Curriculum

Morning Report 

At VA Long Beach, Morning Report is held three times per week (Tuesday, Wednesday and Friday). These encompass a variety of interactive sessions, including case-based traditional morning reports facilitated by our chief residents and VA chair of medicine, multidisciplinary Morbidity & Mortality review, and chief resident-led interactive learning activities. The goal is to help develop our residents’ diagnostic thought processes and clinical reasoning through dedicated educational time.

Noon Conference

Noon Conferences are held daily on weekdays at both UCI Medical Center and VA Long Beach, with a streaming option for those who are offsite. These include a fundamentals series on core curriculum topics, subspecialty lectures, Journal Club sessions, Morbidity & Mortality, Department of Medicine Grand Rounds, ambulatory case conferences focused on cases specifically related to primary care practice and a weekly “Crack the Case” session, where a resident presents a case and two attendings unfamiliar with the outcome discuss their clinical reasoning as they attempt to search for the ultimate diagnosis. 

Core Conference (aka “MoonGoat Monday”)

On Monday mornings, Y week residents start their ambulatory week with a case-based discussion at a local café. Faculty prerecord short lectures on high-yield internal medicine topics, which residents are encouraged to watch during the week. Residents work together in small groups to answer questions specific to the three videos and topics assigned per conference.

Friday Morning Academy 

On Friday mornings, all residents on their ambulatory Y week attend a three-hour dedicated didactic session over Zoom. The first segment includes lectures and discussions with interdisciplinary staff, including pharmacy, social work, case management, and physical/occupational/speech therapy over advancements in their department and their role in patient care. This is followed by a lecture from a subspecialty faculty member in their area of expertise. Afterward, residents complete Medical Knowledge Self-Assessment questions during a board review session to apply their knowledge from the subspecialty lecture and the discussion from the core conference on Monday.

Doctoring Skills Rotation (DSR)

Monday afternoons of the ambulatory Y week are dedicated to an in-person curriculum focused on fundamental aspects to becoming a competent and compassionate physician.

These include sessions on: 

• Point-of-care ultrasound 
• Simulation Training 
• Implicit Bias Training 
• VitalTalk – communicating serious illnesses 
• Student Teachers and Resident Scholars (STARS)  
• Culinary Medicine 
• Quality Improvement  
• Business in Medicine 

DEI Curriculum

Diversity, equity and inclusion are a core component of our curriculum and are infused throughout all three years of the program. 

• PGY-1: Intern orientation includes a “Welcome to OC” session about caring for the diverse patient populations in the areas we serve. First-year doctoring skills rotations cover diversity, equity, inclusion and structural inequities and include tours of skilled nursing facilities.
• PGY-2: The yearly R1-R2 retreat has a bystander intervention training, and the doctoring skills rotation includes a 3-part implicit bias training series. 
• PGY-3: Doctoring skills rotations during the third year of the program include an opportunity to volunteer for a summer outreach program with high school students from backgrounds underrepresented in medicine.
• Throughout the program, didactic offerings cover topics like health equity, social determinants of health, racism in medicine, the care of incarcerated patients and LGBTQ+ health.

Our program operates with a three-site model: university, private community and VA. The majority of our inpatient time is spent at UCI Medical Center, our university hospital. The campus was previously the local county hospital until it was bought by UCI School of Medicine in 1976. Since then, UCI Medical Center has served as the local safety net hospital. At this location, we cover eight ward teams with one medicine consult service, two medical ICU teams and one cardiac care unit team. We also rotate at VA Long Beach, where we staff four inpatient general medicine teams, and at Long Beach Memorial Hospital, where we staff a teaching ICU service. Subspecialty experiences are spread over all three sites, allowing our residents to see how medicine is practiced in different models. All of our UCI and LBM inpatient services are night float-based, and night coverage at the VA is provided by a private nocturnist group. The only 24-hour call shifts in our program are to cover the ICU when the day- and night-shift senior residents have their day off — a total of about three to six shifts in the PGY-2 and PGY-3 year.

Our schedule is based on an X+Y model, with three weeks of inpatient or elective time separated by one week of ambulatory time. During the ambulatory Y week, our residents rotate between primary care continuity clinic and subspecialty clinic experiences. 

Primary Care Experience

• Prior to starting the intern year, residents are assigned to continuity clinics at either UCI Medical Center or VA Long Beach and are matched with a faculty attending who will act as their outpatient mentor through all three years of residency. At the VA, residents are assigned their own patient panel and work in an interdisciplinary patient-aligned care team (PACT), which includes the physician, case manager, clerk, RN and pharmacist. At UCI, residents see patients as part of their faculty mentor’s panel. Residents develop strong outpatient skills as a result of the diversity of backgrounds and high medical complexity of these patients, as well as the strong longitudinal relationship they build with their clinic mentor.

