Program Curriculum

Ambulatory Subspecialty Clinics

Residents spend four weeks in both PGY-2 and PGY-3 rotating through subspecialties at Scripps Clinics, including rheumatology, pulmonology, gastroenterology, infectious disease, nephrology, neurology, endocrinology and hematology-oncology. Training focuses on evaluating, diagnosing and managing common conditions encountered in outpatient primary care and specialty clinics.

Behavioral Health & Psychiatry

PGY-1 residents complete a two-week rotation focused on mental health, substance use and social services available in the community. They rotate with FHCSD adult and pediatric psychiatrists, participate in mental health process groups and attend substance use support programs such as Solutions for Recovery and AA. Training includes community mapping, behavioral health interventions, reflection practices and a wellness day. Behavioral health training continues throughout residency via didactics, continuity clinic, the Behavioral Health Clinic (BHC) and faculty shadowing.

Community Medicine

This longitudinal experience introduces residents to social service agencies in City Heights and teaches them to navigate and collaborate with community resources. Training emphasizes culturally competent care within diverse community contexts. Rotation sites include syringe services, transitional medicine, physical therapy, family planning, infectious disease care, refugee health, healthy development services, reentry support and group diabetes visits.

Dermatology

PGY-2 residents spend four weeks learning to diagnose and manage common dermatologic conditions and perform outpatient procedures such as biopsies, cyst removals, dermoscopy and cryotherapy. Rotations occur at local outpatient practices and FHCSD dermatology clinics.

Electives

Residents have four weeks of electives during their PGY-2 year and 12 weeks of electives their PGY-3 year. Past elective experiences have included subspecialty services at Scripps including gastroenterology, infectious disease, endocrinology, and palliative care. Residents have created custom rotations covering multiple specialties in a four-week block by combining two-week rotations in urgent care, sports medicine, MAT, procedures and many more. There are options to perform away rotations. Residents have done electives such as Indian Health Services within the U.S. and international experiences in Latin America and Africa.

Family Medicine Clinic

Residents participate in a longitudinal continuity clinic at City Heights Family Health Center throughout all three years. Under faculty supervision, they practice full-spectrum care for patients of all ages and manage chronic conditions such as diabetes, hypertension and COPD. They also care for refugee patients; patients experiencing homelessness; and those with infectious diseases or recent incarceration histories. Specialty clinic experiences include procedures, colposcopy, group diabetes visits, behavioral health and refugee health assessments. Additional clinics include osteopathic manipulative treatment, sports medicine and integrative medicine, with planned additions in infectious disease care and MAT.

Geriatrics

In this two-week rotation, PGY-1 residents learn about care specific to elderly populations through UCSD’s Geriatrics Department and the San Diego County Aging and Independence Services Department. They spend time at the Senior Behavioral Health Center and the Medicine for Seniors Clinic at UCSD. Residents also gain longitudinal geriatrics experience through their continuity clinic and FHCSD’s Program for All-Inclusive Care for the Elderly (PACE) program.

Gynecology

This four-week rotation allows PGY-3 residents to gain exposure in diagnosing and managing common outpatient gynecological conditions. Residents spend four to six half days per week rotating with FHCSD OB/GYN providers at our different clinic sites. Residents work in our FHCSD Breast Clinic learning about common breast conditions and rotate through FHCSD family planning clinics, learning about contraception and placing Long-Acting Reversible Contraceptives.

HIV/Hepatology

This two-week rotation allows all PGY-3 residents to gain exposure in HIV services available through FHCSD and our community. Residents work with our HIV and HCV providers at our FHCSD Hillcrest location. In addition, they rotate at our Hillcrest Night Clinic providing HIV/PrEP and transitional care. Residents who wish to become boarded in HIV medicine apply for the HIV track in the spring of their first year of residency.

Palliative Medicine

Second-year residents rotate for two weeks with the multi-disciplinary Palliative Care Consultation Service at Scripps Mercy, which cares for patients of all ages and cultural backgrounds facing serious illness. Residents participate in palliative care consultations within the hospital environment. Residents become part of the palliative care team at Scripps Mercy Hospital and work alongside palliative care attendings, fellows, mid-level providers and social workers. During this time, residents develop the skills to evaluate, diagnose and manage common disorders in patients nearing the end of life, learn evidence-based symptom management and gain experience in leading goals of care discussions and family meetings.

