Curriculum
Chart |
Clinical Sites - Description of rotations |
A Statement of Resident
Duty Hours
Description of sites
UCLA Medical Center
Since opening its doors in 1955, UCLA Medical Center has consistently been
a healthcare innovator. Known worldwide for its pioneering technological
contributions, including advancements in organ transplantation, artificial
insemination and ultrasound, UCLA Medical Center year after year is ranked
number one in the West by U.S. News and World Report’s annual survey of
"America's Best Hospitals."
More
than 300,000 people from Los Angeles, from across the country, and from
around the world come to UCLA Medical Center each year to receive care
from some of the world’s best healthcare providers. More than 120 of our
physicians are cited in The Best Doctors in America, which is based
on an extensive poll of thousands of medical specialists.
The
collaboration of patient care, medical education and scientific research
form the foundation of UCLA Medical Center. Each part of the triad
enhances and enriches the other so that patients receive compassionate
care based on the latest medical knowledge.
UCLA
Medical Center, with more than 600 beds, offers patients of all ages
comprehensive care, from routine to highly specialized medical and
surgical treatment. Some factors that contribute to our top rankings are
specialized intensive care units, state-of-the-art inpatient and
outpatient operating suites, a Level-1 trauma center, the latest
diagnostic technology, and a high level of commitment from our dedicated
and experienced staff of over 1,000 physicians and 3,500 nurses,
therapists, technologists and support personnel.
Noted for the scope and quality of our specialty and subspecialty care,
UCLA offers the same level of expertise in the primary care areas of
internal medicine, family medicine and pediatrics.
Mattel Children’s Hospital
at UCLA, located within the Medical Center, offers
complete well-child care, plus a full range of specialty health services
for children from birth through adolescence. Mattel Children’s Hospital at
UCLA includes a 120-bed inpatient unit as well as comprehensive outpatient
care programs.
UCLA
Medical Center is a highly acclaimed training site for physicians, many of
whom choose to stay on as clinicians, teachers and researchers. Academic
medical centers, such as UCLA, are the backbone of innovation in American
medicine because they develop the knowledge that results in new
life-saving drugs, medical devices and surgical procedures that improve
the quality of healthcare, and move these innovations to the bedside.
UCLA—Santa Monica
Medical Center
Santa Monica-UCLA
Medical Center is a 337-bed, nonprofit hospital dedicated to meeting the
healthcare needs of the Westside of Los Angeles. Founded as a 60-bed
hospital in 1926, the medical center has changed dramatically over the
years in response to the changing needs of the community. Today, the
medical center features several nationally recognized clinical programs
located within its seven-acre medical campus. A staff of highly skilled
physicians works together with the medical center's nurses, technologists
and other specially trained health professionals to provide high-quality,
cost-effective patient care.
In 1995, Santa Monica
Hospital Medical Center was acquired by the University of California Board
of Regents and renamed "Santa Monica-UCLA Medical Center." The hospital
now serves as a cornerstone of UCLA Healthcare and provides both primary
and specialty care.
In 1998, UCLA
Healthcare signed a strategic alliance with Orthopaedic Hospital/Los
Angeles that will result in the relocation of Orthopaedic’s inpatient
services to Santa Monica when the replacement Santa Monica-UCLA Medical
Center is completed in 2005.
Olive View Medical
Center
Olive View-UCLA
Medical Center is set at the foothills of the San Gabriel mountains in the
northeast San Fernando Valley. This hospital is one of six operated by
the Los Angeles County Department of Health Services. It is a general
acute care teaching hospital which serves more than one and one-half
million residents of the San Fernando Valley and adjacent north Los
Angeles County areas. The hospital began operations in the new facility
May 1987 with a 350 bed capacity. Olive View-UCLA Medical Center is a
teaching hospital which provides residency training programs affiliated
with UCLA.
