Internal Medicine Los Angeles Medical Center - Training

Overview

We believe that strong clinical training, professional identity development, and physician well-being are interdependent and necessary to promote competent and compassionate physicians. We aim to provide individual roadmaps to success guided by concrete and practical feedback as well as programmatic structure to foster growth as a group.

Training Sites

Kaiser Permanente Los Angeles Medical Center (KP LAMC), a 560-bed facility in East Hollywood, not only cares for the socioeconomically and culturally diverse patient population in Los Angeles, but also serves KP Southern California’s 4.7 million members as the major integrated tertiary referral center in our network. As such, our residents care for some of the most medically and psychosocially complex patients across all disciplines, and our medical center boasts some of the highest numbers of specialty surgeries and procedures in California, such as cardiac catheterizations, cardiac surgeries, and endoscopies. Our Medical Center is a Comprehensive Stroke Center as designated by the joint commission.
KP LAMC is also a major academic teaching hospital center that is community-based, representing the best of both worlds. At the epicenter of three medical schools, KP LAMC serves as a major training site for UCLA, Keck USC, and KP School of Medicine, as well as many visiting rotators, and our residents all participate in teaching and in unique small group formats. Further, KP, as an organization produces world-class research utilizing one of the largest, comprehensive electronic medical databases in the world, but especially prides itself in patient care and patient satisfaction. Our faculty are expert clinicians first who came to KP LAMC because they love to teach.

KP LAMC consists of the main hospital and many satellite offices. Our residents train mostly at the main hospital on Sunset in East Hollywood, but also rotate through the Romaine West Hollywood Offices and DTLA Offices as well as the Hollywood Sunset Free Clinic.

What Makes Our System Unique

At KP, you will experience the wonders of an expertly implemented, fully integrated health care system that puts patients first. You will see the impact that efficiency and thoughtfulness can have on patients – they can get their appointments, screening, immunization, labs, imaging, and more all in the same facility, often on the same day! You will be at the center of this and become a master coordinator who optimizes health at the population and individual level.

Some of the most unique aspects of training at KP LAMC are that 1) KP Physicians have final say on all medical decisions (we do not ask for permission from insurance) and 2) as a fully integrated health care system, we have the benefit of seeing our patients through all phases of care. Our residents can truly spend time with patients instead of on non-physician obligations, and they can see the impact of medical decisions on patients as they transition through the health system.

What Makes Our Curriculum and Schedule Unique

Residents in our program experience robust Critical Care, Cardiac Care, and Wards experiences that edify clinical skills, enhance autonomy, and provide the depth needed to inform shared decision making and care for patients with serious multi-morbid disease. Residents also rotate through EACH medical subspecialty to provide well-rounded training to all. Categorical residents rotate through the Capstone rotation, in which residents practice as independent hospitalists under supervision.

Our schedules consist of two-week blocks, roughly forming a hybrid 4+2 schedule that provides our residents flexibility for scheduling outside rotations, vacations, conferences, and more. Our curriculum is focused on skill acquisition, meaning you will be exposed to key subspecialties early (ID, Neurology, Palliative Care, Endocrinology) to set you up for success as you progress through your training.  You are also allotted a generous amount of electives to personalize your training.

Within this curricular framework, our program aims to smooth the transition from UME through GME to independent practice, utilizing coaching, mentorship, and semi-annual reviews along with graduated autonomy. Our residents are always supported, with 24/7 support from hospitalists and Critical Care staff as well as fellows from various programs.

Primary Care Curriculum

Our primary care curriculum aims to provide our residents with practical skills and experience in various clinic settings to prepare residents for primary care practice. The mainstay of the curriculum is our Continuity Clinic located at LAMC (East Hollywood). Interns inherit a panel of patients, which grow over time as they are assigned new patients or become primary physicians for patients they cared for in the inpatient setting. Interns have Continuity Clinic weekly on most rotations to promote the development of meaningful, therapeutic relationships with their panel of patients and to foster camaraderie with colleagues – you will see all of your classmates there! Continuity Clinic is further augmented by weekly seminars based on the Yale Primary Care curriculum.

During Intern year, all our categorical interns have continuity clinic each Thursday afternoon, providing a unique opportunity for camaraderie with all their classmates. During PGY2 and PGY3 years, residents have clinic during subspecialty and dedicated primary care rotations. Our Primary Care rotations are designed to foster greater autonomy, providing experiences in Romaine West Los Angeles and DTLA, which are innovative, reimagined KP ambulatory settings with state-of-the-art technology. Residents also receive training in outpatient procedures with ultrasound, Women’s health, and more. Furthermore, our residents have scheduled experiences in HIV Clinic, LGBTQ+ Care Clinic, Gender Affirming Care, and rotations at our Hollywood Sunset Free Clinic. You are also afforded a generous amount of elective time to personalize your experiences.

Primary Care Track

The Primary Care Track was developed to further improve our pipeline to primary care in our local communities. Interns may apply into our innovative PGY2/PGY3 Primary Care track. The primary care track aims to provide practical and useful experiences rather than serving as a track that simply checks boxes or provide more clinic.

