What does a typical day on inpatient look like?
Inpatient days start fairly early, especially for interns. Our morning rounds are at 7:30 am, with the expectation that interns have pre-rounded before that, and sign out is at 6 pm. The patients on our service are our clinic patients, and span the spectrum from newborns and new moms to our patients with chronic medical conditions. During the day, along with patient care tasks, we see our own patients in the ED to evaluate them for admission or discharge (definitely ask residents about this during your interview day, this is a unique aspect to our program!) When we have newborns on service with families requesting circumcision, the opportunity is given to the inpatient team for the procedure! While frequently busy, our inpatient blocks are where we have some of our best learning opportunities, with articles that the team reviews together and protected lunch hour for didactics, where your senior answers any pages or calls. Our census varies widely, but is typically between 8-12 patients. If the service is busy, our interns have a cap at 7 patients.
How does your night float system work?
Night float starts on Monday night and goes until Friday night/Saturday morning – this is how we cover our inpatient service during the week (weekends are covered with 24 hour calls which you can read more about below). Float is covered by the residents on service – interns cover night float with a senior resident as in house backup and second years are on “solo nights”. One week out of each four week inpatient service block will be spent as night float. 3rd year residents only work night float as back up.
Does your program have 24-hour calls? How many calls does each resident have every year?
Yes, we do have 24 hour calls in our program. Intern year these calls are taken across a few services that we rotate on (Labor and delivery and surgery). On our own FM inpatient service, our interns work “sunshine shifts” which are not true 24’s as there is a break between morning rounds and working the night call with your senior resident. As 2nd and 3rd years, you take traditional 24 hour calls for our FM inpatient service. Approximately 5 calls 2nd year and 8 calls 3rd year.
Is intern year difficult at Long Beach? What kind of resources does your program have to help interns?
Like many other family medicine programs in California, most of our intern year is inpatient including FM service, MICU, pediatrics, and inpatient surgery. While the hours can be long, we try to break this up with built in outpatient rotations intern year (cardiology, pediatric clinic, gynecology, and newborn). Every month, interns have protected time for Intern Meeting, which is a chance for interns to come together, eat a meal with their chiefs, and unpack what’s happening on their rotations. We have a big-little program with a stipend for a “family dinner”, allowing our interns to connect with their seniors. Each resident is assigned a faculty advisor, with scheduled meetings (where our attendings treat us to lunch!)
How much elective time do residents get? Which electives are most popular with your residents?
Residents get a total of 20 weeks of elective time, the majority of it is during our 3rd year. We have great relationships with many of the specialists in the area and even give out a yearly “Golden Apple” award to our best non-faculty teachers! Popular electives include nephrology, pulmonology, and general and specialty pediatrics to name a few. This is also the time residents use to go on international trips or other away rotations.
Are there opportunities for pursuing global health?
Absolutely! In non-Covid times, we have opportunities for residents to pursue global health trips. Our residents have been all over the world, most recently to Jamaica, Vietnam, and Peru. Our area of concentration allows residents to receive funding for their learning opportunities.
How do the OB experiences of your residents compare to other programs?
Intern year each resident spends 7 week at White Memorial on Labor and Delivery with the goal of participating in 40 vaginal deliveries. It’s a high volume service, so our residents get a lot of hands-on experience. We’re required to complete another 3-4 weeks of OB second year, but have the option to complete this time at our home institution. We also participate in prenatal care in our clinic and continuity deliveries of our clinic patients, with most residents getting to the goal of 50 total deliveries. We also have a Maternity Health AOC, which facilitates more OB experiences for interested residents.
Does your program offer abortion training?
Yes! We currently have the capacity for MABs in our clinic with our faculty. We very recently received the RHEDI grant, which will allow us to offer opt-out abortion training at both planned parenthood and in our office. We are currently working on developing a family planning area of concentration, which will hopefully be in place by the time you get here!
What is the relationship with the community specialists at your hospital?