Pediatric Outpatient

This outpatient rotation, present in all three years of training, teaches residents how to diagnose and manage common pediatric conditions. In the busy pediatric clinics, residents perform well child exams, preventative care and immunizations. Residents spend time rotating with FHCSD pediatricians at our North Park location for four weeks during PGY-1 and PGY-3 years, as well as two weeks during PGY-2 year. In addition, residents take care of pediatric patients during their continuity clinic at City Heights.

Practice Management/Population Health

This two-week rotation allows PGY-3 residents to transition from residency medical training to their professional life post-graduation. The overarching goal is to gain the knowledge and skills needed to manage all the different components needed for a successful practice such as organization of a clinic, physician-patient communication, care coordination, cost/benefit decision making, administration and marketing. This includes both rotational and longitudinal experiences. Residents are given the opportunity to interact with various clinic and organizational administrative staff members to gain insight into the different aspects of clinical operations and health care.

Sports Medicine

This two-week rotation in PGY-2 year and four-week rotation in PGY-3 year allows residents to learn about and manage common musculoskeletal injuries and conditions. Residents spend three half-days per week rotating with our FHCSD Sports Medicine Department, one half-day per week rotating in FHCSD’s Podiatry Clinic and one half-day per week with our physical therapy/chiropractic services. Residents spend several half-days per rotation rotating with UCSD’s and Rady Children’s Sports Medicine clinics. Residents perform procedures such as joint injections and joint aspirations, interpret radiographic imaging, use ultrasound-guided techniques and perform sports physicals.

Adult Medicine Inpatient

FHCSD residents have their own inpatient teams supervised by hospitalist attendings. These two teams work alongside the internal medicine resident teams but carry their own panels of patients. The FHCSD team consists of a senior resident and two interns. In the first half of the year, a third-year resident will lead the team. During this time, there will also be a second-year resident working one-on-one with an attending on a separate team. Halfway through the academic year, the roles switch and the second-year resident will lead the team and the third-year will do the one-on-one “lone wolf” schedule. Residents triage and manage patients through all levels of acuity, from the ED to the ICU.

Cardiology

Second-year residents work with Scripps and FHCSD cardiologists in all aspects of cardiology including inpatient consultations and management, electrocardiogram readings, performing echocardiograms, treadmill testing, nuclear perfusion scans, catheterizations and cardiac rehabilitation.

Emergency Medicine

The PGY-2 residents participate in four-week shifts and PGY-3 residents perform two-week shifts in the Scripps Mercy Emergency Department working with emergency physicians to triage and treat patients in this Level 1 trauma center.

ICU

PGY-2 residents spend two weeks working alongside the Scripps internal medicine residents on the ICU teams admitting and managing the intensive care patients.

Nursery

First-year residents work with pediatricians, pediatric intensivists and neonatologists to take care of infants, many of whom are delivered by the FHCSD OB service. In this four-week rotation, residents learn how to do newborn exams and address concerns such as hyperbilirubinemia, infections and conditions specific to neonates and possible congenital issues.

Obstetrics

The residents work one-on-one with the FHCSD OB/GYN attending physicians. The FHCSD residents are the only residents performing deliveries at Scripps Mercy and Sharp Grossmont Hospital, which serve the urban underserved populations of San Diego County. Residents learn to assess and monitor patients in labor, perform vaginal deliveries, are first-assist in C-sections and take care of the patients in the postpartum period.

Pediatric Emergency Medicine

Residents rotate through the only Level 1 pediatric trauma center in San Diego County. It is the only center in the area dedicated to the emergency care of children. Residents gain valuable experience from the opportunity to aid children in varying degrees of distress, injury and infection.

Pediatric Inpatient

FHCSD residents, along with family medicine residents from other San Diego programs, perform their inpatient pediatric rotation at Rady Children’s Hospital; the largest children’s hospital in California. As a nationally ranked pediatric medical center, the residents work with highly trained specialty teams in order to treat a spectrum of illnesses ranging from common seasonal ailments to rare and unusual diseases.

