Curriculum

Dr. Beaman in Intern Clinic
Interns 2023
Faithful Fools
Dr. Addington-White and Residents in Clinic

PGY1 Year

The intern year for primary care medicine interns at SFPC is similar to that for the categorical internal medicine interns, with 9-10 months spent on hospital-based and emergency department rotations in addition to 2-3 months of outpatient rotations. SFPC interns will participate in 2 clinic immersion months alongside their fellow SFPC interns focused on outpatient medicine skills, community activities, and SFPC team building. 

Sample SFPC Clinic Immersion Month:

PG1 MON TU WED TH FRI
AM Urgent
Care
Ambulatory
Medicine
Didactics
Intern
Half
Day
Ambulatory
Medicine
Didactics
Social Medicine
& Community
Site Visits
12 Medicine
Conference
SFGH Medicine
Grand Rounds
M&M
Conference
Medicine
Conference
Journal
Club
PM RFPC
Continuity
Clinic
Ambulatory
Medicine
Didactics
Administrative
Time
RFPC
Continuity
Clinic
RFPC
Continuity
Clinic

PGY2 Year 

The second and third year for SFPC residents involve 6-7 outpatient blocks alternating with 5-6 inpatient rotations. Ambulatory months are designed to include intensive continuity clinic experiences with rotations through core medicine subspecialty clinics. SFPC residents participate in dedicated primary care and health equity didactic curriculums in addition to having time for academic and quality improvement projects.

Sample SFPC Block Month:

PG2 MON TU WED TH FRI
AM Subspecialty Clinic Elective*

Administrative Time

Second Continuity Clinic​​​​

Core Outpatient
Medicine Didactics

Health Equity Didactics & Community
Site Visits
12 Medicine
Conference
SFGH Medicine
Grand Rounds
M&M
Conference
Medicine
Conference
Journal
Club
PM Subspecialty Clinic Elective* RFPC
Continuity
Clinic
Project
Time
RFPC
Continuity
Clinic
Administrative Time

*Electives include: Cardiology, CHF, Dermatology, ENT, GI, Hepatitis C treatment, HIV, ID, Injections, MSK, Pulmonary, Renal, TB, etc.

PGY3 Year

During this year there is time for more elective choices for subspecialty clinics as well as elective months for international rotations, Addiction Medicine, Homeless care, and research activities.

Sample SFPC Block Month:

PG3 MON TU WED TH FRI
AM Subspecialty
Clinic
Elective*
Administrative
Time
Subspecialty
Clinic
Elective*

Core Outpatient
Medicine
Didactics

Health Equity Didactics
&
Community Site Visits
12 Medicine
Conference
SFGH Medicine
Grand Rounds
M&M
Conference
Medicine
Conference
Journal
Club
PM Second
Continuity
Clinic
​​​​
RFPC
Continuity
Clinic
Project
Time
RFPC
Continuity
Clinic
Administrative
Time

 *Electives include: Cardiology, CHF, Dermatology, ENT, GI, Hepatitis C treatment, HIV, ID, Injections, MSK, Pulmonary, Renal, TB, etc.

Pathways

Health Equities and Advocacy Training (HEAAT) Track

The HEAAT track is based at San Francisco General Hospital, and its primary focus is developing an understanding of the structural and systemic causes of health inequities. Through a series of workshops, didactics, site visits and case conferences, residents explore ways in which social determinants of health influence illness and the practice of medicine. Participants gain an in-depth knowledge of the issues surrounding inequities in health and health care by concentrating on the care of patients and populations who have been historically marginalized or made vulnerable by structural and systems factors. We consider this all within the context of the doctor-patient relationship and healthcare delivery systems. This is a two-year longitudinal curriculum, and each block, we delve into complex issues such impacting health such as food insecurity, inadequate housing, language and cultural considerations, the carceral system, substance use disorders, trauma, and poverty. An example of our block themes this year is listed below:

Year 1 Block Focus

Year 2 Block Focus

Foundations in Disparities, Bias and Privilege in Healthcare and Core Primary Care Topics

Trauma Informed Care

Food Insecurity

Care of Patients Experiencing Homelessness or Marginal Housing

Incarceration and Chronic Disease 

Gender Affirming Health Care

Substance Use Disorders

Violence Prevention

Mental Health and Caring for Patients with Mental Health Disorders

Disability and Ability

Advocacy

Care of Immigrant Patients: Legal, Provider and Systems Considerations

Our goal is to train residents in all facets of social medicine and health equity so that they can recognize, address, care for, and advocate for individual patients as well as have the tools to improve the health of populations.

