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Internal Medicine Residency Training Program - Clinical Training
There are five inpatient services that residents will rotate on at Cedars-Sinai Medical Center:
- General medicine wards
- Cardiology / Heart Failure ward
- Medical intensive care unit
- Cardiac Intensive Care unit
- Consultation services
There are three inpatient services residents will rotate on at the West Los Angeles VA:
In general, each of these services has a team of house staff, which includes a second- or third-year resident, one to three first-year residents and, frequently, a fellow and a junior or senior medical student.
There are daily morning report sessions on all of these services during the week, and attending rounds from five to seven times a week.
This service admits a wide variety of patients with medical problems that range from the common to the esoteric. The majority of patients are uninsured or have Medi-cal and have no primary care physician. Attending rounds occur daily with a full-time faculty member.
This 32 bed unit serves as a step down unit for monitoring of patients with advanced heart failure who do not require intensive care. Patients admitted to this unit may be pre-cardiac transplant, or post-transplant with non-surgical issues, as well as non-transplant candidates with advanced heart failure. The medical team consists of two Interns and three Residents, as well as a combination of general Cardiology Fellows and advanced Heart Failure Fellows. Rounds with as attending specializing in Heart Failure occur daily.
This is an approximately 12-bed unit in the new Saperstein Critical Care Tower which is staffed by housestaff in the form of two day teams and two night teams. Critical care fellows and full-time attendings who are board certified in critical care medicine round on every patient in the ICU daily. Morning didactic sessions supplement the bedside teaching on this rotation. Acute management of medical emergencies, including drug overdoses, sepsis, GI bleeding, hepatic failure, CNS bleeding and stroke are but a few of the issues discussed during these didactic sessions.
Housed in the new, state-of-the art Saperstein Intensive Care Tower, this 12-bed intensive care unit admits patients with a variety of medical conditions. Both full-time faculty and private attending staff consult on the management of patients in this unit. Rounds with both a fellow and a full-time member of the Division of Cardiology occur every day. Responsible attending staff sees patients at least once a day. Patients are admitted for the management of acute myocardial infarction, decompensated heart failure, unstable valvular disease as well as a variety of other acute cardiac illnesses.
All internal medicine subspecialty services have residents and fellows performing subspecialty consultations on both hospitalized and ambulatory patients.
Our consultation services include:
- Infectious Diseases
- Medicine Consultation
- Palliative Care
Each of these subspecialty rotations differs slightly in its structure, but all include formal didactic sessions and a defined educational curriculum. Teaching attending rounds occur on all these services two to five times a week. Individual teaching sessions with the subspecialty fellows occur more frequently. Both fellows and attendings are available daily for patient care issues.
This service admits patients with a wide variety of bread and butter medical problems. All patients are admitted to the teaching service, which is led by a full-time faculty member. Other important members of the multidisciplinary team include a case manager, social worker, clinical dietitian and clinical pharmacist.
This service provides a multi-disciplinary approach to the care of Geriatric inpatients. Led by Board certified attendings and Fellows, the service allows Residents to care for symptoms and diagnoses that maybe specific to this patient population.
Continuity Ambulatory Experience
Categorical residents will have a continuity clinic where they will see patients in a one week block that occurs at the end of every four week rotation (4+1 model). Residents will be able to choose to do their continuity experience at one of four different sites, allowing them to pick a site that most closely aligns with their career interests.
- Cedars-Sinai's Ambulatory Care Center- At the Cedars-Sinai Ambulatory Care Center, residents manage a predominantly poor, immigrant patient population in a traditional hospital-based ambulatory setting.
- Cedars-Sinai Medical Group- At the Cedars-Sinai Medical Group, residents work with primary care physicians and care for mostly middle-class patients in a managed care practice.
- The Saban Community Clinic- At The Saban Community Clinic (formerly named the Saban Free Clinic and the Los Angeles Free Clinic) residents care for indigent patients through a public-private program supported by federal and local resources.
- Sepulveda VA- At the Sepulveda VA, residents will provide primary care to patients through the VA healthcare system, the largest integrated healthcare system in the United States.
Other Ambulatory Experiences
There are multiple other ambulatory experiences that residents may do on a two to four week block basis. In addition to doing continuity at their own site, residents will have the ability to work at the other continuity sites doing both ambulatory care and ambulatory subspeciality clinics. Residents also have the opportunity to work at the Vencie Family Clinic, Clinica Oscar Romero, or the Los Angeles Mission, where they work with a poor and underserved patient population.