Alameda County Medical Center, Highland CampusOakland, California Residency Training In Internal MedicineThe residency program in Internal Medicine at Highland General Hospital offers an excellent opportunity for integrated three-year clinical training. The Medical service has an average daily census of seventy patients, the majority of which enter the hospital through the Emergency Department. A smaller number are admitted through our clinics. The average length of stay is short, and patient turnover is high due to the acuity and severity of these illnesses. The range of clinical conditions encountered at Highland General Hospital is broad and far more diverse than that of most hospitals: the underprivileged and impoverished present the medical problems so often found in these groups. The ethnic and social diversity of the East Bay brings to the hospital many patients with uncommon medical and psychosocial problems, urgently in need of care and assistance. Highland General Hospital serves these people and in so doing, provides its staff of resident physicians with an unusual opportunity for graduate medical training. The clinical instruction in the Department of Internal Medicine is provided by a faculty of general internists and subspecialists who hold full-time positions at the hospital. All faculty physicians are board-certified and hold clinical appointments at the University of California-San Francisco. Daily work rounds and patient teaching rounds are made with the housestaff. Beginning in 1992, an affiliation between Highland and the Kaiser Permanente medical system has given our residents increased opportunities and patient exposure. Rotations at Kaiser-Martinez for Ambulatory Care have broadened their experience, as well as given them exposure to an HMO-type delivery system. We are confident that this affiliation will continue to expand in the future. In 1998, we began rotating Residents to California-Pacific Medical Center in San Francisco for an intensive four week experience in Critical Care Medicine. This rotation has proven to be educational and exciting and has added greatly to the program. Housestaff accepted into the three-year program will be reappointed based on satisfactory performance. There are positions for all who wish to continue and who perform in a satisfactory manner. Medical students are present on all services; requests for such rotations are welcomed, but available slots fill up quickly. Three tracks are available for applicants of Internal Medicine: Preliminary Medicine Internship (C-15), Categorical Medicine Internship (C-16) and Primary Care Medicine Internship (C-17). In addition to these inpatient duties, every intern and resident is assigned to the General Medical Clinic for one half day each week throughout the year. The resident sees follow-up patients discharged from the hospital and new referrals to the clinic. Gradually, the resident accumulates a group of patients in the clinic who remain with the resident for the duration of his stay at Highland General Hospital. Block rotations in Ambulatory Care occur in PGY-II and III. Internships-PG-I All interns in the program are expected to assume primary patient responsibility assisted by residents and attending physicians. The patient load varies among the services but is generally between 8 and 12 per intern. Typically, one or two interns work with one resident, and one attending. The training "year" is divided into 13 four-week months resulting in 12 clinical rotations plus a month for vacation. Interns in the Primary Care Division are scheduled for 3 months of each year on the Primary Care Service with activities in the Outpatient Clinics. First-Year Medical Resident-PG-II First-year medical residents are assigned to the adult medical wards of Highland General Hospital for part of the year and take subspecialty elective rotations for the majority of the year. There are no subspecialty wards at Highland-all patients admitted to the hospital medical service are cared for on the general medical wards. While on the ward rotation, the resident will work with two interns and two medical students. Each such team usually cares for 15-20 patients. Night call is every fifth night. A system utilizing a "night float" is in place. Attending rounds are made every day, and attending physicians are available at all times for consultation. Subspecialty rotations in the PG-II year include: Cardiology, Ambulatory Care, Neurology, Pulmonary, and Gastroenterology. One of the strengths of the Highland residency is that senior subspecialists are in close and daily contact with the housestaff to provide consultations, teaching, and guidance on the management of difficult problems. Second-Year Medical Resident-PG-III The second year of medical residency is the continuation of the PG-II year with additional months spent on general ward rotations and with completion of additional medical subspecialty rotations-hematology, oncology, consults, infectious disease, etc. Third-Year Medical Resident-PG-IV Three Residents remain for a final, fourth year of training during which they serve as Chief resident, performing the traditional duties of that position-administration (scheduling and planning conferences), liaison with the chief of the department, consultants to other departments, serving as junior faculty, etc. Primary Care Training Program The Primary Care Division of the Internal Medicine Department at Highland General Hospital offers a three-year training program designed to teach general internists skill in both ambulatory and hospital care. It is the aim of this program to train competent and compassionate physicians who will practice in medically underserved areas. The Primary Care Program includes three to four months yearly of rotations in ambulatory medicine. The remainder of the year is spent in ward medicine and subspecialty training similar to the traditional internal medicine tract. The objective of the program is to enhance Highland's excellent training experience in intensive, acute illness with teaching in non-internal medicine specialties, behavioral science, preventive health care, and cultural awareness and sensitivity. The Primary Care curriculum includes a yearly didactic rotation with teaching in behavioral science, ambulatory medical practice, multicultural medicine, bioethics, clinical preventive medicine, medical decision making and research methods. Additionally, during the first year of training Primary Care interns spend rotations developing skills in gynecology, office ENT, dermatology, radiology, laboratory medicine and ophthalmology. During the second two years of training the primary care rotations include substance abuse training, geriatrics, HIV care, endocrinology, community practice and elective time. Second and third year residents also have two weekly continuity clinics: one at the Highland General Medical Clinic and the second at a community primary care site. The community clinics provide a rich experience in multicultural community-based medicine. The curriculum also includes a behavioral science practicum in which housestaff work with our staff psychiatrist, to develop interviewing skills, to learn the diagnosis and treatment of mental illness, and to become trained in the case management model of primary care. The geriatrics program includes work in the Highland Geriatric Evaluation Clinic, the local community geriatric primary care clinic, supervised home visits, conferences, and objective-based materials. The computer project offers training in literature searches, database, use of diagnostic tutorials, and assistance in independent research. Time is allotted for independent study projects during the Primary Care rotations. Didactic sessions include behavioral science conferences, weekly ambulatory medicine conferences, and multidisciplinary case conferences. The three-year program fulfills the requirements for Internal Medicine Board eligibility. Applications We accept applications from all LCME accredited U.S. medical schools and osteopathic schools. International applicants must posses and authorization letter from the California Medical Board, have satisfactory USMLE scores, be fluent in the English language, and be a U.S. citizen or Permanent Resident.
Applications for PG-II positions are welcomed. Interviews will be scheduled after receipt of completed applications and are by appointment only. Internal Medicine Residency Training Program Faculty Theodore G. Rose, Jr., M.D., FACP Stephen D. Yee, M.D. Colin M. Feeney, M.D., FACP Steven Sackrin, M.D. Kathleen Clanon, M.D., FACP Sonia Levingston, M.D. Robbin Green-Yeh, D.O. Cardiology Division: Walter S. Stullman, M.D. Garwood Gee, M.D., FACC Thoracic Medicine Division: Jamie Bigelow, M.D. Gastroenterology Division: Michael Silpa, M.D. Ralph Bernstein, M.D. Bob Narayan, M.D. Juergen Mueller, M.D. Infectious Disease Division: Robert McCabe, M.D. Valerie Chirurqi, M.D. Primary Care Medicine Division: Judith H. Wofsy, M.D. Linda Engelstad, M.D. Lyn Berry, M.D. Jim Mittelberger, M.D., FACP Sharone Abramowitz, M.D. Nephrology Division: Mario Corona, M.D., Chief Swati Patel, M.D. Dermatology: Elizabeth Reed, M.D., Chief Neurology: Claudine Dutavet, M.S. Twenty Questions about the Medicine Residency at the Alameda County Medical Center and Kaiser Hospitals
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