Schedules and Rotations

PGY-1 Rotation Schedule

Rotation	Location	Weeks per Year
Inpatient Wards	SBMC	10
	SGMH	6
	Total	16
Night Float	SBMC	2
	SGMH	2
	Total	4
ICU	SBMC	4
Subspecialty	SBMC and OP	12
Ambulatory - Cat Only		10
ED - Preliminary Only	SGMH	4

PGY-2 Rotation Schedule

Rotation	Location	Weeks per Year
Inpatient Wards	SBMC	4-6
	SGMH	4-6
	Total	10
Night Float	SBMC	0-2
	SGMH	0-2
	Total	2
ICU	SBMC	4
Subspecialty	SBMC and OP	12
Elective		6
Ambulatory - Cat Only		10

PGY-3 Rotation Schedule

Rotation	Location	Weeks per Year
Inpatient Wards	SBMC	0-4
	SGMH	0-4
	Total	4
Night Float	SBMC	0-4
	SGMH	0-4
	Total	4
ICU	SBMC	4
Subspecialty	SBMC and OP	16
Elective		8
Ambulatory - Cat Only		10
ED		4

St. Bernardine Wards

There are three inpatient teaching teams at Saint Bernardine Medical Center, with each ward team consisting of a resident, two interns, and up to three medical students. Long call is not team based, but rather, one member of each team is on call every day and each team member is on call every third day. This allows residents to trade call days with their colleagues within teams and between teams so that they can take days off to accommodate important personal and professional engagements.

Long call ends at 7 pm.
From 5 pm to 7 pm, the long call team admits no more than three patients.
On regular non-long call days, residents can come to the hospital by 7 am and leave by 5 pm.
Teams admit patients throughout the day.
Daily rounds start at 8:30 am and end at 10:30 am.
At 11 am, residents participate in multidisciplinary rounds with case management.

Because successful medical care requires holistic attention, participation in these rounds both at SBMC and at SGMH accustom residents to work with other allied health professionals to craft care plans that can lead to optimal outcomes for all our patients. One of the things we like most about this rotation is its academic nature: residents and interns that are interested in developing their teaching skills have the opportunity to teach junior learners.

San Gorgonio Memorial Hospital Wards

At SGMH, ward teams consist of one resident and two interns. There is only one inpatient teaching team at SGMH. There are no long call days, but the team admits daily.

Night Float

Both interns and residents do night float at both SBMC and SGMH. SBMC is staffed with three house staff and SGMH is staffed with two house staff. There is always a junior or senior resident on night float to provide guidance and support to interns. At SBMC, night float runs from 6:30 pm until 7 am. At SGMH, the shift is from 9 pm to 7 am with the resident working from 5 pm to 3 am.

Night float house staff are responsible for cross-cover on floor patients and for admitting new patients from the emergency department and admitting transfers from other hospitals; each admitting house officer typically admits three-to-six new patients per shift.

ICU

ICU rotations are held exclusively at SBMC.

Inpatient Subspecialty Services

These include cardiology, gastroenterology, hematology-oncology, pulmonology, and nephrology. There are no calls on these rotations. In general, residents are expected to come to the hospital at 7 am and leave at 5 pm.

Outpatient Subspecialty Services

These include endocrinology, rheumatology, dermatology, and transitions of care. On endocrinology, residents rotate at several different community clinics, enriching their exposure to various pathologies and practice styles. Rheumatology and dermatology rotations are held at the VA. Our third-year residents do two two-week rotations back-to-back at the dermatology clinic.

The Transitions of Care Clinic (TOC) rotation is a unique rotation not found at most residency programs. Housestaff see patients recently discharged from SBMC. This experience allows for housestaff to observe what makes for successful hospital discharges and instructs them on how to ensure that important patient needs do not fall through the cracks as patients transition from the inpatient to the ambulatory environment. TOC is held every at a clinic across the street from SBMC.

Emergency Department (both preliminary and R3)

Rotations at the SGMH Emergency Department provides an opportunity to diagnose undeclared medical problems by incorporating elements of history, physical examination, laboratory testing, and other diagnostic methodologies.

It provides exposure to bedside procedures that are done via point-of-care ultrasound (POCUS) guidance. Residents learn to stabilize critical and highly acute patients, developing skills that will be valuable to those who pursue careers in hospital medicine, ICU, or cardiology and for preliminary interns who seek a career in anesthesiology.

Residents complete seven to eight 10-hour shifts in a two-week period, that will be a mix of both days and nights and will include weekend shifts. Preliminary interns and residents do two two-week rotations back-to-back in the emergency department.