The ER experience is both focused and longitudinal.  
A dedicated block each year provides concentrated ER training, while evening and weekend shifts scattered throughout other rotations maintain skills over a longitudinal experience.  Our residents take the role of the primary ER resident, assessing and stabilizing patients under the supervision of our ER staff physicians. Residents learn acute care, accumulate procedural experience, and get point-of-care ultrasound training.  
PGY-1 residents have a 3-week night-float block where they work alongside the PGY-3.
PGY-2 residents have a dedicated block of daytime ER where they gain additional experience and confidence in preparation for their senior rotation.  
The experience culminates with the PGY-3 "Night ER Doctor" rotation, a 3-week block in which the resident is the primary ER physician under the supervision of an in-house attending.   
All residents also cover weekend ER shifts over the course of several rotations.

OBSTETRICS AND WOMEN'S HEALTH

Every delivery at VCMC is performed by a Ventura resident, and residents are involved with all postpartum and antepartum care. During the day, a PGY-1 resident is “on deck” with both a family physician and an obstetrician immediately available for supervision and teaching. Overnight a PGY-2 or PGY-3 manages the OB floor with a family physician and obstetrician who are available by phone for consultation and come into the hospital when needed.  This progressive responsibility allows residents to build their skills independently managing labor and delivering babies.  A NICU staff member is always in house, and residents help with neonatal resuscitations.  Postpartum patients are managed as couplets, so the resident who performs the delivery will care for both the mother and newborn until discharge.
All C-sections are done by a resident with an obstetrician or fellowship-trained family physician. Residents may sign up for additional (paid) C-section call overnight, and motivated residents have logged over 100 operations.  Residents scrub into gynecologic cases 3-4 days a week as well.  Residents are the primary operators for cesarian deliveries, tubal ligations, diagnostic D&Cs, suction D&Cs for incomplete SAbs and other procedures. On outpatient days residents rotate through our OB-GYN clinic and high-risk OB clinics, as well as an optional experience at Planned Parenthood.
Women's health and maternity care are an integral part of family medicine.  Residents are privileged to participate in such an important event in a family as the mother's pregnancy and the baby's birth.  We take pride in the fact that about two-thirds of our graduates include obstetrics in their practice, and approximately 30% have C-section privileges.
PGY-1 and PGY-2 residents do 6 weeks each of the OB-Gyn and Couplet Care rotation, while PGY-3 residents do a 3 week block as chief of service.  PGY-2s and PGY-3s each do a week and a half of night float coverage for the service.

PEDIATRICS

A team of three residents cares for all inpatient pediatrics patients, supervised by a full-time pediatric hospitalist as well as a complement of specialist pediatricians affiliated with Children's Hospital LA. In addition to a full scope of general pediatrics, a pediatric hematologist-oncologist and a cystic fibrosis center admit to the resident service. Residents are also involved with the care of patients in our new PICU. There is also a strong outpatient experience at our on-campus Pediatrics Diagnostics Center with both generalist and specialist pediatricians. Residents may rotate by elective through our NICU as well.  While on inpatient medicine, residents help with overnight pediatric admissions, extending the pediatric experience longitudinally.
Residents gain exposure to well child care, developmental assessments, sports participation physicals, adolescent medicine, and parent education.  Subspecialists from Los Angeles come to Ventura to provide care closer to the patients' homes, allowing residents exposure to a broad array of pathology.  In addition, there is a robust pediatric population in our continuity clinic, and pediatricians are present a few days a week to provide supervision to residents seeing their own patients.
There is one block of this rotation in each of the PGY-1 and PGY-2 years, and two blocks in PGY-3.