Different from academic hospitals, we are the only residency program in the hospital (though there are other residents rotating from other institutions), which gives us the opportunity to work directly with our specialists! The specialists are generally kind, patient, very happy to teach, and even happier to take the consult. Our community cardiologists, nephrologists, and pulmonologists work with us to help provide the best care for our patients. You can get a hold of them via our secure texting app when they’re inpatient or via our EMR (Epic) if you want to send a chart or question to them outpatient.
What are didactics like?
We have (almost) daily lunch time didactics. Once a month we also have a whole afternoon of didactics with protected time on most rotations. This is a space that we frequently use for workshops (i.e. sports/sidelines triage or colposcopy workshop).
Where do most of your residents end up practicing after they graduate?
Our residents practice in a variety of different settings after graduation including managed care practices, FQHCs, urgent care, academic medicine, corrective medicine and concierge medicine. In recent years, we’re had several graduates join MemorialCare, Altamed, Kaiser Permanente and UCLA Health. For those from Northern California, a recent graduate is now working for Stanford Health providing full spectrum family medicine including obstetrics and we have several graduates working for Kaiser and Sutter in Northern California. We’ve had multiple Community Medicine Fellows (through Kaiser Permanente), sports medicine fellows, palliative care fellows and geriatric fellows. Several have become faculty at FM residency programs (including one at our own program!).
How do residents spend their free time?
Our residents have a diversity of hobbies and talents that they continue to enjoy on their days off! Some of our residents are parents, and we’re ok sharing them with their families. Many of our residents are active and take advantage of the year-round sunshine with hikes, beach days, and running along the coast. Many also have family and friends close by that they’re able to keep up with. We have artists, athletes, equestrians, spin enthusiasts, bakers, and travelers in our program! Lastly, you’ll often stumble upon our residents spending their Saturday afternoon with their classmates on call over Thai food.
What is Long Beach like?
Long Beach is a very cool and unique place! It’s perfectly situated on the coast, a stone’s throw away from Los Angeles but without the parking and traffic fiasco. It’s a diverse city that has a spot for anyone to find a place they would like to call home. There’s an incredible amount of good food, great coffee, cool bars, and independently owned shops that make this city unlike any other. Shoreline Bike path is a 3.1 mile paved path along the beach that encapsulates how bike, rollerblade, and skateboard-friendly the city is while Rosie’s Dog Beach is a testament to our love for pets/best friends. Learn more at https://www.visitlongbeach.com/.
Where do residents usually live?
Our residents live in a variety of communities and zip codes around the hospital. Many of our residents live in Long Beach, which has a myriad of neighborhoods and options to find the best fit for you. In the past residents have lived as far north as DTLA and south into Orange County.
What programs are dedicated to outreach to the underserved community of Long Beach?
We have several programs dedicated to outreach to the underserved community. Neighborhood Med is a pipeline program started by one of our former grads that matches traditionally underrepresented students with residents to shadow, build networks, and help on their path to medical school. The Doc Is In is a program that sets up residents to give monthly lectures to high schoolers at a local magnet school with a track for students interested in science and health careers – this time is protected for residents. We also have An Lanh Clinic, a free clinic where our residents can volunteer and precept medical students. You can find more details under our community medicine tab on the website.
What is the meal stipend? Does the cafeteria have good food?
Our meal stipend was previously ~$5/meal and money was allotted per month based on how many “meals” you were slated to have in the hospital. The program is currently trying a new way of dispersing our money so that we’re given a lump sum every quarter to spend how we wish. Every resident will have a different opinion on this, but it’s certainly better than the food some of our residents have had in their medical school hospital cafeteria!
What kinds of procedures can you do in clinic?
We can do most procedures in our office! We do everything from IUD and nexplanon insertions to toenail removals. We have faculty that can precept paracentesis, colpos and EMBs and ultrasound guided joint injections.
Which EMR does your hospital and your clinic use?
Both our clinic and our hospital use Epic as our EMR. It is also integrated meaning that we use the same log in for both locations and notes and results will all cross over.