The Primary Care Track consists of a focus on building primary care skills, including experiences in outpatient procedures, HIV Care (with certification opportunity), LGBTQ+ care, Gender Affirming Care, Lifestyle Medicine, Obesity Medicine, Health Policy Elective, Community Medicine, Conferences, and Global Health. Primary Care Residents will have more opportunity to personalize experiences through selectives.

Quality Improvement Curriculum

Our novel QI Curriculum leverages our integrated health care system to provide an immersive learning experience. Residents receive strong background training via IHI modules and in-person didactics and are integrated into existing Quality and Patient Safety committees to experience all of the work that happens in the background to keep our patients well and safe. Residents are guided through each step of the Quality Improvement process as they complete projects via their respective committees.

Didactics

We thoughtfully plan out our didactic schedule to provide timely and practical educational content, not only in areas of medical knowledge, but also for professional development and more. We provide noon didactics most days (and cater lunch from local restaurants!).

Topics include:
Summer Intern Series: Designed to review high-yield topics to help interns hit the ground running!

Narrative Medicine: Our thought-provoking narrative medicine sessions seeks to prompt reflection and processing of collective
experiences that define the physician experience.

Professional Development: Underlined by a philosophy that professional identity is developed over time, we cover topics such as difficult conversations, medical errors, and more.

Faculty Development: As KP LAMC is a major teaching hospital, we also bring faculty development from various medical schools to our residents.
M+M: Residents facilitate monthly, interdisciplinary Morbidity and Mortality conferences to investigate systemic causes for adverse events and foster just culture.

Journal Clubs: Our Research Track Residents provide quarterly Journal Club presentations designed to develop a culture of critical appraisal and lifelong learning by teaching the tools necessary to critically analyze medical literature to prepare for their own research projects. Research Track residents will also provide Updates in Research to help residents stay up to date with the latest literature.

Morning Report: Our Morning Reports (Tues-Thurs) are aimed to develop clinical skills, focusing on problem representation and assessment formulation.

Grand Rounds: National and in-house experts discuss systemic issues like COVID-19, Healthcare Access, LGBTQ issues, Family Violence, along with common medicine topics like Sepsis, Hypertensive Crisis and Stroke. All medical center physicians attend and contribute to these discussions for interdisciplinary learning.

Board Prep: Physicians from different subspecialties host monthly board reviews to supplement digital MKSAP subscriptions purchased for every resident. During board reviews, the subspecialists teach the most high-yield topics and give clinical context to board questions.

Scholarly Activity

At KP, our residents have access to one of the largest health care databases in the world. More importantly, residents are supported through the process via funding, mentorship, IRB guidance, and more. Residents can join the many ongoing projects or choose to start one on their own.

Simulations/Procedures

During intern boot camp week and throughout the year, residents take advantage of our newly remodeled simulation lab to practice bedside procedures. Monthly Code Blue Simulations reinforce skills and confidence.

Residents have ample opportunity to perform procedures in the hospital – one recent resident was able to perform close to 100 central lines.

POCUS Training

Since 2017, our program has offered formal Point-of-Care Ultrasound Training, including practice on live patients in the Cardiac ICU and in our state-of-the art Simulation Lab. Each rounding team is equipped with their own GE VScan, which residents use during bedside rounding. We also have our own dedicated Zonare ZS3 for use for various procedures. All graduates become proficient in performing bedside POCUS during everyday patient care.

Global Health

Your schedule is flexible and can accommodate Study Abroad experiences throughout the year. Learn more about the different opportunities here https://residency-scal-kaiserpermanente.org/globalhealth/

Sample Schedule

Our curriculum fulfills all of the latest ACGME requirements; you will rotate through each of the subspecialties. Consequently, our graduates are well prepared for advanced fellowship training and for careers as hospitalists or generalists.

Our schedule is unique in that it seeks to immerse you in subspecialties earlier in your training to provide you with crucial context as you learn medicine. Also, as each year is divided into 26 two-week rotations, you will have the opportunity to revisit rotations at different times, which we believe enhances your learning.

Pre Intern Sample Schedule

RotationWeeks
Wards16
ICU4
CCU6
Flex6
NF4
ER2
Elect + Vac12
Backup2

CAT Intern Sample Schedule

RotationsWeeks
Wards16
ICU4
CCU4
NF4
ER2
ID2
Endo2
Neuro2
Pall2
Misc Amb2
Elec + Vac10
Backup2

PGY2 Sample Schedule

Rotations Weeks
Wards8
Capstone4
ICU2
CCU2
PULM4
DayFloat2
Night ICU4
Night Float4
GI2
Renal2
Neuro2
ID2
Rheum2
Med Consult2
Backup2
Elec + Vac8

PGY3 Sample Schedule

RotationsWeeks
Wards8
Capstone2
ICU2
CCU2
HemeOnc4
Cards2
Dayfloat2
Night Float4
HEP2
Rheum2
Primary Care8
Backup2
Elect + Vac8
Endo2
MedConsult2