Our Impact in Graduate Medical Education

A National Leader in Graduate Medical Education

In 2015-2016, the University of California, San Francisco (UCSF) trained 1,478 residents and fellows in 26 residency, 62 ACGME/ABMS fellowship, and 87 nonaccredited fellowship programs. As one of the largest graduate medical education (GME) programs in the United States, UCSF is leading the way in innovations in education, patient care, research, and community service. In partnership with UCSF Health, San Francisco Veterans Affairs Medical Center, and Zuckerberg San Francisco General Hospital and Trauma Center, as well as 60 additional training sites, we strive every day to provide our residents and fellows with the highest quality education and training, graduating some of the best doctors in the world.

In recent years, there has been significant national focus on improving the clinical learning environment. We now know that the quality, safety, and cost of care provided in the environment in which physicians train predicts the quality of their lifelong practice. As a result, GME programs around the country are increasing their work in six focus areas: patient safety, health care quality and equity, care transitions, supervision, fatigue management, and professionalism. UCSF has been at the forefront of this national conversation, particularly in the areas of patient safety and quality improvement.

Ten years ago we developed the UCSF Resident and Fellow Quality Improvement Incentive Program. This program, the first of its kind in the country, is an incentive program that gives residents and fellows three all-trainee goals in patient experience, quality of care, and cost of care. Each residency and fellowship program also has the opportunity to develop additional program-specific quality goals. This program has resulted in several innovative projects to improve patient care, including the development of an interprofessional curriculum, improving physician communication, and a medication reconciliation program. UCSF’s longstanding work improving the clinical learning environment was recognized this year through a new competitive grant program, Pursuing Excellence, sponsored by the Accreditation Council for GME (ACGME). UCSF was selected as one of eight Pursuing Excellence Innovators across the country. Through the support of this grant, we aspire to be a national leader in further innovations and best practices in the clinical learning environment.

In March 2016, the “California’s Macy Regional Conference on Innovation in GME: Building a Better Workforce for Better Health” highlighted the innovative work done at UCSF and other GME institutions in the state of California. The conference, supported by the Josiah Macy Jr. Foundation and organized by UCSF, highlighted statewide examples of innovation in GME. Themes included new models of developing and financing GME, teaching and assessment of new competencies, the development of new sites and new inter-professional collaboration, and the use of innovative technology. UCSF presented innovations in resident and fellow well-being and resiliency; trainee engagement in quality improvement and patient safety; interprofessional learning; improving health equity; global health training; and building a more diverse workforce. We invite you to explore the work we are doing to improve our clinical learning environment and improve the lives of our patients.