Internal Medicine Residency Training Program - Clinical Training

Residents rotate on inpatient and ambulatory rotations at our two main training sites: Cedars-Sinai, an approximately 900-bed tertiary referral hospital, and the West Lost Angeles VA, a 250-bed tertiary referral hospital for the Veterans Administration system. Trainees spend approximately two-thirds of their time at Cedars Sinai and approximately one-third of their time at the VA.  Categorical residents will also have a continuity clinic where they will see patients in a one-week block that occurs at the end of every four-week rotation (4+1 model).

Inpatient Training

There are six inpatient services that residents will rotate on at Cedars-Sinai:

  • General medicine wards
  • Advanced heart failure/heart transplant wards
  • Medical intensive care unit
  • Cardiac intensive care unit
  • Bone marrow transplant wards
  • Consultation services

There are five inpatient services residents will rotate on at the West Los Angeles VA:

  • General medicine wards
  • Hospitalist service
  • Cardiology wards
  • Consultation services
  • Geriatrics wards
  • Cedars-Sinai general medicine wards

This service admits a wide variety of patients with medical problems that range from the common to the esoteric. The majority of patients are uninsured or have Medi-Cal and have no primary care physician. Attending rounds occur daily with a full-time faculty member.

Cedars-Sinai Advanced Heart Failure/Heart Transplant Wards

This 54-bed unit serves as a step-down unit for monitoring of patients with advanced heart failure who do not require intensive care. Patients admitted to this unit may be pre-cardiac transplant, or post-transplant with nonsurgical issues, as well as nontransplant candidates with advanced heart failure. The medical team consists of two Interns and three residents, as well as a combination of general cardiology fellows and advanced heart failure fellows. Rounds with an attending specializing in heart failure occur daily.

Cedars-Sinai Medical Intensive Care Unit (ICU)

This 24-bed intensive care unit is staffed by two day teams each composed of two residents and two interns, and one night team composed of three residents. Pulmonary fellows help supervise the unit around-the-clock. A separate attending staffs each day team.

Cedars-Sinai Cardiac Intensive Care Unit (ICU)

This 12-bed intensive care unit is staffed by two day teams, each composed of one resident and one intern, and one night team composed of one resident and one intern. Cardiology fellows are actively involved in the management of the patients as well as in teaching on bedside rounds and in didactic sessions. Each day team is staffed by a separate attending.

Cedars-Sinai Bone Marrow Transplant Wards

This approximately 32-bed unit is staffed by three interns, one resident, as well as nurse practitioners. Patient care is supervised by a fellow and attending hematologist/oncologist. Patients on this unit generally are admitted to receive bone marrow transplants for underlying hematologic malignancies or are admitted for management of complications.  

Cedars-Sinai or VA Consultation Services

All internal medicine subspecialty services have residents and fellows performing subspecialty consultations on both hospitalized and ambulatory patients.

Our consultation services include:

  • Cardiology
  • Endocrinology
  • Gastroenterology
  • Hematology/oncology
  • Infectious diseases
  • Nephrology
  • Neurology
  • Pulmonary
  • Rheumatology
  • Palliative care

Each of these subspecialty rotations differs slightly in its structure, but all include formal didactic sessions and a defined educational curriculum. Fellows and attendings are responsible for teaching rounds and didactic sessions.

West Los Angeles VA General Medicine Wards

This service, staffed by a resident and two interns admits patients with a wide variety of "bread and butter" medical problems. All patients are admitted to the teaching service, which is led by a full-time faculty member. Other important members of the multidisciplinary team include a case manager, social worker, clinical dietitian and clinical pharmacist.

West Los Angeles VA Hospitalist Service

Similar to the general medicine wards at the VA, the team admits patients with a wide variety of "bread and butter" medical problems.  However, this service is staffed solely by senior residents and an attending. This rotation provides excellent preparation for those considering hospitalist careers.

West Los Angeles VA Cardiology Wards

This cardiac monitoring ward is made up of three teams of one resident and one intern each who are supervised by cardiology fellows and board-certified cardiologists.

West Los Angeles VA Geriatrics Wards

This service provides a multidisciplinary approach to the care of geriatric inpatients. Led by board-certified attendings and fellows, the service allows residents to care for symptoms and diagnoses that maybe specific to this patient population.

Ambulatory Training

Continuity Ambulatory Experience

Categorical residents will have a continuity clinic where they will see patients in a one-week block that occurs at the end of every four-week rotation (4+1 model). Residents will be able to choose to do their continuity experience at one of four different sites, allowing them to pick a site that most closely aligns with their career interests.

  • Cedars-Sinai's Ambulatory Care Center: Residents manage a predominantly underfunded, immigrant patient population in a traditional hospital-based ambulatory setting.
  • Cedars-Sinai Medical Group: Residents work with primary care physicians and care for insured patients in a managed care practice.
  • The Saban Community Clinic (formerly named the Saban Free Clinic and the Los Angeles Free Clinic): Residents care for indigent patients through a public-private program supported by federal and local resources.
  • Sepulveda VA: Residents provide primary care to patients through the VA healthcare system, the largest integrated healthcare system in the United States.

Other Ambulatory Experiences

Residents may do multiple other ambulatory experiences on a two- to four-week block basis. In addition to continuity at their own site, residents will have the ability to work at the other continuity sites practicing at both ambulatory care and ambulatory subspecialty clinics. Residents also have the opportunity to work at the Venice Family Clinic, Clinica Oscar Romero or the Los Angeles Mission, where they work with a poor and underserved patient population.

 

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