Outpatient and Inpatient Rotations

Diverse Learning Experiences at Scripps Mercy Hospital San Diego

Outpatient

While on elective rotations, Scripps Mercy residents have the opportunity to work in several different types of specialty clinics within Mercy Clinic . This provides an optimal and diverse learning experience while providing continuity of care for patients.

Specialty outpatient clinics

  • Cardiology
  • Chronic Heart Failure
  • Endocrinology and Diabetes
  • Gastroenterology
  • Neurology
  • Hematology/Oncology
  • Pain management
  • Pulmonology
  • Nephrology
  • Rheumatology

Providing patient care at Mercy Clinic allows residents and faculty to learn how to navigate the rapid changes occurring at Scripps Health and the economics of health care while keeping the spirit of the Mercy Clinic alive.

Inpatient

Program duration: Four weeks

Work team: Two interns, one senior resident and one or two hospital-based attendings. The team sometimes includes podiatry residents and visiting medical students, as well.

There are five teaching ward teams. One team integrates case managers, RNs and clinical pharmacists into the rounding process to better coordinate patient treatment, discharge planning and continuity of care. The case managers and pharmacists are available to each of the teams to assist with discharge planning.

Support staff: There are full ancillary support services available with case managers, pharmacists, social workers, nutrition, physical, occupational and speech therapy teams.

Patient load: Intern caps are nine per intern with a total team cap of 18 patients, except for the first four months which has a total team cap of 16 patients. Patients are admitted through the Scripps Mercy emergency department—and occasionally—directly from the Mercy Clinic.

Educational experience: The rotation encompasses an ethnically diverse patient population from a wide variety of socioeconomic backgrounds with medical diagnoses ranging from commonly encountered conditions to more complex and rare diseases. Most patients are seen under hospitalist supervision. Occasionally, however, interesting patients of private attendings are admitted to the teaching service.

Categorical PGY-1 sample schedule

There are 13 blocks rotations of approximately 28 days each at Scripps Mercy Hospital.

  • Ward medicine: 3 rotations
  • Day float ward medicine at Scripps Mercy: 1 rotation
  • Night float: 1 rotation
  • Medical intensive care unit (MICU): 2 rotations
  • Ambulatory medicine clinic: 1 rotation
  • Emergency medicine: 1 rotation
  • Elective: 3 rotations
  • Primary care clinic (urgent care clinic): 1 rotation

Categorical PGY-2 sample schedule

  • Ward medicine: 3 rotations
  • Resident day float: 1 rotation
  • ICU: 2 rotations
  • Ambulatory clinic: 1 rotations
  • Night float: (2 weeks each) 1-2 rotations
  • Adolescent medicine – Navy: (2 weeks) 1 rotation
  • Gynecology rotation – San Ysidro: 1 rotation
  • Endocrinology: 1 rotation
  • Wards/Cardiology/GI/Heme-Onc: 1-2 rotation
  • Electives: About 1.5-3 rotations

Categorical PGY-3 Sample Schedule

  • Ward medicine: 3 rotations
  • ICU: 1-2 rotations
  • Night float: 2 weeks
  • Geriatrics/Palliative medicine: 2 weeks each
  • Cardiology: 1 rotation
  • GI (unless done in PGY-2 year): 1 rotation
  • Heme-Onc (unless done in PGY-2 year: 1 rotation
  • Ambulatory clinic: 0-1 rotation
  • Resident day float: 0-1 rotation
  • Electives: 2 to 3 rotations