Inpatient/Outpatient US Clinical Experience in Internal Medicine in San Francisco

Information about this clinical experience:

This is a combined inpatient and outpatient experience during which you will be under the supervision of a board-certified internal medicine physician with an extensive background in patient care, teaching, leadership, and service to the community. With respect to the latter, the doctor is actively involved in underserved care through involvement in local free health clinics. Having completed medical school outside the U.S., this preceptor is well aware of the challenges that today’s international medical graduates face. The attending is on staff at multiple hospitals, including California Pacific Medical Center and Seton Medical Center.

The inpatient component of this clinical experience will take place at a hospital that serves a very diverse patient population. People living in the community hail from all over the world with nearly 50% having been born outside the U.S. Approximately 60% of residents speak a language other than English at home. On a typical day, you will see approximately 20 inpatients with a range of acute medical issues. You will learn how a hospitalist provides high-quality care to an ethnically and linguistically diverse patient population through a team-based approach.

Time will also be spent in several skilled nursing facilities (SNF) and rehabilitation centers. These opportunities will allow rotators to gain experience in post-acute care institutions. During residency, many of your hospitalized patients will be discharged to SNFs. Therefore, a strong understanding of how care is delivered in SNFs will allow you to effectively transition the care of medically complex patients from acute care hospitals to these post-acute care facilities. In these facilities, you will see how care is coordinated among a multidisciplinary team, including physical, occupational, and speech therapists. You will see how admission evaluations are completed in recently discharged patients from acute medical or surgical wards and ongoing care is provided to prevent avoidable hospital readmissions.

Twice per week, you will attend the outpatient clinic where you will encounter patients with a range of chronic medical issues. As this physician is also trained in vascular medicine, you will also see patients with vascular disease.

During your experience, you will learn the following U.S. medical practices under the preceptor’s supervision:

• Taking patient histories under supervision.

• Performing physical exams under the physician's supervision.

• Presenting patients.

• Navigating the EMR (Practice Fusion, Epic, TruBridge)

• Have opportunities to research the literature to answer clinical questions at the point of care.

• Being involved in patient education.

• Spending time with other healthcare professionals to understand their roles and responsibilities.