San Francisco VA Medical Center

The San Francisco VA provides residents with the opportunity to care for our veterans on one of the most beautifully situated campuses in the nation, being located near Land’s End at the mouth of the Golden Gate. Here, residents are able to spend part of their training within the federal VA system, allowing insight into its unique integrated model of care not possible in other hospital systems. Many of the veterans who receive their care here travel for several hours from all over Northern California, allowing trainees to care for patients coming from rural areas, which may otherwise be difficult to find in San Francisco.

The VAMC has five residents on duty at a time: a ward resident, consult resident, epilepsy resident, neuromuscular resident, and telemedicine/movement disorders resident. The ward resident is an R2 and runs the service, allowing an early opportunity to develop leadership and teaching skills. The consult resident is an R3 and serves as the practice group leader for the month. The epilepsy, neuromuscular, and telemedicine/movement disorders residents staff a wide array of outpatient clinics. Some of these clinics include the Comprehensive Epilepsy Center, the Center for Parkinson's disease and Movement Disorders, neuromuscular and traumatic brain injury clinics. The San Francisco VAMC offers tertiary-level neurological care for patients with epilepsy (including an epilepsy monitoring unit), Parkinson's disease and other movement disorders, Alzheimer's disease and other dementias, neurovascular disease, and neuromuscular disorders. Residents are closely involved in all facets of neurological care offered by the service, including state-of-the-art diagnostic evaluation, advanced medical, interventional, and surgical treatments, as well as long-term management of neurological disorders. There are approximately 200 inpatient admissions and 300 consultations per year.

There is a robust outpatient practice with roughly 3000 clinic visits per year. Residents are involved in presentations for the Department of Medicine, the emergency department and at journal club. Call is from home, and is divided among the 5 rotating residents, with outpatient rotators given either a full day or half day off after each call night.”