UCSF Benioff Children’s Hospital, San Francisco
Residency Program Site Director: Daniel West, MD
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 highly specialized care, we also provide primary care for many families within the City of San Francisco at our Mount Zion campus in the Western Addition neighborhood. Faculty and residents have large clinical practices side by side.
Residents have the opportunity to care for patients on 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 three teams. The two primary teams, Purple and Orange, are staffed by one PL-3, three PL-1s (one of who is on nights at any time), and medical students. The average census is 8-12 patients per team. The teams round with an attending hospitalist as well as with subspecialists, using our unique appointment-based family-centered rounding. There is a third team which is staffed by a PL-3 and a hospitalist working side-by-side, which handles sedations, transfer calls, attends rapid response team activations, and also carries a service of primarily procedural patients (e.g. video EEG).
The adolescent medicine inpatient service is covered by two PL-1s working directly with a fellow and an attending. The adolescent medicine rotation is split between inpatient and outpatient, and while on the inpatient service residents learn to care for patients with eating disorders.
The intensive care nursery has three teams – Bridge, Redwood, and Pacific. Bridge Team is staffed by two PL-1 residents, and covers near-term babies in addition to being the primary delivery service. Every high-risk delivery at BCH is attended by residents. Redwood Team, staffed by two PL-2 residents, covers the premature babies as well as the Neurological-Intensive Care Nursery (NICN). Pacific Team primarily covers patients with congenital anomalies, surgical conditions, and pulmonary hypertension.
The pediatric intensive care unit (PICU) is a 20-bed unit for children with critical medical and surgical illnesses. It is staffed by a mix of PL-2 and PL-3 residents, working together with Nurse Practitioners, Fellows, and Critical Care attendings.
The pediatric cardiac intensive care unit (CICU) is a 12-bed unit for children with congenital heart disease who are either pre- or post-operative. Residents provide daytime coverage in this unit, together with NP’s and fellows. They may do additional elective experiences if desired.
The pediatric oncology service and blood & marrow transplant service are combined into a longitudinal rotation, and staffed by a team of four PL-2s, who split their time with four weeks of oncology, two weeks of BMT, and two weeks covering the night shift.
The transitional care unit is a higher-acuity inpatient unit with a mix of medical and surgical patients. Two PL-2s share responsibility for this unit, under the supervision of an intensivist.
The pediatric emergency department has 19 private patient rooms, including two large resuscitation areas. Pediatrics residents share coverage with Emergency Medicine residents. Fellowship-trained Pediatric Emergency Medicine attendings supervise this unit 24/7.
The Ron Conway Family 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.
The Mount Zion campus houses our primary care resident and faculty practices. The urgent care walk-in clinic is covered by the residents rotating at Mount Zion. About half of our residents have their clinics at this site. In addition, the Adolescent and Young Adult clinics are at Mount Zion.
Residents spend about 50-60% 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)
Residency Program Site Director: Elena Fuentes-Afflick, MD, MPH
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 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 an acute-care, general hospital setting.
Residents at SFGH have a good deal of 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 practice and emergency room.
The ward team, consisting of a family medicine R-1, medical students, and a supervising R-3 pediatric resident, is responsible for the 50-90 patients per month admitted to the 12-bed 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.
The Community Level III Nursery admits over 1600 babies each year. It is staffed by one PL-3, one PL-1, an intern from family medicine, medical students and one of 4 full-time neonatologists. This rotation offers residents a busy, hands-on experience ranging from delivery room resuscitation and routine care for normal newborns to intensive care for infants with moderately severe neonatal conditions or those requiring mechanical ventilation.
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 emphasizes all aspects of social pediatrics and includes CASARC, the regional referral center for child neglect, abuse and sexual abuse.
The Emergency Department is the designated regional trauma center; pediatric residents are involved in the assessment, stabilization and care of all pediatric patients and trauma victims. Pediatric residents see approximately 6,000 children per year through the emergency room, ranging from basic general pediatrics to major trauma.
Residents spend an average of 20-30% of their time at San Francisco General Hospital over the three years of training.
San Francisco Kaiser Permanente Medical Center
Residency Program Site Director: Carlos Botas, MD
Kaiser Permanente is the largest Health Maintenance Organization in the United States, with over 2.4 million members in Northern California. San Francisco Kaiser Permanente, together with the new Kaiser Mission Bay Medical Offices, serves as a primary care center for children residing in San Francisco, providing care for over 25,000 pediatric patients. The San Francisco Kaiser facility is also a tertiary care referral center for the entire Northern California Kaiser Permanente population.
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.
Most residents who have continuity clinic through Kaiser are based at the new Kaiser Mission Bay Medical Offices, just a few blocks from Benioff Children’s Hospital.
Pediatric Ward: One PL-2, 1-2 PL-1s and a medical student manage the 10-bed ward service under supervision of a staff pediatrician.
Nursery: One PL-3 is assigned to the 14 bed Level III Nursery in conjunction with a staff neonatologist. One PL-1 and one medical student provide care for the well newborns together with a general pediatrician and a nurse practitioner. 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 are organized into three group practices, with each group averaging 6 residents and 2 attendings, who function as consultants/supervisors for the residents in clinic.
Specialty Care: All major subspecialties are represented, with particularly active adolescent and diabetes services available as consultants for resident's primary care patients.
Residents may spend an average of 10-15% time at Kaiser San Francisco during their training. Residents who have continuity clinic at Kaiser rotate through the newborn nursery to facilitate recruitment of babies into their clinics.
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 he residency programs remain distinct, we have created opportunities for collaboration and cross-pollination between residents in the two training programs.
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 PL-2 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. BCH-Oakland also offers a Pediatric Emergency Medicine fellowship.