions in favor of a “slow drip”, round robin distribution of new admissions. This has resulted in an improved educational experience and a more predictable workday on the wards.

Admitting teams evaluate and treat patients at the time of their initial presentation to the ED. In doing so, they hone their clinical reasoning, acute management, and triage skills. Rounding teams are based on the hospital wards and are not called upon to admit patients. This allows them to better focus on their hospitalized patients and experience fewer interruptions to teaching rounds and patient care activities. Rounding teams assume care for newly admitted patients with a warm handoff from the admitting team.

I’m interested in primary care. What can I expect from my continuity clinic experience?

Our goal is to provide residents with an authentic and meaningful primary care experience. Residents are encouraged to grow their own patient panel, and rotation schedules are structured to allow residents to maintain a regular presence in their continuity clinic. Faculty preceptors utilize the Yale Office-Based Medicine Curriculum as a framework to emphasize an evidence-based approach to ambulatory medicine.

Are there opportunities to work with the underserved and vulnerable patient population or in other health care settings?

We serve a local patient population that has tremendous socioeconomic, ethnic, gender, and cultural diversity. Non-Hispanic whites comprise less than half of the population in San Francisco, and nearly half of all households speak a language other than English at home. In addition to our patients with traditional Kaiser insurance, we care for more Medicare patients than any other health system, as well as patients without any health insurance. Housing and food insecurity, substance use disorders, and low health literacy are common challenges for our urban patient population.

We also believe it is important for our residents to experience working in other health care settings. All second-year residents do a two-week rotation in the emergency department at Zuckerberg San Francisco General Hospital, our county safety net hospital. Residents also care for uninsured patients at the Clinic by the Bay during their Ambulatory rotation.

How does the program promote a diverse and inclusive resident culture?

We strive to foster a welcoming and safe work environment where all our residents feel supported and have a sense of belonging. During our recruitment process, we employ anti-bias practices and conduct a holistic review of applicants with a goal of attracting residents from a variety of backgrounds and life experiences. Our residency also participates in outreach efforts with organizations such as the Student National Medical Association and the Latino Medical Student Organization, and are proud to host medical students in the Kaiser Permanente Introduction to Integrated Health Care program.

How is the internal medicine residency program at Kaiser Permanente San Francisco different from the other Northern California Kaiser Permanente internal medicine training programs?

While we share many similarities with our sister programs, here are some unique features of our program:

  • We are a tertiary referral center for various specialty care services, including structural heart disease, pulmonary hypertension, adult congenital heart disease, advanced endoscopy, complex liver disease, inflammatory bowel disease, gastrointestinal and gynecological oncology, transgender care, high-risk obstetrics, hepatobiliary surgery, and cardiac surgery.
  • Our combined Internal Medicine/Public Health and General Preventive Medicine residency program is a joint collaboration with the UCSF Division of Preventive Medicine & Public Health and the UC Berkeley School of Public Health. In contrast to other internal medicine programs that offer an addition year for the MPH degree, our program is a dual, combined residency, and graduates are eligible for dual board certification by both the American Board of Internal Medicine and the American Board of Preventive Medicine.
  • We are home to the Northern California Kaiser Permanente Cardiovascular Disease Fellowship. Our hospital is one of the busiest cardiac care programs in Northern California in terms of volume of percutaneous coronary intervention, cardiac surgery, and transcatheter valve procedures.
  • We are also the site of the Northern California Kaiser Permanente GastroenterologyHematology/Oncology, Nephrology, and HIV Medicine Fellowship programs.

Will I be able to conduct research during my residency?

Residents are encouraged to pursue scholarly activity, including research projects, poster presentation, abstracts, and quality improvement projects. Resident research projects vary from individual projects to collaborative efforts with other residents or staff physicians, and often culminate in presentations at medical society meetings and journal publications.

We have a GME Research Program Manager, Aida Shirazi, PhD, who assists our residents at each phase of a research project, ranging from the development of a research proposal to study design to statistical techniques to the preparation of manuscripts. She also serves as a liaison with the Kaiser Permanente Division of Research, including its researchers, scholars, and Biostatistical Consulting Unit, which provides biostatistician support for residents and fellows conducting research.

What proportion of residents pursue fellowship training, and how successful are they in securing a fellowship position?

Very successful! Historically, approximately half of each class of residents pursue subspecialty training, and they have a long track record of consistently matching into competitive fellowship programs.

What proportion of residents go into primary care or hospital medicine, and how successful are they in finding a job?

Also, very successful! Historically, a quarter of each graduating class goes into primary care and another quarter goes onto a career in hospital medicine. Our residents learn firsthand the many benefits of practicing medicine in a fully integrated healthcare system, and many choose to stay within the Kaiser Permanente system upon graduation.

How successful are our graduates at passing the American Board of Internal Medicine certification exam?

Our three-year rolling program pass rate for the American Board of Internal Medicine certifying examination between 2020-2022 is 100%.

How much time off will I have? How much vacation time do I get?

All residents have at least one day in seven free of clinical duties and required education when averaged over four weeks, and at least eight hours off between all scheduled periods of clinical work and education.

First-year residents have 3 weeks of paid vacation, while second- and third-year residents have 4 weeks of paid vacation. Vacation time is taken during elective rotations. There are also 5 days of educational leave for interns and residents.

Can I afford to live in San Francisco on a resident salary?

Kaiser residents enjoy very competitive salaries and benefits. The residency program pays for resident parking fees, medical licensing fees, and provides a $500 educational stipend for first- and second-year residents, and a $750 stipend for third- and fourth-year residents. There is also a one-time $1000 relocation stipend for new KP residents, an annual wellness stipend of $720 for personal health and wellness, and a $3500 housing stipend per academic year.

How can I maintain my wellness when I’m going to be so busy during residency?

Resident wellness is an integral part of our culture, as we believe that learners cannot realize their full potential unless they attend to their own physical, psychological, and emotional wellbeing. Residents benefit from supportive mentors, responsive program leadership, and a wellness stipend. There is a range of free mental health services available to residents including our Employee Assistance Program and UWill, a service that provides residents free, immediate access to teletherapy. Additionally, there is a Supplemental Medical Plan that provides additional coverage beyond the medical benefits provided by Kaiser Foundation Health Plan coverage.

Outside of work, residents have an abundance of recreational activities in the Bay Area and Northern California to find ways to recharge.

How can I connect with the chief residents or some residents to learn more about the program?

We encourage interested applicants to either contact our 2023-2024 chief residents, Dr. Andrea Lim and Dr. Pradeep Koripella, by email or by phone at (415) 833-3814.
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