Subspecialty Clinics Experiences

• During the intern year, residents are assigned to rotate through a core set of subspecialty clinics to expose them to subspecialties important to producing well-rounded internists. During subsequent years, residents are allowed to request certain subspecialties or clinic experiences (including pulmonary, cardiology, gastroenterology, rheumatology, allergy/immunology, women’s health, preoperative medicine, etc.) to gain further insight into select fields and develop a longitudinal relationship with faculty in their selected subspecialties.

We offer a wealth of opportunities to our residents during their elective time. Residents are encouraged to rotate through a wide array of experiences, including many outside the Department of Medicine. Special electives are available by arrangement on an individual basis, as are externships and international rotations.

Schedules

Our schedule consists of a 3+1 rotation model, with three weeks of inpatient or elective, followed by one week of ambulatory experience. During the ambulatory weeks, residents have:

• Three half-days dedicated to didactics.
• One half-day of admin time to respond to clinic messages and labs or complete other tasks.
• Six half-days of clinic time.
• A golden weekend!

The year consists of 13 three-week rotations, along with 13 one-week ambulatory blocks.

Each year, residents have the following required electives:

• PGY-1: VA Emergency Department, UCI palliative medicine
• PGY-2: Long Beach Memorial hematology/oncology, Long Beach Memorial neurology
• PGY-3: VA geriatrics

For more details, please see our sample schedule.

Example Ambulatory Y Week

• Monday: Coffee Shop Cases and doctoring skills
• Tuesday-Thursday: Primary care or subspecialty
• Friday: Virtual Academy and admin half-day
• Saturday-Sunday: Golden weekend

Research and Mentorship

At UCI, we value the role that mentors, coaches and educators play in the daily lives of residents. Recognizing that the transition to residency is a difficult one, we assign residents to faculty and chief resident mentors from the beginning.

Every categorical resident is paired with a primary care attending, who serves formally as their faculty mentor for all three years of residency. Residents meet every eight weeks throughout the academic year with their mentors for faculty development and a review of each resident’s progress.

In addition, numerous subspecialty and research mentors are available for career and fellowship development. Our chief residents also serve in mentorship and coaching roles, with a chief resident assigned to every cohort of residents.

The Department of Medicine has more than 300 research protocols that represent the entire spectrum of medicine, including basic science, clinical trials, healthcare policy and outcomes, and translational medicine. Our principal investigators hold nearly $40 million in awards, including prestigious National Institutes of Health and other federally funded grants.  

Our residents routinely have the opportunity to participate in cutting-edge research with our 11 subspecialty divisions. Every year our residents are successful in first- and second-author publications, national conference presentations and regional research competitions. 

Residents have the opportunity to use elective time for dedicated three-week research blocks. We also host an annual research day to give residents the opportunity to showcase their work in a poster presentation session, as well as oral presentations during the Department of Medicine Grand Rounds.

The American Board of Internal Medicine (ABIM) Research Pathway is an integrated program combining training in research and clinical internal medicine. This pathway is appropriate for physicians who intend to pursue a career substantially based in basic or clinical research.

Our program sponsors residents in the ABIM Research Pathway. We strongly encourage individuals interested in either clinical or basic research careers to consider our program for their clinical and research experience. The Research Pathway allows trainees to accelerate their clinical training in return for a commitment to research time and productivity under the supervision of a faculty mentor.

On this track, the candidate can obtain board eligibility for general internal medicine, as well as a subspecialty of medicine. The minimum requirement for full-time clinical subspecialty training for certification through the Research Pathway varies by discipline and is 24 months in general internal medicine (rather than 36 months), followed by:

• 12 months in allergy and immunology, critical care medicine, diabetes and metabolism, geriatric medicine, hematology, infectious disease, nephrology, medical oncology, pulmonary disease or rheumatology.
• 18 months in gastroenterology, hematology/oncology, pulmonary/critical care, rheumatology/allergy and immunology.
• 24 months in cardiology.

After completion of the appropriate clinical curriculum, the trainee enters the research period for three years, with 80% of their time spent in research and 20% in clinical activities. Candidates must be qualified both clinically and academically to be considered for the pathway. Evidence of commitment to an academic career is also required. Candidates should already have obtained a PhD or other advanced degree.

All applicants must apply to the Categorical Program via ERAS. Candidacy for this pathway will be determined during your intern year.

For more information regarding the ABIM Research Pathway, please visit ABIM.org.