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UCSF General Internal Medicine Residency

Zuckerberg San Francisco General Hospital

The UCSF Primary Care Internal Medicine Residency program is based at Zuckerberg San Francisco General Hospital (ZSFG), a publicly funded hospital. Their continuity clinic, the Richard H. Fine People’s Clinic, exclusively serves uninsured or publicly insured individuals and has a high burden of complex chronic disease, substance use disorder, and mental illness.

The UCSF Primary Care Internal Medicine Residency program implemented the UCSF Double Helix Practice Transformation curriculum into their program in July 2016. Curricular leaders identified 20 hours that were available during the interns’ intensive didactic month at the beginning of the year. Over the course of the month, materials from this website were used to introduce residents to the concepts of practice transformation and provide them in-depth learning on key areas. In addition, the residency identified residents with a key interest in practice transformation and invited them to join the clinic management team, where they became resident liaisons and leaders for clinical quality improvement projects.

We are currently developing an interactive timeline detailing how this residency implemented the UCSF Double Helix Practice Transformation curriculum into their program. It will be available on this page in Summer 2017.

Tips from the Residency Program...

- Use existing, carved-out teaching time – pre-clinic conference, didactic half-days, post-clinic conferences, etc.

- Change the way you teach: we are increasingly “living” the building blocks in clinic so be explicit with the residents when the building blocks are in display.

- Consider inviting residents to a clinic retreat (in lieu of a clinic session) with staff and focus on some aspect of primary care transformation.

- Pick your materials based on internal strengths. For example, if you have a champion for diabetes population management in your clinic or academic department, then build a session around that.

- Pick materials based on resident interest. There is usually some aspect of primary care transformation that is personally relevant to residents – i.e., access questions (how do I see my patient for follow-up?, how come I don’t get to see my same patients again).

Give faculty FTE to support work on these teaching sessions. Or offer to pride credit for a clinic session.

- Resident enthusiasm (topics may be considered “soft” compared to traditional didactics). Focus on resident-sepcific data from clinic so it feels relevant.

- Lack of faculty champions. These may need to be built up.

- Lack of time.

- Guide the teaching based on what you have interest and/or champions for. We did a session on blood pressure control and racial disparities in our clinic and the residents led the teaching session to their peers, which was very successful.

- Make sessions interactive.

Extremely well. We have rolled out these sessions with primary care residents, who are more interested in this than most, but as long as the materials are relevant to the learners, it can be very engaging.
Try and mix residents with clinic staff – it’s a great opportunity to bring them together for a common purpose.


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