The Sierra View Internal Medicine curriculum is designed to graduate confident,
well-rounded internists prepared for hospital medicine, primary care,
or fellowship. Residents train in a community hospital setting where they
care for a broad range of patients and work closely with supportive attending
physicians.
Our curriculum combines hands-on inpatient experience, subspecialty exposure,
outpatient training, and structured education, with increasing responsibility
and independence each year.
Year by year
Intern year
Interns build the core skills of internal medicine through General Wards,
along with rotations across critical care, primary care, and subspecialty
medicine. Interns learn to evaluate and manage patients, communicate effectively
with care teams, and develop strong clinical habits under close supervision.
Second year
Second-year residents take on greater responsibility, including leading
inpatient teams during General Wards, caring for critically ill patients,
and teaching interns and students. Second-year residents also spend one
month in the Emergency Department. Rotations in subspecialty medicine
broaden clinical knowledge and refine decision-making.
Third year
Third-year residents serve as senior leaders, through General Wards rotations
focused on supervision, teaching, and complex patient care. Schedules
allow more time for subspecialty and outpatient experiences that fit each
resident's career plans, whether in hospital medicine, primary care, or
fellowship.
Sample schedule
Our academic year is divided into 13 four-week blocks. The sample below
shows what a year can look like at each level of training. Individual
schedules vary by resident and class year.
Class
Block 1
Block 2
Block 3
Block 4
Block 5
Block 6
Block 7
Block 8
Block 9
Block 10
Block 11
Block 12
Block 13
Intern
Wards
Nephrology
Wards
PCP
MICU
Wards
Cardiology
GI
Night float
Wards
US/Procedures
PCP
Wards
Second year
Emergency medicine
Wards
Cardiology
Wards
MICU
Infectious disease
PCP
Night float
Heme-Onc
Wards
US/Procedures
Pulmonology
Wards
Third year
Wards
Neurology
MICU
Cardiology
Elective rotation
Night float
PCP
Rheumatology
Infectious disease
US/Procedures
Wards
Radiology
Geriatrics & Addiction
PCP = primary care. US/Procedures = Ultrasound and Procedures. Scroll sideways
on a phone to see every block.
Rotations
Residents rotate through the following core and subspecialty experiences
throughout training.
General wards
Manage a wide variety of acute and chronic conditions as part of a team-based
inpatient service.
Intensive care unit
Care for critically ill patients and gain experience with common ICU conditions
and procedures.
Nights
Build skills in admissions, cross-cover, and independent decision-making
with attending support.
Emergency medicine
Evaluate and stabilize patients with undifferentiated and urgent presentations.
Primary care
Develop long-term patient relationships and learn preventive care and chronic
disease management.
Cardiology
Learn to evaluate and manage common cardiovascular conditions in inpatient
and outpatient settings.
Nephrology
Gain experience with kidney disease, electrolyte disorders, and acid-base
management.
Gastroenterology
Evaluate digestive and liver disorders and learn when and how endoscopic
evaluation is used.
Pulmonology
Manage common lung conditions and build skills in interpreting pulmonary testing.
Hematology-Oncology
Learn the evaluation and management of blood disorders and cancer.
Neurology
Develop a systematic approach to neurologic evaluation and common neurologic
conditions.
Rheumatology
Evaluate and manage autoimmune and inflammatory conditions.
Ultrasound
Build point-of-care ultrasound skills to support bedside diagnosis and
procedures.
Wound care
Learn to assess and treat acute and chronic wounds as part of comprehensive
patient care.
Infectious disease
Evaluate and manage a broad range of infections, with an emphasis on antibiotic
stewardship.
Geriatrics and addiction medicine
Learn the care of older adults and the evaluation and treatment of substance
use disorders.
Radiology
Strengthen skills in selecting and interpreting imaging studies.
Simulation lab
Our simulation lab gives residents a safe space to practice procedures,
teamwork, and high-stakes clinical scenarios before they encounter them
at the bedside. Training sessions support skill development, confidence,
and patient safety throughout residency.
Procedures
Procedural training is built into all three years of residency. Each resident
completes a dedicated Ultrasound and Procedures block every year, where
they build point-of-care ultrasound skills and gain hands-on experience
with common bedside procedures.
Commonly performed procedures include paracentesis, thoracentesis, lumbar
puncture, and central venous access.
Ultrasound is used to guide procedures and support bedside diagnosis.
Skills are first practiced in the simulation lab, then performed on patients
under direct supervision.
Senior residents teach and supervise junior residents as their own skills grow.
Conferences and didactics
Residents take part in regular educational conferences throughout the year,
including:
Morbidity & Mortality (M&M) conference
Journal Club
Case of the Month
Grand Rounds
Didactics led by attending physicians
Guest lecturers
Other educational sessions, such as board review and skills workshops
Protected learning time helps residents grow as clinicians and prepare
for board certification.
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