San Francisco Kaiser Permanente Medical Center
Kaiser Permanente is the largest Health Maintenance Organization (HMO) in the United States, with over 2.4 million members in Northern California. San Francisco Kaiser Permanente, together with the new Kaiser Mission Bay MedicalOffices, serves as a primary care center for thousands of children residing in San Francisco.
Residents receive training by practicing primary care pediatrics in an HMO setting with adequate volume to develop strong skills in efficiency and clinical confidence. This program component provides excellent resources for learning preventive pediatrics and the practice of cost-effective medicine. Residents may spend an average of 10-15% time at Kaiser San Francisco during their training.
Pediatric Ward: One PGY-2, one to two PGY-1s and a medical student manage the 10-bed ward service under the supervision of a staff pediatrician.
Nursery: One PGY-3 is assigned to the 14-bed Level III Nursery in conjunction with a staff neonatologist. There are over 2,000 deliveries per year, and ample opportunity to learn and participate in the early discharge/home care aspects of newborn care.
Primary Care/Continuity Clinic
Residents who have continuity clinic at Kaiser are based at the Kaiser Mission Bay Medical Offices just a few blocks from Benioff Children’s Hospital or in the Western Addition next to UCSF/Mt. Zion. Specialty Care: All major subspecialties are represented, with particularly active adolescent and diabetes services available as consultants for residents' primary care patients.
UCSF Benioff Children’s Hospital, Oakland
In 2014, UCSF Benioff Children’s Hospital formally affiliated with Oakland Children’s Hospital, now known as UCSF BCH-Oakland. Although the residency programs remain distinct, we have opportunities for collaboration between residents in the two training programs including a one-week exchange during the PGY-1 year adolescent rotation.
The emergency department at BCH-Oakland is one of only five Level 1 Pediatric Trauma Centers in California. About two-thirds of the admissions to this hospital are through the busy emergency department. Many of our residents elect to have Emergency Medicine experiences in this setting, and participate in all aspects of assessment and care, under the supervision of Pediatric Emergency Medicine board-certified attending physicians. Some residents also elect to rotate in BCH-Oakland’s PICU as an elective.
BCH-Oakland also offers a Pediatric Emergency Medicine fellowship and critical care with BCH-San Francisco.
UCSF Benioff Children’s Hospital, San Francisco
UCSF Benioff Children’s Hospital San Francisco is our primary training site and the flagship of the Mission Bay campus. We are a 183-bed quaternary care center, which includes a dedicated Pediatric Emergency Department, a 50-bed Intensive Care Nursery, a Pediatric Intensive Care Unit, Cardiac Intensive Care Unit, Bone Marrow Transplant Unit, and more. Referrals from all around the state of California, as well as nearby states, often arrive at our hospital via our helipad — the only one in the City of San Francisco.
In addition to the full spectrum of pediatric subspecialty care, UCSF Health offers primary ambulatory services for many children and families within the City of San Francisco at our UCSF/Mount Zion campus in the Western Addition neighborhood. Residents are integrated into the large academic clinical practice that provides primary care and acute care services. Mount Zion is the largest clinical site for UCSF pediatric continuity clinics.
Residents have the opportunity to care for patients in all of our clinical services, both inpatient and outpatient. In addition to the core rotations described below, we offer a wide array of electives, including opportunities to design custom electives if desired.
The hospitalist service is made up of two primary teams: Bayview and Ashbury. The teams round with an attending hospitalist as well as with subspecialists, using appointment-based family-centered rounding. There is a third team which is staffed by a hospitalist (and can be an elective rotation for people interested in hospital medicine that handles sedations, transfer calls, attends rapid response team activations, and also carries a service of primarily procedural patients.
The adolescent medicine inpatient rotation is split between inpatient service (one week when residents mainly learn to care for patients with eating disorders) and outpatient clinics (two weeks in SF and one week at BCH Oakland) to provide a broad exposure to different populations and clinical needs.
Intensive Care Nursery and Pediatric Intensive Care
The intensive care nursery is a 50-bed unit where residents have the opportunity to attend high-risk deliveries, care for premature and low-birth-weight infants and babies who need care prior to cardiac surgery or require neurological intensive care.
The pediatric intensive care unit (PICU) is a 20-bed unit for children with critical medical and surgical illnesses. The PICU is staffed by a mix of PGY-2 and PGY-3 residents who work with Nurse Practitioners, Fellows, and Critical Care attending physicians.
