The education and clinical training of internal medicine residents are the central focus of the department of medicine. Our curriculum is well balanced between inpatient and ambulatory care activities. The unifying principle is to provide experiences that enable the trainee to acquire the knowledge, skills, values, and attitudes of the internist in order to provide in-depth, comprehensive care.
In a usual year, there are approximately 100 residents rotating through 3 hospitals. The hospitals affiliated with our program are all Joint Commission-approved facilities near LLUMC. They include the following:
- Loma Linda University Medical Center (LLUMC)
- Jerry L. Pettis Memorial (Loma Linda) VA Medical Center (VAMC)
- Riverside County Regional Medical Center (RCRMC)
The diversity of these settings and patient populations gives our residents a well-rounded clinical and technical experience. For example, at the county hospital you serve the indigent of the Inland Empire. In this setting residents will see late stages of disease as well as new presentations of unusual, undiagnosed conditions. On the other hand, the VA hospital population exposes residents to a variety of bread and butter cases of medicine. This gives the residents a solid foundation in the diagnosis and management of common cases in Internal Medicine. In spite of the homogeneity of the group, you will still get exposure to unusual cases. Loma Linda University Medical Center is a tertiary referral center, and while we serve the communities of Riverside and San Bernardino counties, you will see very unusual cases frequently referred by local subspecialists. Upon completion of our program, residents will have a clear understanding of how to manage diverse populations across a multitude of settings.
Internship is designed to provide experiences which enable the trainee to make the transition from medical student to clinically competent physician. PGY-1 residents spend approximately 4 months in general medicine wards, 2 months in critical care and 6 months in other rotations, including geriatrics, neurology and an elective month.
Preliminary interns take part in the same curriculum and develop a solid base of internal medicine knowledge before entering their chosen specialty. Residents completing their preliminary internship pursue such fields as anesthesiology, dermatology, emergency medicine, neurology, ophthalmology, physical medicine and rehabilitation and radiology. Inpatient experience is predominantly scheduled on the general medicine and subspecialty wards at LLUMC and VAMC. Ambulatory experience is provided through ambulatory and elective rotations.
The second year is designed to provide experience in the supervision of interns and medical students within broader clinical experiences in primary and consultative medicine. They spend time on MICU, CCU, and 3 months of general medicine wards. The remainder consists of an elective, subspecialty and ambulatory rotations.
The third year of training is designed to provide mastery of the academic and clinical skills necessary to become a board certified internist. Clinical experiences emphasize ambulatory training. Generally, residents rotate through the medicine wards at RCRMC and have approximately 2 months of critical care and 2 months ambulatory medicine in addition to an elective, emergency medicine, and exposure to the subspecialty rotations.
Primary Care Track
The primary care track provides unique and comprehensive training for those who plan careers in primary care general internal medicine. Our goal is to train highly competent, socially responsible general internists skilled in the contemporary methods of primary care. While maintaining the traditional core of training in internal medicine, the primary care track emphasizes the role of the internist as a member of an interdisciplinary healthcare team working not only with other physicians, but also allied health professionals such as psychologists, nurses, social workers, dietitians, physical therapists, and occupational therapists.
The primary care track supplements the traditional track in several ways. First, the curriculum emphasizes rotations in outpatient geriatrics, adolescent medicine, psychiatry, dermatology, community resources, managed care, and women's health. The curriculum also includes conferences on primary care topics and ambulatory case presentations. Second, elective opportunities are extended beyond the traditional subspecialty rotations to include addiction medicine, allergy and immunology, otolaryngology, ophthalmology, orthopedics, pediatrics, physical medicine and rehabilitation, and women's health. Third, the continuity care clinic experience is extended to include two clinics per week on non-call rotations. In general, the ambulatory care experience emphasizes preparation for the practice of integrated, whole-person, primary care. Residents learn ambulatory procedural skills such as flexible sigmoidoscopy, skin biopsies, and medical gynecology in order to prepare them for the delivery of comprehensive primary care.
The preliminary program in internal medicine
Preliminary interns take part in the same curriculum as Categorical PGY-1 residents and develop a solid base of internal medicine knowledge before entering their chosen specialty. Residents completing their preliminary year typically pursue such fields as anesthesiology, dermatology, emergency medicine, neurology, ophthalmology, physical medicine and rehabilitation, and radiology. Inpatient experience is predominantly scheduled on the general medicine and subspecialty wards at LLUMC and the VA Medical Center. Ambulatory experience is provided through the intern ambulatory block and elective rotations.
