Rotations

The specific distribution of Internal medicine and ICU weeks will be adjusted to give each resident a minimum of 28 weeks of Fundamental Clinical Skills (FCS) rotations. Furthermore, there is no required overnight call (in-house or from home) during this residency. We use a "night float" shift to cover the internal medicine services overnight. All residents will participate in this night float coverage.

Internal Medicine Wards at SAMC
There are four ward teams, each made up of a full-time faculty member in Internal Medicine, a senior house officer (PGY-2 or 3), two interns, and medical students.

The “cap” for admissions is five (5) new patients for PGY-1 residents. Residents average around 65 working hours per week, with a mandatory day off.

Our 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 residents also work closely with the Medicine subspecialty services, the other specialties, and the ER staff.

Intensive Care Unit at SAMC
The critical care rotations take place in the several ICUs at Saint Agnes Medical Center. There is an in-house Critical Care attending physician present for teaching and direct supervision of the residents 24 hours a day.

The rotation allows residents to gain competence in the care of critically ill patients. They also become experienced in performing invasive procedures, cardiopulmonary resuscitation, mechanical ventilation, and hemodynamic stabilization.

Ambulatory Clinic
This rotation takes place for four (4) weeks at a number of affiliated clinics in the Fresno/Clovis metropolitan area. The accrediting body (ACGME) requires that each resident complete a minimum of 140 patient care hours in primary care Ambulatory Medicine.

Night Float at SAMC
The night float resident, under supervision by an on-call 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.

Emergency Medicine at SAMC
The residents are directly supervised by full-time emergency medicine faculty. In addition, they will be exposed to the full range of medical and surgical conditions across all age groups except young children. Residents will also have ample opportunity to practice a wide variety of procedural skills.

Electives
Offered in the following areas:

Radiology (DR and IR), Pediatrics, Anesthesiology, Neurology, Pathology, Dermatology, OB/GYN inpatient, Surgery, Psychiatry, Physical Medicine and Rehabilitation, Ophthalmology, Sports Medicine, and Chronic Pain Management.