The pediatric cardiac intensive care unit (CICU) is a 16-bed unit for children with congenital heart disease who are either pre-or post-operative. Residents provide daytime coverage in this unit, together with NPs and fellows. This rotation is an elective experience.
The pediatric hematology/oncology rotation is a combined inpatient and outpatient rotation where residents have and staffed by a team of four PGY-2s. There is also a separate, elective bone marrow transplant (BMT) service.
The transitional care unit is a higher-acuity inpatient unit with a mix of medical and surgical patients. Two PGY-2s share responsibility for this unit with Nurse Practitioners, all under the supervision of an intensivist.
Pediatric Emergency Department
The pediatric emergency department has 19 private patient rooms, including two large resuscitation areas. Pediatric residents share coverage with Emergency Medicine residents. Fellowship-trained Pediatric Emergency Medicine attending physicians supervise this unit 24/7.
Ron Conway Family Gateway Medical Building
The Ron Conway Family Gateway Medical Building houses clinicians practicing in over 50 different specialties, as well as the Pediatric Brain Center and the Pediatric Heart Center. Residents have elective time in all three years of training and may choose from any of our specialties.
UCSF Mount Zion
The UCSF Mount Zion campus is a hub of specialized medical center clinics and surgery services located in the Western Addition.
Pediatric primary care at UCSF Mt. Zion provides young patients with a wide range of care, from routine health examinations to managing chronic health conditions and acute care. The providers work with patients and their parents to promote health through preventive medicine, health screenings and health education. Mount Zion is the largest continuity clinic site and is where residents in the Primary Care track have their continuity clinic.
Mount Zion Hospital was established in 1887 by the San Francisco Jewish community as a non-profit hospital to render "medical and surgical aid and service to the needy and distressed sick of the community…without regard to race or creed."
Today, Mount Zion continues its involvement in teaching, research and patient care as a campus of the UCSF Medical Center. The Mount Zion campus houses our primary care resident and faculty practices. The acute care clinic is covered by the residents rotating at Mount Zion. About half of our residents have their clinics at this site.
Residents spend about 60% of their time at UCSF Benioff Children’s Hospital, including the Mount Zion practices, with more time for those residents doing Continuity Clinic at Mount Zion.
Zuckerberg San Francisco General (ZSFG)
Located in the city's multicultural Mission district, "The County" is the City and County hospital for San Francisco. The new facility — Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG) opened in the spring of 2016. It provides primary health care for many in the city and is also the designated regional trauma center. Caring mostly for the medically underserved, the hospital offers residents a rewarding pediatric experience in the ambulatory and inpatient settings.
Residents at ZSFG have a good deal of significant autonomy, with full responsibility for diagnostic evaluation and treatment of patients in consultation with the Chief Residents and attendings. Rotations include the inpatient ward, the newborn and newborn intensive care nurseries, and ambulatory services, including primary care, urgent care and the emergency room.
The ward team, consisting of a family medicine PGY-1, medical students, and a supervising PGY-2 pediatric resident, is responsible for the patients admitted to the pediatric ward for medical or surgical illness; all pediatric patients admitted to the Intensive Care Unit are included in this responsibility. Surgical patients are managed jointly by pediatrics and the relevant surgical specialty service.
Level III Nursery
The Level III Nursery admits over 1,600 babies each year. The nursery is staffed by one PGY-3, one PGY-1, an intern from family medicine, medical students, and one of four full-time neonatologists. This rotation offers residents a busy, hands-on experience ranging from delivery room resuscitation and routine care for healthy newborns to intensive care for infants with moderate to severe neonatal conditions or those requiring mechanical ventilation.
Children’s Health Center
The Children's Health Center, with more than 34,000 visits per year, provides all aspects of well-child care, including residents' continuity clinic practices, drop-in acute care, and specialty visits. The Children’s Health Center aims to provide holistic and trauma-informed care, and the Behavioral Health Team and nutritional services are present on site to support patient care.
The Emergency Department is the designated regional Level 1 trauma center. Pediatric residents are involved in the assessment, stabilization and care of all pediatric patients and trauma victims presenting to the emergency department.
Residents spend an average of 20-30% of their time at San Francisco General Hospital over the three years of training.