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 10-15 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. The night team consists of a senior resident (second or third year) and an intern OR just a senior resident doing a week of solo nights. On the weekend, the hospital team covers Saturday and Sunday day shifts (intern #1/second year and intern #2/third year so that everyone on service gets 1 day off a week) and a senior resident not on the hospital service covers Saturday night and Sunday night/Monday morning with the rest of Monday off.
Does your program have 24-hour calls? How many calls does each resident have every year?
There are 1-2 24 hour calls during intern year at White Memorial while on the OB rotation. Otherwise, in response to resident feedback, there are no longer any 24-hour calls on our family medicine inpatient service. In its place, we now have an additional weekend night float in place, where a covering senior resident will take admits and cover the inpatient list from 6PM-8AM on Saturday night and Sunday night. Senior residents will have 3-4 weekend evening calls a year (in addition to weeks of solo nights), and residents vastly prefer this to the 24-hour call.
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. 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?
During second and third year, you get plenty of elective time to explore your different interests. During second year there are approximately 10 weeks of elective time and during third year there are approximately 20 weeks of elective time!
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, infectious disease/HIV medicine, general and specialty pediatrics, street medicine, LGBTQ+ health, and student health at CSULB, to name a few. This is also the time residents use to go on international trips or other away rotations.
How do the OB experiences of your residents compare to other programs?
Intern year each resident spends 6 weeks at White Memorial on Labor and Delivery with the goal of participating in 20-40 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 40 total deliveries, with 10 of those being continuity deliveries. The second year on the family medicine service and senior resident on nights manage our laboring patients in the hospital, and the resident who has been performing the prenatal care is called in for the delivery. For interested residents, we have a Maternity Health Area of Concentration (AOC) which facilitates more OB experiences than those already built into the curriculum.
Does your program offer abortion training?
Yes! We currently have the capacity for (medication abortions) MABs in our clinic with our faculty. We are the proud recipients of the RHEDI grant, which allows us to offer opt-out abortion training at both Planned Parenthood and in our office. Residents in the Family Planning AOC receive additional training in procedural abortions, which is completed at Planned Parenthood, with the additional option to pursue more training in Mexico City for 2-4 weeks.
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. We also have quarterly workshops that are during protected time (for most rotations). Past workshops have included family planning hands-on training, sideline triage, suturing skills, ultrasound workshops.
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 the last five years, we’ve had residents match into fellowships for geriatrics, palliative care, sports medicine, and family planning. Most of our graduates stay local (see our “Alumni” page for more details), and some of the larger medical groups that recruit our residents include MemorialCare, AltaMed, Kaiser Permanente and UCLA Health.
Does the program have dedicated time for research or quality improvement?
There are opportunities for both PDSA and community needs assessment projects that are integrated into the curriculum. Recent examples include HPV self-swab for cervical cancer screening, letrozole induction protocol for patients navigating infertility, and providing mental health tools to Spanish-speaking community leaders to respond to the needs of their target population. Residents have gone on to present these at conferences, and we are always looking for ways to improve care of our patient population and community more generally.
Do residents interact with medical students?
Throughout the year, we have between medical students rotating with us from UCLA and UC Irvine (as well as USC Keck’s PA program) on their family medicine clerkship with senior residents and faculty in their clinic as well as students completing their sub-i’s who spend time both in clinic and on the hospital service. Many students have commented on how welcoming and supportive the learning environment is, and we love having the opportunity to support them in their medical school journeys!
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! Many of our residents are active and take advantage of the year-round sunshine with hikes, beach days, and running along the coast. Currently, our residents have a variety of hobbies: pickleball, rock climbing, trying restaurants and cafes, walking/biking/rollerblading on the beach, going to concerts/shows/movies, hiking. Many also have family and friends close by that they’re able to keep up with. We have artists, dancers, athletes, spin enthusiasts, bakers, and travelers in our program!
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. Most 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 as far south as 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.
What is the meal stipend? What’s the food like in the cafeteria?
The program disperses money so that we’re given a lump sum every quarter ($900) to spend how we wish. The food is pretty good for hospital food! There’s a grill where you can get sandwiches and wraps made to order, there’s a large salad bar with soups, a few hot entrees every day, sushi, and a large variety of caffeinated and non-caffeinated beverages.
What kind 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 colposcopies, endometrial biopsies, procedural abortions, and ultrasound-guided joint injections.
Which EMR does your hospital 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.