Harbor-UCLA Medical
Center
Los Angeles
County Harbor-UCLA Medical Center is a major teaching hospital providing
care for the underserved population in southern Los Angeles County. The
professional and educational components of the hospital, including its 32
accredited residency programs, are managed through an agreement with the
David Geffen School of Medicine at UCLA. The 271 full-time faculty members
as well as many of the 700 voluntary professional staff hold academic
appointments in the medical school. Medical students have 3rd and 4th year
clerkships in the hospital and clinics. The 72-acre campus is located in
the South Bay area of metropolitan Los Angeles about 15 minutes from the
beach. The 8-story acute care hospital has 553 beds and 63 bassinets. It
is a Level 1 Trauma Center, and it has an NIH-funded General Clinical
Research Center. A 52,000 square foot Primary Care and
Diagnostic
Center is an addition to the main hospital
building. The Harbor-UCLA Research and Education Institute, with an annual
budget over 50 million dollars, provides extensive laboratory and
administrative facilities for faculty investigators.
West Los Angeles
Veterans Administration Hospital
The West Los Angeles Healthcare
Center strives for excellence in patient care, research, and education. It
provides a full spectrum of primary and tertiary inpatient and ambulatory
care (acute, sub-acute, rehabilitation, extended care, mental health
services, and home healthcare) to over one-million veterans residing in
the primary service area of Los Angeles County, which has the largest
concentration of veterans of any county in the United States. The
comprehensive diagnostic and treatment services provided include a broad
range of medical, surgical, and psychiatric care. The Internal Medicine
subspecialties include cardiology, infectious diseases, gastroenterology,
pulmonology, nephrology, endocrinology, rheumatology, allergy, and
hematology/oncology. Major surgical subspecialties include orthopedics,
urology, neurosurgery, ophthalmology, plastics, ENT, podiatry, and cardiac
surgery.
To complete the continuum of care,
numerous geriatric and extended care services are offered. In addition to
the Post-Acute care inpatient unit, there are two 120 bed nursing home
care units located on the grounds and an active community nursing home
program.
The Healthcare Center operates a
321 bed domiciliary that provides medical care in a therapeutic
institutional environment to prepare veterans for re-entry into a
community setting.
Venice Family Clinic
Founded in 1970, the Venice Family
Clinic has grown from a small storefront operation into the largest free
clinic in the country based on the number of patients and volunteers.
Currently, approximately 1,900 individuals -- including 500 physicians --
donate their time, valued at more than $1 million annually. Specialty
services, medications and supplies are made available through the
generosity of Clinic partners, which include hospitals, laboratories,
specialty care providers and pharmaceutical companies, who donate
approximately $4 million in products and services each year.
The Clinic currently provides a
medical home for 18,500 low-income men, women, children, teens and seniors
who lack health insurance or sufficient access to medical care. These
patients live in Venice, Santa Monica, Palms, Mar Vista, Inglewood, Culver
City and other areas throughout the Westside of Los Angeles County, and
have income at or below 200% of federal poverty guidelines.
Description
of rotations
Medicine
Inpatient Wards
The inpatient
wards are the hallmark of training in internal medicine—where residents
learn to diagnose and manage the wide spectrum of illnesses in adult
patients. UCLA med-peds residents have the opportunity to manage adult
patients on the inpatient wards at UCLA Medical Center, Harbor-UCLA
Medical Center, Olive View Medical Center, West Los Angeles VA Hospital,
and UCLA-Santa Monica Medical Center. The combined breadth and depth of
experiences at these institutions give residents a database of knowledge
and skills from which to draw upon.
The inpatient
wards at UCLA Medical Center house patients with varied diagnoses, from
illnesses as common as community-acquired pneumonia to much more rare
diseases. Medicine residents at UCLA have the opportunity to manage
illnesses that others only read about. The residents are supervised by
a top-rate faculty and have the resources of a number of sub-specialty
experts, many of whom are conducting cutting edge research in their
fields.
At
Harbor-UCLA and Olive View, two of the county hospitals in Los Angeles,
residents manage patients with common community illnesses. Residents
also gain an appreciation for the issues facing the underserved
populations of Los Angeles, mainly immigrant populations and persons
living in poverty or near-poverty with little or no access to health
care. These experiences combine the medical management disease with the
psychosocial and cultural aspects of caring for people with illness.
