See example schedule

4+1 Schedule Structure

Pet Therapy. Internal Medicine Residency. UCLA Health

Here at UCLA, we have a long tradition of focusing a substantial amount of our subspecialty training in the ambulatory setting. In this way, trainees are exposed to a wide breadth of subspecialties that will best prepare them for a career in internal medicine. In order to continue in this tradition and to improve our residents’ experiences in their continuity clinics, we have adopted the 4+1 block scheduling model for our program.

Inpatient Experience

The inpatient rotations have benefited from the 4+1 schedule. Residents no longer have outpatient clinic responsibilities that interrupt inpatient rotations. This increases the number of days when the entire team is together, improving team cohesiveness and patient continuity. More time is spent on teaching activities such as patient presentations, pre-rounds and work-rounds, procedures, and patient centered points of interest learning topics.

 
Ronald Reagan General Medicine Wards

Our medicine ward team at Ronald Reagan hospital is comprised of one resident and two interns. There are 6 general teams. The full complement of each team also generally includes one to two 3rd year medical students and one 4th year sub-intern. Most of the attendings are part of the UCLA hospitalist group.

 

Ronald Reagan Medical Intensive Care Unit

The MICU team at Ronald Reagan hospital is comprised of two attendings, two ICU fellows, four residents, and four interns. Call is every fourth day for the resident and intern. A dedicated night team takes over patient care overnight. On this service, residents become well versed in the workup and treatment of respiratory failure, pulmonary hypertension, septic shock, liver disease, gastrointestinal bleed, and other life-threatening pathology.

 

Ronald Reagan Cardiac Care Unit

The CCU team at Ronald Reagan hospital is comprised of two attendings, two cardiology fellows, four residents, and four interns. Call is every fourth day for the resident and intern. The teams manage a combination of ICU and floor-status level patients. A dedicated night team takes over patient care overnight. On this service, residents learn to diagnose and manage acute cardiac pathologies such as acute coronary syndrome, heart failure, various arrhythmias, and adult-congenital heart disease.

 

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Santa Monica Solid Oncology

The Solid Oncology service at Santa Monica hospital cares for patients with solid organ malignancies. The team is comprised of an oncology attending, an oncology fellow, two residents, and two interns. Housestaff learn the pathophysiology of common malignancies and gain competency in managing complications associated with cancer and its treatment. Residents and interns are on call every fourth night until 7pm (not overnight).

 

Santa Monica Hospitalist

All second and third year residents rotate on the Hospitalist service at Santa Monica hospital one or two months a year to experience a community hospitalist practice model. This innovative rotation incorporates residents into a busy hospitalist practice as junior attendings. Residents enjoy a collegial style of supervision. The rotation provides seniors an opportunity to function independently as community physicians. Overnight call is every sixth night.

 

Night Float/Night Admitting Rotation

All interns spend 2-4 weeks on night rotations as either the night-float for general medicine wards or the ICU. Second and third year residents participate in a 2 week rotation, alternating nights serving as the night admitting resident or night float at each of our clinical sites.

 

Santa Monica Geriatrics

This rotation offers exposure to a multidisciplinary geriatrics ward in a community hospital setting. There are two teams, each comprised of a geriatrician and two second- or third-year residents. A primary objective of the rotation is to offer residents an opportunity to function as junior attendings. Another is to provide evidence-based training in geriatric medicine. A nurse practitioner also participates in patient care. Residents take home call every fourth night.

 

Ronald Reagan Emergency Department

The RR ED provides care to over 50,000 patients per year and is a Level 1 Trauma Center and a Pediatric Critical Care Center. Second- and third-year residents rotate through the ED once in their training to learn about the initial triage and resuscitation of acute medical problems and see a variety of urgent and emergent medical concerns.

 

VA General Medicine Wards

The medicine ward teams at the West Los Angeles VA are made up of five traditional teams (each comprised of an attending, one resident, two interns, and at least one UCLA medical student). These teams admit on a Q5 day call schedule. Other important members of the multidisciplinary team include a case manager, social worker, clinical dietitian and clinical pharmacist.

 

VA Intensive Care Unit

Pet Therapy. Internal Medicine Residency. UCLA Health

The Medical ICU at the West Los Angeles VA is comprised of four teams, each with one resident and one intern. A dedicated night float intern provides overnight intern coverage for the on-call team. Residents take overnight call every 4th night.

 

VA Cardiology Telemetry Ward

The Cardiology Telemetry ward at the West Los Angeles VA is comprised of 2 teams (each with one resident and one intern), admitting every other day under the supervision of 1 cardiology attending and fellow.

 

VA Geriatrics/Palliative Care Rotation

The VA Geriatric service is an inpatient service that admits patients over 70 years of age. The focus is on learning how to take care of geriatric patients in an inpatient setting. Teams admit patients Monday through Friday and there is no overnight call. The service consists of a board-certified geriatrician, fellow, and two senior residents.

 

VA Emergency Medicine Department

The VA Emergency Medicine is a busy full-service emergency department which evaluates 33,000 patients annually, with both medical and surgical emergencies. The ED receives non-trauma related emergency ambulance traffic from the surrounding area. Interns and residents staff the ED in 9 or 10 hour shifts from 8am to midnight.

 

Olive View-UCLA Medical Center Wards

Interns will rotate at Olive View-UCLA Medical Center general medicine wards for one month during their first year. Residents may have an additional month at Olive View during their second or third year. Olive View-UCLA Medical Center is a county hospital with an underserved, primarily Spanish-speaking population.


Outpatient Experience

  • Every five weeks, residents have one week dedicated to ambulatory medicine during which they see their own continuity panels and rotate through subspecialty clinics.
  • Residents who have the same +1 weeks are grouped into “firms.” Residents in the same firm have the same weekends off together and get to know each other well throughout residency.
  • Each +1 week includes:
    • Continuity clinic
    • Subspecialty clinics
    • Didactic sessions on ambulatory medicine
    • Simulation sessions
  • Possible continuity clinic sites:
    • Internal Medicine Suites at Ronald Reagan Medical Center
    • West Los Angeles VA
    • Sepulveda VA
    • Simms-Mann Health and Wellness Center (Venice Family Clinic)

 

Find more information on each clinic site.

Clinic partners - Internal Medicine Residency. UCLA Health

 

Subspecialty clinics

  • Cardiology
  • Endocrinology
  • Gastroenterology
  • Hematology-Oncology
  • Pulmonology
  • Rheumatology

Elective rotations

  • Women’s Health
  • Allergy-Immunology
  • East-West medicine
  • Radiology
  • Dermatology
  • Sports Medicine
  • Student health
  • HIV clinic
  • Nuclear medicine
  • Nutrition/obesity
  • Palliative care