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Specialized Pathways

During the first year of residency, Categorical, PSTP, and Medicine/Pediatrics residents can apply for any of five optional specialized pathways to further augment their training. These pathways tailor the clinical and educational experience during the second and third years of residency training and include opportunities for special elective rotations and focused didactic sessions. 

Primary Care Pathway

Pathway Director: Stacy Charat, MD

 
The Primary Care Pathway provides an individualized educational experience for residents interested in pursuing careers in primary care. The pathway offers complements our robust ambulatory medicine training with additional continuity clinic experiences, a supplemental didactic curriculum, and exposure to a range of ambulatory clinics with high relevance to primary care practice. Applications for the Primary Care Pathway occur immediately after the match, for participation in all three years of training, and again during the fall of the PGY-1 year for additional residents who decide to join for the PGY-2 and PGY-3 years.
  • Ambulatory Care Blocks: Residents in the Primary Care Pathway participate in three 4-week ambulatory care rotations annually. Two weeks of each ambulatory rotation are dedicated to customized primary care blocks, and two weeks are dedicated to ambulatory electives. 
  • Elective Rotations: Residents in the primary care pathway work with the pathway director to prioritize elective selections that will best prepare them for primary care practice. They are encouraged to select outpatient electives in endocrinology, dermatology, Kaiser ambulatory medicine, obesity medicine, pain medicine, psychiatry, and surgical subspecialties. These are in addition to the required rotations in geriatrics, musculoskeletal medicine, and neurology. 
  • Primary Care Blocks: Each block consists of a mix of continuity clinics, subspecialty clinics, weekly primary care academic half-days, and unique clinical and educational opportunities.  We strive to individualize each resident's rotation schedule based on personal interests and career goals. 

​Sample Weekly Schedule for Primary Care Block


​Monday
​Tuesday
​Wednesday
​Thursday
​Friday
AM
Primary Care Morning Report

Subspecialty Clinic: Gynecology



Suboxone Training Session




Subspecialty Clinic: Endocrine




Home Visits



Site Visit: Prison Health System
PM
​Continuity Clinic

Research Mentoring Evening
Continuity Clinic
Primary Care Academic Half-Day
​Continuity Clinic
​Friday School:
Primary Care Journal Club

  •  Events/Site Visits: Special events during the primary care blocks include primary care morning reports, primary care journal clubs, general medicine research panels, career panels, unique training in Suboxone prescribing and long-acting reversible contraception, and individualized preparation for the job search process. We also take site visits to learn about different models of care, including the prison health care system, an integrative medicine clinic, and the Indian Health Service. 
  • Didactics: Thursday afternoons of each rotation are dedicated to didactics related to general internal medicine and skills development for primary care doctors. Sessions include topics such as outpatient pain management, agenda-setting in primary care, the business of medicine, EMR data analysis, common ENT complaints, dermatologic procedures, common eye complaints, motivational interviewing, and smoking cessation. Residents are encouraged to suggest topics of interest. 
  • Scholarly Work: Residents in the pathway are encouraged to create scholarly work including clinical vignettes, original research projects, and educational innovations and submit their work for presentation or publication. The primary care blocks are scheduled to overlap with the Society of General Internal Medicine conferences to promote attendance at and submission to them. 
  • Mentoring: Primary care residents are individually mentored through the career exploration and job search process by the pathway director and other select primary care faculty. The primary goal of the pathway is to help our residents find the best possible career pathway that allows them to achieve their professional goals while maintaining a healthy work-life balance.

Resident as Clinician Educator (RACE) Pathway

Pathway Directors: Supraja Thota, MD; Connie Chace, MD; Sean Kenmore, MD

 
Diversity Residents at Dinner

The RACE (Resident as Clinician Educator) Track is a training pathway devoted to building clinical education skills and a diverse teaching portfolio. Residents are paired 1:1 with faculty mentors who provide focused training in medical education and oversee resident progression towards professional teaching goals. Additionally, the RACE Track runs sessions for all residents via our Friday School didactics. 

The RACE Track consists of three primary components:
  • Didactic Workshops: These small-group sessions focus on various educational topics, such as curriculum development, giving effective feedback, and crafting a teaching portfolio.
  • Two-week annual RACE Track elective: This is a teaching elective block wherein residents focus on leading teaching workshops and conferences with medical students and resident peers.
  • Longitudinal Scholarly Project: Residents create an education project of their choosing. Previous projects include podcasts, a notewriting course for MS3's, and sub-curricula within Friday School.

Hospital Medicine Pathway

Pathway Director: Ali Farkhondehpour, MD

 
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The Hospital Medicine Pathway provides specialized training to residents who are interested in becoming leaders in academic hospital medicine. Residents in the pathway receive relevant, unique inpatient training, specialized didactics, one-on-one mentorship, and opportunities to participate in a variety of quality improvement projects.
  • Pathway provides flexibility to start at the beginning of either PGY-2 or PGY-3 year
  • Close one-on-one mentorship with an assigned academic hospitalist
  • A 4-week “Junior Hospitalist” rotation at the UCSD Medical Center in La Jolla
  • Didactics on patient safety, billing/coding, business of hospital medicine, inpatient medical consultation, ethics, and more!
  • Hands-on point-of-care ultrasound rounds
  • Participation in a 2-week “Professional Development” block, including unique rotations with IR, Radiation Oncology, Speech Therapy, and more!
  • Field trips to long-term acute care (LTACs) and skilled nursing facilities (SNFs)
  • Participation in hospital medicine grand rounds and hospital medicine journal club

Global Medicine Pathway

Pathway Directors: Annie Cowell, MD

 
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The Global Medicine Pathway at UCSD leverages our interdepartmental and international relationships to provide residents with opportunities to learn about and provide care in underserved communities around the globe. This includes our multidisciplinary workshops, simulation sessions, and elective rotations with our international clinical partners in Mozambique and Mexico.  
  • Simulation workshop in collaboration with other departments (Emergency Medicine, Reproductive Medicine, and Surgery) centered on providing care in limited-resource settings
  • 1- to 2-month elective rotation at Maputo Central Hospital in Maputo, Mozambique, with housing provided by the residency
  • Underserved medicine elective also available, providing care for correctional systems in San Diego
  • Opportunities to participate with tele-ICU with hospitals in Tijuana, Mexico
  • Scholarly project in Global Medicine

Integrative Medicine Pathway

Pathway Co-Directors: EB Sladek, MD; Samantha Spilman, MD

 
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The Integrative Medicine Pathway focuses on exploring a holistic approach to patient care. In this pathway, residents explore the evidence surrounding various traditional healing techniques and how they blend into Western medicine. The pathway features quarterly, interactive didactics in which they learn general principles of integrative medicine as well as disease specific treatments. They also are assigned an integrative medicine faculty mentor and work one-on-one on a scholarly project. UCSD is the 5th internal medicine program nationwide to participate.


Year 1: Focus on general principles of integrative medicine

  • Quarter 1: Nutrition
  • Quarter 2: Vitamins and supplements
  • Quarter 3: Wellness (physical activity, sleep medicine, mindfulness, burnout
  • Quarter 4: Tools in integrative med (OMM, acupuncture, motivational interviewing)

Year 2: Focus on disease specific treatments and principles

  • Quarter 1: Oncology and pain management
  • Quarter 2: Women’s health and preventive medicine
  • Quarter 3: Cardiovascular health and microbiome
  • Quarter 4: Presentation of capstone project

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