Eligibility to participate:  Categorical track and primary care track residents

How to apply for the Health Equities pathway: send your most recent CV to Joan Addington-White MD by April 1. 

Contact information: Joan Addington-White, MD, ([email protected]); Eva Lo ([email protected])

Themes/Topics

On outpatient block months, the Thursday and Friday ½ days of Core Outpatient Medical Topics and Health Equity Curriculum follow a theme with didactics, pertinent readings, and site visits.  

Sample themes for PGY2s and PGY3s:

PGY2 Block Focus

PGY3 Block Focus

Foundations in Disparities, Bias and Privilege in Healthcare and Core Primary Care Topics

Trauma Informed Care

Food Insecurity

Care of Patients Experiencing Homelessness or Marginal Housing

Incarceration and Chronic Disease 

Gender Affirming Health Care

Substance Use Disorders

Violence Prevention

Mental Health and Caring for Patients with Mental Health Disorders

Disability and Ability

Advocacy

Care of Immigrant Patients: Legal, Provider and Systems Considerations

The core outpatient didactics include longitudinal curriculums in the following:

Career Series​​​​​​

SFPC residents have opportunities to meet and learn from SFPC graduates about their career journeys. Through the career series, residents have the opportunity to learn about careers in a variety of settings beyond academic medicine including rural medicine, primary care at Federally-Qualified Health Centers, organizational leadership jobs, policy and advocacy work, and incarceration medicine.

Advocacy and Community Engagement

The Advocacy and Community Engagement (ACE) curriculum is co-led by Dr. Beth Griffiths and Tenderloin-based community partners at GLIDE and Faithful Fools. The goals of the curriculum include furthering the mission of community-based organizations, utilizing principles of effective advocacy to partner for policy change, engaging in critical reflection on how to promote social justice, and maintaining hope for positive change through a community of love. Residents partner with GLIDE and Faithful Fools, Tenderloin-based community-based organizations that provide services including daily meals, harm reduction services, and accompaniment, deliver transformational education, and advocate for policy change to further social justice. Through these partnerships, residents provide direct service, engage in critical reflection, learn harm reduction principles and practical knowledge, and partner to take action to affect policy change. Through the ACE curriculum more broadly, residents also learn principles and skills for effective advocacy and community engagement, hear from physicians who have careers that incorporate advocacy and community engagement, and meet directly with policymakers. ​​​​

Curriculum in Sexual & Reproductive Health

This curriculum focuses on the care of patients with female reproductive organs. Sessions employ an interactive Team-Based Learning model to teach about contraception, abortion, abnormal uterine bleeding, urinary incontinence and menopause. The curriculum also includes a four hour workshop specifically focused on the skills needed for internists to provide medication abortion services.

​​

Health Systems & Change Management

This 2-year curriculum for SFPC 2nd and 3rd year residents focuses on identifying areas for improvement in clinical systems and learning to implement change. Using A3 Thinking and Human Centered Design frameworks, residents develop a QI project addressing an operational, quality, or patient safety problem in clinic. Population health management activities are used to demonstrate an approach to clinical healthcare disparities. In their R3 year, residents learn to approach medical errors and patient harm from a systems standpoint as they apply this framework to an ambulatory M&M.

Narrative Medicine

Dr. Ashley McMullen leads our Narrative Medicine curriculum which involves the practice of narrative competency, or the "ability to acknowledge, absorb, interpret, and act on the stories or plights of others." COVID-19 has made readily apparent the consequences of an inequitable healthcare system. While it is important for us as providers to advocate publicly for vulnerable patients, we must also create safe spaces to internally reflect on our own blind spots and strengthen community/accountability among our colleagues. The goal of this curriculum is to use stories and narrative competency to gain proximity to those whose identities and experiences may differ widely from our own and to improve the care that we provide across differences. We may have all the knowledge and facts about health disparities, but stories stick with us in ways that can empower lasting change. Dr McMullen is also an incredible podcast co-host that we highly recommend that you all check out. Dr. Kimberly Manning and Dr. Ashley McMullen are two dope academic internists who use the power of storytelling to explore the human side of medicine, along with teaching, living, learning, and all things in between for the The Human Doctor Podcast,

Support Group/Wellness

Resident Wellness Group meets monthly for residents on block. It provides a safe, confidential space for residents to reflect on their experiences, support each other and learn from the collective wisdom of the group. We use techniques like reflective writing to process the many emotions that accompany the residency experience, and we practice simple stress reduction methods. Resident Wellness Group is supplemented by optional 1:1 emotional office hours, whereby residents can sign up for an individual conversation with Beth about topics ranging from work/life balance to career decisions to individual patient cases and their effect on our well-being.