The West Los
Angeles VA Hospital is part of the network of VA hospitals in the
greater Los Angeles area, which together comprise the largest VA
facility in the country. UCLA medicine and med-peds residents have the
ability not only to care for illnesses common to the veteran population,
but they also have the opportunity to gain an understanding of the VA
model of health service delivery and coverage of services. The UCLA
division of General Internal Medicine/Health Services Research conducts
a substantial amount of health services research in the VA system.
Finally, in
the senior year of residency, UCLA medicine and med-peds residents have
an opportunity to participate in a hospitalist service at the UCLA-Santa
Monica Medical Center, which is primarily a community-based hospital for
Santa Monica and West Los Angeles. This service exposes residents to
the growing field of hospitalist, or inpatient-based medicine.
Residents gain an understanding of community-acquired illnesses for a
primarily middle class population, as well as the communication and
interactions between the hospital-based physician and the patient’s
primary care, community-based physician.
Intensive Care Units
Intensive
care units are traditionally the most demanding rotations of residency
but often are also the setting in which residents learn the most about
medical management. While the volume of patients is substantially less
than on the wards, the cases are far more complex and stimulate
residents to think more broadly about the effects of a disease or
illness on multiple organ systems. Supervised by fellows and faculty
attendings, residents learn about ventilator management, use of pressors
and other advanced pharmacotherapeutics, and other therapies for serious
illnesses. UCLA medicine and med-peds residents rotate through both the
Medical Intensive Care Unit and the Coronary Care Unit at UCLA Medical
Center.
Emergency Medicine
The Emergency
Medicine Center (EMC) at UCLA is a comprehensive emergency facility
staffed to provide 24-hour response to the emergency care needs of the
community. The EMC is prepared to care for critically ill or injured
patients as well as those with minor illnesses or injuries. Through the
EMC, consultation with UCLA's specialty services can be obtained on an
emergency basis. UCLA Medical Center is a Level 1 Trauma Center and a
Pediatric Critical Care Center.
Residents
rotating through the EMC for internal medicine primarily manage the
patients with more serious medical illnesses who are likely to be
admitted to the inpatient wards or intensive care units. In addition,
they have the opportunity to be the first physician to evaluate patients
and make initial diagnoses and therapeutic plans under the supervision
of the emergency department attending physician.
Geriatrics
UCLA has been
the premier site in the country for geriatrics patient care and clinical
training for more than a dozen years. As the elderly population grows
in the U.S., the number of geriatrics patients with multiple chronic
illnesses is increasing as well. Thus, geriatrics training is a crucial
educational component for the well-trained internist. All senior
residents spend one month on an inpatient geriatric service at
UCLA-Santa Monica Hospital providing acute inpatient care to older
adults.
Ambulatory Electives
Ambulatory
electives are arranged in 8-week blocks and allow for greater depth of
experiences and study into a particular subspecialty. In addition to
participating in subspecialty clinics, residents also perform
subspecialty consults on hospitalized patients in conjunction with the
subspecialty fellows and attendings. For med-peds residents, the option
of 4-week ambulatory blocks in order to allow for a greater variety of
subspecialty experiences is available.
Pediatrics
Inpatient Wards
The inpatient
wards at the Mattel Children’s Hospital house a number of children with
illnesses ranging from asthma exacerbations to complex congenital heart
disease and a variety of other subspecialty issues. Pediatric and Med-Peds
residents at UCLA learn to diagnose and manage these common and rarer
pediatric illnesses, in conjunction with fellows and attendings. The
patient population at the Mattel Children’s Hospital comes from not only
the Los Angeles and Southern California areas but also from around the
world.
Newborn Nursery
Pediatric and
med-peds residents learn to care for common newborn issues in the
newborn nursery, both at the Mattel Children’s Hospital and at
Cedars-Sinai Medical Center. With the back up of Level 3 Neonatal
Intensive Care Units (NICU) at the Mattel Children’s Hospital and
Cedars-Sinai Medical Center, residents learn to identify potential
newborn problems, start therapeutic management, and triage babies to the
appropriate care setting. The newborn nurseries are managed by
attending physicians in general pediatrics and in the NICU.