SURGERY

Many diseases encountered in family medicine are best treated with surgical interventions. Our residents are the primary surgery residents when on service. On call days, the resident takes all surgical admits, scrubs in on emergent surgical cases and runs trauma codes. Residents handle postoperative care for general surgery, neurosurgery, bariatrics, urology, and trauma patients. Midlevel providers help to decompress the resident rounding load. Outpatient surgical experiences include plastics, urology, ENT, wound care, and a "lump & bump" clinic for office-based surgical procedures.
We believe that family physicians need to be well-versed in handling surgical diseases.  Our surgeons are approachable and enjoy teaching family medicine residents.  Residents become comfortable with a wide range of pathology including trauma, cholecystitis, thyroid nodules, breast lumps, appendicitis, bowel obstruction, lower GI bleeding, lymphadenopathy, subcutaneous masses, and others.
Residents spend one block of each year on the surgery rotation, with an additional 3 weeks during the PGY-2 year covering the service as night float.

ORTHOPEDICS AND SPORTS MEDICINE

Our sports-medicine trained core faculty member runs a sports clinic in the AFMC.  We have relationships with local schools to staff sporting events, including Friday night high school football and local running events. Our on-campus orthopedics clinic hosts each resident for dedicated orthopedics and sports medicine training. Residents learn x-ray reading, fracture management, joint injections, and post-operative orthopedics care.  Residents work one-on-one with adult and pediatric orthopedic surgeons, sports medicine physicians, podiatrists, and physical/occupational therapists. Additionally, during ER rotations, residents reduce and splint fractures.
There are 6 dedicated weeks in the PGY-1 year and 3 weeks in the PGY-3 year for orthopedics and sports medicine.

AMBULATORY SELECTIVES

CONTINUITY CLINIC

The Academic Family Medicine Center (AFMC), our continuity clinic, is where residents become family physicians.  This clinic, located on the VCMC campus, is the hub of the continuity experience and the resident's "home" during residency.  There are four suites, each containing 7-8 exam rooms, organized around a nursing station with the medical secretary, clinic assistants and a registered nurse to help you see patients. You will have a home suite and be part of the team with your fellow residents and staff, seeing patients 2 - 4 half days a week.  
Teaching: The full-time family practice faculty bring years of experience to precepting resident physicians. We believe continuity and a sensitive approach to dealing with the patient as a person is the key to family medicine. The behavioral sciences are emphasized as integral to patient management. In addition, community family physicians are employed as preceptors to work on a weekly basis, bringing their "real world" experience to give the residents a well-rounded perspective.
Patients: The majority of patients are invited into your practice by residents; from your rotations in the ER, OB, Peds and Medicine clinics or inpatient services. Others are inherited from graduating residents. Some of our patients have "raised" several generations of doctors. We have a very interesting, diverse patient population. The main mission of VCMC is to provide high quality patient care to the underserved and thus the majority of our patients have public health insurance or no insurance. However, about 20% of the AFMC patients are employees of the county government.  Residents get a wide range of experience in treating people from all walks of life. The presence of the insured population also helps ensure that all patients, affluent or poor, are seen in a clean, pleasant atmosphere by competent, caring staff.
Continuity: Patients see the resident as their own personal doctor. Every effort is made to schedule patients with their physician, even when the patient calls for a last-minute appointment. The nurse in the suite is often familiar with the patients and serves to improve continuity as well. Residents have the option of following their own patients when they are admitted to the hospital. Maternity patients from AFMC are delivered by their resident doctor and the baby and family are followed subsequently by the resident in AFMC. Patients become quite attached to their doctor. In order to train to become a family physician, you must be a family physician in your training. Continuity is a major part of that experience, something we emphasize strongly in the VCMC Academic Family Medicine Center.
Women's Health: The primary care practice in the AFMC gives you lots of opportunities in Women's Health. Maternity continuity patients are followed through prenatal care and delivered by their resident physician. There is an ultrasound clinic in AFMC which is taught by family medicine faculty. Residents place IUDs, do endometrial biopsy, colposcopy and other gyn procedures in AFMC in the practice of full spectrum women's health. Our system has a state-of-the-art DEXA machine and Cheryl Lambing, MD, one of our core faculty, is a nationally recognized expert in osteoporosis.