Surgery

The residents work one-on-one with Scripps general surgery attendings in the hospital and general surgery clinic. This rotation allows family medicine residents to learn to recognize and triage possible acute surgical illness, gain technical skills as well as manage the post-op care of patients.

Addiction Medicine Track

The Addiction Medicine Track is a two-year program focused on primary care addiction medicine and behavioral health skills development. The track prepares residents to establish an addiction medicine practice after residency or pursue fellowship training.

Residents complete PCSS Core Curriculum modules throughout the program. During PGY-2 and PGY-3, they participate in one to two half-day clinic sessions caring for patients with substance use disorders at sites such as the City Heights MAT clinic, Hillcrest evening refill groups, the Mobile Medical Unit and an external methadone clinic. Residents also complete a four-week addiction medicine elective.

Additional requirements include delivering two didactic presentations on substance use topics and assisting with motivational interviewing workshops. Residents attend at least one addiction medicine conference and are encouraged to apply for MERF scholarships to support a scholarly project in addiction medicine.

Comprehensive Pregnancy Care Track

The Comprehensive Pregnancy Care Track provides longitudinal training in perinatal care for residents who plan to incorporate inpatient or outpatient obstetric care into their scope of practice after graduation.

Residents complete a minimum of three additional four-week obstetrics blocks, along with longitudinal clinic assignments in obstetric care, fourth-trimester care and gynecologic procedures during PGY-2 and PGY-3.

Residents develop skills to diagnose and manage medical conditions that arise during pregnancy or coexist with pregnancy. Training includes performing vaginal deliveries and laceration repairs independently, developing foundational skills in obstetric emergency management, serving as first assist on cesarean sections, providing family planning and options counseling, delivering comprehensive postpartum care and managing early pregnancy loss.

Residents interested in surgical obstetrics may train as the primary surgeon for cesarean sections at a higher-volume hospital site. Faculty also mentor residents interested in obstetrics fellowship training through the application process.

Comprehensive Reproductive Health Track

The Comprehensive Reproductive Health Track offers longitudinal training for residents who plan to integrate reproductive health care and gynecologic procedures into their future practice.

Residents complete the equivalent of three additional four-week blocks focused on reproductive health and gynecology through longitudinal clinic assignments and away rotations during PGY-2 and PGY-3. Additional elective time may be used to support this training.

Residents gain experience in patient-centered reproductive health care and advocacy, contraceptive and options counseling, gynecologic and long-acting reversible contraception procedures, menopause management and comprehensive breast and pelvic care. Abortion care training and early pregnancy loss management are strongly encouraged but not required.

Residents who wish to pursue advanced training receive mentorship and support through the reproductive health fellowship application process.

Global Health

The Global Health Area of Concentration prepares residents to care for refugee, immigrant and asylum-seeking populations.

All residents complete community medicine rotations and collaborate with community partners such as United Women’s East African Support Team, Survivors of Torture International and the Dunya Women’s Health Collaborative. Residents complete a one-month glocal elective during PGY-2 and an international elective during PGY-3. Residents are encouraged to present scholarly work at global health conferences.

HIV Medicine Track

The HIV Medicine Track provides longitudinal training in outpatient HIV care.

During PGY-2 and PGY-3, residents manage their own HIV patient panels under specialist supervision. Training includes antiretroviral therapy management, treatment of opportunistic infections and management of HIV-related co-infections. Residents also participate in the Pacific AETC HIV Learning Network telehealth program.

Graduates are eligible to sit for the American Academy of HIV Medicine certification exam.

Integrative Medicine Track

Residents in the Integrative Medicine Track complete the University of Arizona Integrative Medicine in Residency curriculum and a two- or four-week elective in integrative medicine.

Residents provide integrative care in clinic and are encouraged to present scholarly work during their PGY-3 year.

Sports Medicine Track

The Sports Medicine Track is designed for residents pursuing advanced training in musculoskeletal and sports-related care.

Residents gain additional experience through event coverage, preparticipation physicals, monthly sports medicine clinics, ultrasound training and mentorship with sports medicine physicians. Many residents pursue sports medicine fellowship training after graduation.