Internal Medicine Curriculum
|General Medicine Wards||4.5-5||5||2.5|
|Intensive Care Unit||2||2||2|
|Bakersfield VA Clinic||1|
*Each rotation occurs in a four-week (28-day) block
* Ward call is every four days.
Research and Publications
Residents are required to actively participate in at least one research undertaking to be presented at the Annual Kern Research Forum, and at the Solomon Scholars Meeting every year at the UCLA main campus. Several of these studies have been presented in national meetings and published in major journals.
Internal Medicine Residency Rotations
The Internal Medicine Ward and Inpatient Consultation Rotation occurs at Kern Medical.
There are four ward teams, each made up of a full-time UCLA faculty member in Internal Medicine, a senior house officer (PGY-2 or 3), two interns, and medical students.
Caps for admission is five and 10 patients for interns and senior residents respectively. Residents average around 65 working hours per week, with a mandatory day off.
The patient population is amazingly diverse in terms of pathology and demographics. Residents learn to manage a wide array of cases with an optimal balance of autonomy and supervision. During the rotation, the Medicine residents also work closely with the Medicine subspecialty services, the other specialties, and the ER staff.
The Critical Care Rotation occurs at the Intensive Care and Direct Observation Units of Kern Medical.
The rotation is closely supervised by a full-time UCLA critical care faculty member. Three ICU teams go on call every three days. Teams admit an average of two cases per call.
The rotation allows residents to gain competence in the care of acutely ill patients. Residents learn proficiency in invasive procedures, cardiopulmonary resuscitation, mechanical ventilation, and hemodynamic stabilization. A formal course in medical ethics is also integrated into the curriculum. The rotation is highly structured academically, and provides nationally accredited training in fundamental critical care and advanced life support.
The Ambulatory Care Rotation occurs at the Medicine Subspecialty Clinics of Kern Medical.
The rotation is designed to provide familiarity with outpatient subspecialties, to develop utilization and referral patterns appropriate to subspecialists, and to learn the preventive health care measures of each subspecialty.
Aside from the Pulmonary, Cardiology, Gastroenterology, Infectious Disease, Nephrology, Endocrinology, Oncology and Neurology clinics (see specific subspecialty rotation description), the department also conducts the Coccidioidomycosis, Hepatology, HIV/Immunology and Rheumatology clinics.
The Cocci Clinic was established by the late Dr. Hans Einstein and is now headed by our Chair of Medicine, Dr. Royce Johnson, the world’s foremost authority on Valley Fever.
The Cardiology Rotation occurs at the inpatient care units and Cardiology Clinic of Kern Medical, supervised by a full-time UCLA Cardiology faculty member.
Residents also rotate at the private practices of UCLA-affiliated cardiologists, where residents see patients and procedures at the private clinics and hospitals (Bakersfield Heart Hospital, Bakersfield Memorial, and Mercy Hospital). The rotation provides opportunities for the resident to become familiar with a broad spectrum of cardiovascular diseases.
Residents gain proficiency in interpreting electrocardiograms, echocardiograms, and stress tests. Residents regularly observe procedures at the Cardiac Diagnostic Lab and at the Cardiac Catheterization Suites of Kern Medical and the other medical facilities.
The Geriatrics Rotation occurs at the UCLA-VA Nursing Home Care Unit at the Sepulveda campus.
The rotation is supervised by full-time UCLA faculty in geriatric medicine and geriatric psychiatry. The residents work closely with UCLA geriatric and geriatric psychiatry fellows as well as internal medicine residents from the other UCLA-affiliated programs. Residents are taught the medical and psychosocial aspects of care of geriatric and institutionalized patients.
The resident becomes part of the interdisciplinary team, which includes physicians, nurse practitioners, nurses, pharmacists, social workers, kinesiotherapists, occupational therapists, nutritionists, and recreational therapists. The scope of care includes skilled nursing care, short-term care, rehabilitation, palliative care, and respite. Rotators also learn to manage decubitus ulcers and skin lesions during wound rounds conducted by the Dermatology Service.
Residents are housed in a UCLA-Kern Medical apartment (two bedrooms, fully furnished) at the Westwood campus. They work office hours on weekdays and have weekends off.
