Curriculum
PG1 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 |
PG2 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 |
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.
PG3 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 |
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.
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 PG2s and PG3s:
PG2 Block Focus | PG3 Block Focus |
---|---|
Health Equity | Trauma Informed Care |
Substance Use Disorders | Gender Health |
Mental Health Disorders | Immigration Health |
Incarceration | Care of patients experiencing homelessness |
Advocacy | Disability |
Community Health | Care of the Community |
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
Writing the Wrongs: Facilitated by Ashley McMullen, host of Black Voices in Healthcare podcast series, Narrative Medicine 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.
Primary Care Building Block Curriculum
In the primary care transformation curriculum, residents will learn the principles of high-performing primary care using the 10 building blocks model. Primary care transformation has improved quality of care, efficiency, and patient satisfaction across practices nationwide. Through interactive multidisciplinary sessions, residents will apply the building blocks to opportunities to strengthen team-based care and population management in their continuity clinic practice at the Richard Fine People's Clinic.
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.