Research Scholars Program
This is a newly initiated program with the purpose of training selected residents to participate in clinical research. Interested residents will apply to this program during their PGY-1 year. A program selection committee will evaluate applications and vote to approve a candidate to become a research scholar by the end of their PGY-1 year. This program provides adequate time during their 3 year residency to perform meaningful research. The program includes a mandatory research curriculum where scholars are taught:
- how to formulate research questions
- conduct a literature review with electronic resources
- develop and implement a study design
- basics of biostatistics
- manuscript preparation
- how to give research presentations
- understanding of research ethics
- funding concepts (loan forgiveness and NIH K grants)
- research career development
The resident will complete an NIH online course entitled "Introduction to the Principles and Practice of Clinical Research," unless prior training has been received. There will be 3-4 months dedicated to research during the residents last two years of training.
The HIV Pathway
The HIV Pathway is a specialized pathway within the Primary Care Track. This pathway is designed for physicians who intend to focus on the treatment of persons with HIV infection or who intend to practice in low and middle income countries where HIV is prevalent. This is a Pathway within a Track. You will participate in our Primary Care Track, where one of your clinics will be primary care of the HIV infected patient. This training is currently located at our Veterans Administration Hospital. You will participate in journal clubs, didactics, local meetings, and webinars focused on HIV care. Plans are in progress which will include a clinic for the underserved. After passing a rigorous examination towards the end of your residency, you will be credentialed by the American Academy of HIV Medicine, which is something not all ID trained specialists have.
The Global Services Pathway
The Global Service Pathway is designed for physicians who intend to practice medicine in low and middle income countries, pursue humanitarian relief missions, and provide HIV or travelers care. This customized postgraduate experience will prepare you to hit the ground running if you choose to work for the underserved. You will obtain certification in Tropical Medicine, HIV medicine, and Health Emergencies in Large Populations. We have partnered with Johns Hopkins Bloomberg School of Public Health and the University of Minnesotato broaden your acquaintance with Global Health experts.
This pathway is a Primary Care Track position. You will receive the same broad Primary Care training, but your second clinic will be an HIV clinic and your electives will all be Global Service electives. Please see our Pathway Description pages page for further information on the global services pathway.
Combined Internal Medicine and Pediatrics Program
The combined medicine-pediatrics residency is a four-year program sponsored jointly by the departments of medicine and pediatrics at Loma Linda University Medical Center and Loma Linda University Children's Hospital. Its purpose is to provide broad, in-depth training for individuals interested in primary care of both children and adults.
This four-year program alternates four-month block rotations between medicine and pediatrics, and exposes the house officer to all the core general medicine and pediatric rotations as well as each of the subspecialties of both departments. A combined medicine-pediatrics continuity clinic is led by medicine-pediatrics attending physicians and maintained throughout the entire training period. Residents interact successfully with house officers of both residencies on a continuing basis. Upon successful completion of this residency program, individuals become board-eligible for internal medicine and pediatrics. Successful graduates have chosen to either practice combined internal medicine and pediatrics as a highly qualified primary care physician, while others have pursued subspecialty fellowships in either internal medicine or pediatrics.
Follow this link for more information on the Med-Peds program: Med-Peds Combined Residency or email firstname.lastname@example.org.
Fellowships and advanced training
Approximately 1/3 of our residents go on to fellowship and the remainder move on to careers as hospitalists or primary care physicians--many in an academic setting. In addition, eight (8) Chief Medical Residents are appointed each year.
LLUMC offers the following fellowships:
- Pulmonary/Critical Care
All our applications are processed through the Electronic Residency Application Service (ERAS).
If you're interested in applying to our program please note the following requirements must be submitted at the time of application:
- Deans Letter
- Medical school transcript
- USMLE/NBME scores
- 3 letters of recommendation
- Valid California PTAL for International Graduates
Much like LLUMC's Mission of Whole Person Care, we take a holistic approach to our residents training them to be well-rounded, compassionate and caring physicians. If you would like to know more about our training program, please contact our office.