Internal Medicine Los Angeles Medical Center - Curriculum

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 tertiary referral center in our network. As such, our residents care for some of the most medically and psychosocially complex patients across all disciplines. However, residents in our competitive program are up to the task as the training here provides well-rounded experiences in all subspecialties, along with robust Critical Care, Wards, and Capstone rotations 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. Our residents experience continuity clinic in various campuses, including here in East Hollywood, Downtown Los Angeles, West Hollywood, and our Hollywood Sunset Free Clinic – each with their unique patient populations – and experience unique rotations such as HIV Clinic, LGBTQ+ Care Clinic, Social Medicine, Community Medicine.  

KP LAMC is a major, academic, teaching medical center that is community-based, representing the best of both worlds. Our organization produces world-class research utilizing one of the largest, comprehensive electronic medical databases in the world. Our faculty are expert clinicians first who came to KP LAMC because they love to teach. They also dedicate their time to their specific interests, whether to research, quality improvement, leadership, and other interests. Our program is affiliated with UCLA (our faculty hold UCLA appointments) and serves as the major training site for UCLA’s clerkships; however, located in the center of three different medical schools, KP LAMC is uniquely positioned to also provide world class training to medical students from Kaiser Permanente School of Medicine (KPSOM) and Keck School of Medicine of USC as well as visiting rotators through VSLO. All house officers actively participate in teaching.  

Inpatient Wards

Our Inpatient Wards experience is truly interdisciplinary. Resident teams consist of an attending, one senior, two interns, one MS-4 sub-intern, one MS3 student, a case manager, and a social worker. Each team works in their own large, dedicated workroom. Senior residents also work with Utilization Management (UM) to identify and solve barriers to discharge.   

All attending hospitalists are teaching faculty – you will not encounter “private” patients. The hospital group is large, and you will experience various teaching styles and methods, but common to all attendings is their dedication to the residency program.   

During rounds, attendings, colleagues and medical students all contribute to learning, including dedicated presentations, and review of landmark articles and the latest evidence-based medicine.   

The cross-coverage system allows teams to sign out at 5pm on non-call days, allowing residents time for reading.  

Capstone Rotation

Our unique Capstone Rotation is designed to push residents to “put it all together” as an independent hospitalist. In this rotation, a senior resident works one-on-one with an attending the attending is able to focus on the senior resident, tailoring rounds to build up the resident’s skills, including workflow, efficiency, autonomous decision making and building rationale while reviewing landmark articles.    

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.  

The primary care curriculum was redesigned in 2022 to increase outpatient exposure and consolidate primary care experiences into dedicated rotations for PGY3 residents. The new dedicated Primary Care rotations (PC3) includes opportunities to rotate and care for the unique populations in DTLA and West Hollywood office buildings, which are innovative, reimagined KP ambulatory settings with state-of-the-art technology. Residents also rotate in our Hollywood Sunset Free Clinic and Urgent Care, learn about HIV/LGBTQ+ healthcare, practice POCUS and outpatient procedures, learn panel management by leveraging our electronic medical record system to achieve clinical strategic goals, gain more experience in Gynecology and Dermatology clinics, and are allotted time for community medicine seminars. 

These rotations are expected to serve as the backbone for a planned Primary Care Track, planned to begin 2025-2026 academic year.  

 Subspecialty Rotations

Our hospital receives referrals from all of the other Kaiser Permanente medical centers for higher level of care. As such, our hospital is among the busiest in the nation in terms of volume for specialty procedures such as cardiac catheterizations, cardiac surgeries, and endoscopies. Our Medical Center is a Comprehensive Stroke Center as designated by the joint commission.   

During your subspecialty rotations, not only will you see a wide range of pathologies, but you will see the full power of a fully integrated health care system in our wide range of transitional care programs and as patients seamlessly transition between outpatient and inpatient and outpatient diagnostic tests as well as between subspecialists and primary care.   

Our curriculum is skills-based, 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.  

Electives

You will be able to shape your curriculum with 22 weeks of electives. We offer a wide variety of in-house electives from which to choose, but you also have the option of pursuing electives at other institutions. You may also utilize your electives to pursue your research interests. 

Conferences

Academic time, including Morning Report, Lectures, and attending rounds, is protected and prioritized so that residents can attend conferences and rounds with minimal disturbance.

During lectures (most days during lunch time, food, provided), specialist attendings and fellows focus on the most up-to-date diagnostic and treatment practices in their fields. 

During Morning report(Tues-Thurs) residents discuss complex patients as well as bread-and-butter cases to develop clinical reasoning, a focused differential, an accurate assessment, and a thorough plan. 

Journal Club

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.  

Morbidity and Mortality Conferences

Residents facilitate monthly, interdisciplinary Morbidity and Mortality conferences to investigate root causes for adverse events and create action plans for implementation. This is in line with our program’s focus on continuous quality improvement.  

Board Review

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. 

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. 

Additional Programs

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/ 

Simulations/Procedures

During intern boot camp week and throughout the year, residents take advantage of our newly remodeled simulation lab to practice bedside procedures and code blue simulations to build knowledge 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.  

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.