San Francisco VA Medical Center

VA SAN FRANCISCO: 20010/11:GME Orientation

VA Office of Academic Affiliations

• VA: 4 Core Missions– To fulfill President Lincoln's

promise “To care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America’s veterans

– To Educate for the VA and Nation• Office of Academic Affiliations

– Partnered since 1946 with medical schools

• 107 affiliations with medical schools

– Agreements with>1200 educational institutions

– >100,000 trainees annually– 10% GME costs nationally

I J 2002

N ANUARY

W ERE INTEGRATED AND

RENAMED

VISN 13 14

VISN 23

S AND

VA Organization

• VA’s aligned in regions or VISNS

• VISN 21– San Francisco (UCSF)– Palo Alto (Stanford)– Reno– Northern California (UC

Davis)– Hawaii– Guam– Fresno

I J 2002

N ANUARY

W ERE INTEGRATED AND

RENAMED

VISN 13 14

VISN 23

S AND

Eureka

Ukiah

Santa Rosa

San Francisco VAMC/Nursing Home Unit

3rd and HarrisonSouth San Francisco

VA San Francisco (AKA Ft Miley)

• Patient Care– 55,000 primary care patients– 5000 annual admissions– 436,000 outpatient visits

• Education– 326 paid faculty, all with UCSF appts– 622 volunteer faculty– UME

• Approximately ¼ student programs– GME

• 33 specialties/subspecialties• 178 positions• Designated a VA Education Innovation

Site • Associated Health programs

– Nursing, dental, podiatry, psychology

• Research– #1 VA in research dollars, 76 million

dollars

VASF Strengths• VA Centers of Excellence

– Cardiac Surgery– HIV Medicine– PTSD– Epilepsy– Dialysis

• Western Pacific Region Emergency Center• National Referral Center

– Pacemakers/EP– Movement Disorders– Robotic Surgery

• Regional Referral Center– Hematologic malignancies– Cardiovascular diseases– Pathologic diagnoses– ENT – GI surgeries– Etc……

Federal Government Specific Issues

• Information Security

• Resident/Fellow Supervision

• Care of OIF/OEF Veterans

• PCMH

Information Security

• Residents/Fellows are consideredVA employee– Must adhere to VA

regulations in regards to information security

– Affirm your acceptance at first computer log in

• ISO/IG inspections

• Home access highly recommended

Resident/Fellow Supervision

• All care (except moonlighting) provided by residents/fellows is under the supervision of attendings

• Document attending involvement

• Keep your attending informed of changes in patient status

OEF/OIF Veterans

• Performance measures related to timely care of OEF/OIF veterans

• Dedicated social workers

• Sensitive to returning combat veteran issues– Traumatic brain

injuries– PTSD

Patient Centered Medical Home

• New VA national initiative

• Resources• Focus on resident

education

The Good Life at the VA

• Shuttles• Cheap Parking• Meal program

San Francisco VA Medical Center

Additional Trainee Resources

• Simulation Center• Evening food program