Intensive Care Units
The intensive
care units in pediatrics are traditionally the most demanding rotations
during residency training, but can also be fulfilling in the
interactions with patients and families. During these stressful times
for families, pediatric and med-peds residents are the contact persons
to provide information and support. In the Pediatric Intensive Care
Unit (PICU), residents learn about the unfortunate consequences of
unintentional (trauma) injuries to children and how to manage serious
medical problems such as oncologic diseases or organ failure. In the
NICU, residents learn about peri-natal issues and management of
premature newborns, as well as newborns with congenital issues.
Ambulatory Clinics
The
ambulatory clinics are the hallmark of general pediatrics and a sampling
of what pediatrics is like in the community. The ambulatory clinics at
the Children’s Health Center at UCLA, Olive View Medical Center, and the
Venice Family Clinic/Burke Health Center are all set-up so that
residents see a mixture of continuity and urgent care patients in the
same clinic session, much as a community pediatrician would see in the
office. In all of these three settings, we care for the underserved
children of Los Angeles county, mostly uninsured or insured by Medicaid
or Healthy Families, our Title XXI program. The ambulatory pediatric
experiences are rich not only in the common outpatient medical problems
seen, but also the cultural diversity of families and issues pertaining
to these populations.
Child Development
Child
development is unique to pediatrics and the basis for understanding how
children cope with illness. It is also important for understanding the
ways that pediatricians can help families promote their children’s
health and education to insure future school success and well-being.
The child development rotation consists for 4 weeks, during which time
residents rotate through a number of community settings (child care
centers, family day care, schools, Head Start programs) in which they
are able to observe children between 0 and 12 years in their “natural
environments.” In addition, residents also participate in specialized
development clinics such as ADHD clinic and Educational Advocacy clinic
(a multi-disciplinary clinic with law students and psychology interns
for children with school problems).
Adolescent Medicine
Adolescent
medicine works with a distinct and important population of youths that
by definition are underserved because of their infrequency of visits to
health care professionals. Med-peds physicians are uniquely positioned
to understand adolescents from a developmental perspective (which their
pediatric training gives them) and from the perspective of where
adolescents are heading (which their medicine training gives them). The
UCLA Adolescent Medicine rotation is comprised of clinical experiences
geared towards getting to where the adolescents are. Most of the
rotation is spent rotating through school-based health clinics which are
located on school campuses and the Venice Teen Clinic, in which
adolescents can come for care without their parents. The Teen Clinic is
located near Venice High School, one of the largest high schools in the
Los Angeles Unified School District.
Community Medicine (Venice Family
Clinic) Rotation
The
Community Medicine (Venice Family Clinic) rotation takes place at the
largest free clinic in the country. This community clinic has several
sites, and on this rotation residents predominantly see pediatric
patients at the main Venice Family Clinic site on Rose Avenue and the
Burke Health Center in Santa Monica. The main objectives of this
rotation for residents are to experience a busy outpatient Pediatric
Community Clinic, identify medical/social problems and possible
prevention or management of these problems, and describe community
resources that support families in the Venice Family Clinic or Burke
Sites.
Quality Improvement in Primary Care to the Underserved
This unique
and popular two week elective is part of the PGY-2 curriculum. It is
designed to enhance the ability of our residents to work with
underserved populations and prepares them to provide high quality care
for patients with chronic illness. Topics covered include:
communicating with low health literacy patients, providing culturally
competent care, quality improvement theories and skills, and best
practices in chronic illness care.
Child Advocacy Rotation
This rotation
will give you some insight and understanding of the family courts system
and how the health and well-being of children in this system are managed
by various legal, medical, and educational agencies. These agencies
include but are not limited to the California Department of Children and
Family Services, the LA County Department of Mental Health, the juvenile
and children’s courts, volunteer groups, and the LA Unified School
District, just to name a few.
