General Medicine Clinic at San Francisco General Hospital

The General Medicine Clinic of San Francisco General Hospital is the primary residency continuity clinic site for 53 internal medicine residents at University of California, San Francisco.  The mission of the General Medicine Clinic is to provide comprehensive, high quality primary care services to adults in the San Francisco safety net, and to provide an excellent teaching environment for UCSF students and residents. 

During the 2011-2012 academic year, the clinic provided more than 32,000 patient visits to more than 6,500 individual patients, the majority of whom were low-income people with complex medical conditions. 

As a patient-centered medical home (PCMH) that practices team-based care, clinic patients select or are assigned to a primary care provider to ensure both continuity of care and the opportunity for residents to develop longitudinal relationships with patients. At the same time, in order to support residents in caring for patients, a team model of care is used that includes a practice partner, a primary attending preceptor, a resident continuity nurse practitioner, team medical evaluation assistants, team behavioral assistants, and team clerks. The clinic also uses an electronic health record that is integrated with hospital data, and includes notes, medications, allergies, laboratory and diagnostic studies, as well as an electronic referral and consultation system.

Objectives for this three-year program include:

1. to provide training and a high degree of competence in the management of severely ill hospitalized patients
2. to provide an ambulatory care experience that has continuity throughout the three years of training and provides increasing breadth and intensity of experience in the primary care setting
3. to acquire the specialty and subspecialty skills necessary for the practice of internal medicine
4. to develop skills in interviewing and patient communication in order to gather data effectively and to understand illness in the context of patients' life patterns
5. to learn to function effectively as the internist member of a primary health care team, working with other physicians, psychologists, nurse practitioners, pharmacists, social workers, dieticians and physical therapists
6. to learn the skills needed for modern medical practice