The Nightfloat Rotation occurs at the inpatient care units of Kern Medical.
The nightfloat resident, under supervision by an on-call UCLA faculty member, works independently to see consults and admit patients overnight. Working in this fashion permits residents to develop important skills that will be used later in the practice of medicine, including the ability to triage and recognize limitations. They will develop interpersonal communication skills, maximizing information exchange with patients, fellow residents and attending physicians.
During the rotation, the resident develops skills in system-based practice, using a variety of hospital resources to provide optimal patient care. The nighfloat resident works five nights a week (Sunday to Thursday).
Residents get the opportunity to do at least two Medicine subspecialty rotations of their choice at the other UCLA-affiliated campuses in Los Angeles.
Any rotation (subject to availability) can be selected, although most residents prefer rheumatology, endocrinology, cardiology, nephrology, gastroenterology, and hematology-oncology. Most residents elect to rotate in Olive View and Harbor-UCLA.
During the rotation, residents are housed in a UCLA-Kern Medical apartment (two bedrooms, fully furnished) at the Westwood campus. They work office hours on weekdays and have weekends off.
The Bakersfield VA Clinic Rotation occurs at the local outpatient care facility of the Veterans Affairs Greater Los Angeles Healthcare System.
Residents are supervised by UCLA-affiliated faculty in internal medicine. In addition to developing well-rounded competence in ambulatory medicine and preventive care, the resident also gains experience in health care issues specific to the veteran population that affords unique challenges in diagnosis and management.
Residents work office hours on weekdays and have weekends off.
The Emergency Medicine Rotation occurs at the Kern Medical Emergency Department, the only Level II Trauma between Los Angeles and Fresno.
The residents are directly supervised by full-time emergency medicine faculty. The resident is exposed to a wide range of medical-surgical problems across all age groups in the ER and urgent care settings.
Residents also develop procedural skills unique to the acute care setting. During the entire rotation, residents work a total of 14 eight-hour shifts.
The Gastroenterology Rotation with Dr. Ishaan Kalha gives residents the opportunity to see a variety of pathologies in both acute inpatient consults and outpatient clinics. Residents are exposed to procedures including colonoscopy, EGD and ERCP. With a wide variety of pathology, residents have the opportunity in managing chronic conditions such as cirrhosis from diagnosis to transplant medicine.
The Infectious Disease Rotation occurs at the inpatient care units, as well as at the ID, Cocci, Hepatology and HIV/Immunology Clinics of Kern Medical.
The rotation is supervised by a full-time UCLA Infectious Diseases faculty member. Most of the educational experience is derived from inpatient consultations and from the cases seen in the four clinics, each conducted a half-day per week. The rotation provides a concentrated experience in managing patients with bacterial, viral and fungal infections, coccidioidomycosis, HIV, Hepatitis C, parasitic infections, and tuberculosis.
Residents also gain proficiency in preparing gram stains, AFB smears and cultures at the twice-weekly sessions in the Microbiology Laboratory. Residents work weekdays and have weekends off.
The Nephrology Rotation occurs at the inpatient care units and the Renal Clinic of Kern Medical.
The rotation is supervised by part-time visiting UCLA faculty in nephrology. Most of the educational experience is derived from inpatient consultations, and from cases seen in the Renal Clinic conducted a half-day per week. The rotation provides a concentrated experience in managing patients with disorders of renal function and the urinary tract.
Exposure to inpatient hemodialysis occurs at Kern Medical, while experience in chronic outpatient dialysis comes from weekly visits to the Bakersfield Dialysis Center, a private facility. Residents work weekdays and have weekends off.
The Neurology Rotation occurs at the inpatient care units and the Neurology Clinic of Kern Medical.
The rotation is supervised by part-time visiting UCLA Neurology faculty. Most of the educational experience is derived from inpatient consultations, and from cases seen in the Neurology Clinic conducted a half -day per week. The rotation provides a concentrated experience in managing patients with neurologic disorders.
Residents also regularly observe procedures at the Neurodiagnostic Laboratory of Kern Medical, and learn basic skills in interpreting electroencephalograms, electromyelograms, nerve conduction studies, and neuro-imaging modalities. Residents work weekdays and have weekends off.