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Kennamer Fellowship

Supported by The Albert Parvin Foundation

The Kennamer Fellowship Program in General Internal Medicine at the UCLA School of Medicine provides an opportunity for advanced training in Internal Medicine for those already board-certified or board-eligible in Internal Medicine. Initiated on July 1, 1982, the Program was made possible by a continuing grant from the Albert Parvin Foundation.

For many years, faculty and residents in the Department of Medicine at UCLA expressed the wish to pursue advanced training in Internal Medicine before entering practice. Many third year residents enrolled in subspecialty training because opportunities for advanced preparation in General Internal Medicine were unavailable. Some attempted to achieve the same goal by taking a chief residency but then had to assume major administrative responsibilities as a result. Others considered the Clinical Scholars Program of the Robert Wood Johnson Foundation, but found it oriented appropriately for its mission, toward research and away from training for careers in the practice of internal medicine per se.

Thus, the Kennamer Fellowship was designed to meet the following needs:

Goals and Objects
  1. To meet perceived needs of participants for additional training.
  2. To strengthen the field of General Internal Medicine by creating a cadre of intensively trained internists.
  3. To produce superb teachers and/or clinicians in the field of General Internal Medicine.
  4. To stimulate interest in General Internal Medicine.
  5. To allow participants the unique opportunity for self-directed growth and exploration.
Five of UCLA's major teaching programs are participating in the Kennamer Fellowship Program. One Kennamer Fellow will be based at each of the following five programs:

    Cedars-Sinai Medical Center - a 1000 bed, tertiary care, academic institution with a commitment to medical education. The institution supports one of the largest Internal Medicine Residency in the country, and multiple subspecialty fellowship programs. The Kennamer fellowship at this site is highly flexible, and the curricullum can be significantly modified to meet the fellow’s educational goals

Harbor-UCLA Medical Center - a 579 bed tertiary care county facility, including research; serving a cross-cultural population with wide spectrum acute pathology.

Kaiser Permanente - a 613 bed, tertiary care medical center serving a diverse patient population, offers a flexible curriculum with a unique focus in working with underserved populations through our partnership with the Hollywood Sunset Free Clinic.

UCLA-Olive View Program - a 400 bed county hospital with a focus on clinical education and teaching, serving a large underserved population. The Kennamer fellowship is individually modified to meet the fellow's educational and professional goals.

Greater Los Angeles VA Medical Center - a 500 bed full service VA hospital with an excellent patient mix and complete ambulatory and inpatient experiences.

UCLA Ronald Reagan Medical Center - a full service tertiary care hospital with 750 beds and excellent opportunities for ambulatory and inpatient medicine and research.

The guiding principle of the Kennamer Fellowship Program is individualization, since there are many approaches to the practice of General Internal Medicine. Available opportunities include:
  1. Extra work in selected subspecialties to fill possible gaps in training or to develop a "strong suit" in an area within Internal Medicine in which the physician feels particularly expert.
  2. Rotations on specialties that are not usually a part of the 3-year core in Internal Medicine, such as nutrition, clinical pharmacology, behavioral medicine and allergy.
  3. Ability to acquire knowledge and skills in non-medical disciplines important to internists such as family planning, orthopedics, dermatology or rehabilitation medicine.
  4. Opportunities of develop and refine teaching skills.

Mandatory Features
Each Fellow will have an intensive one-year advanced program in Internal Medicine, including four mandatory features:
  1. Two to three months of ward Internal Medicine in the position of a junior attending physician.
  2. At least 1/2 day per week in which the fellows will see their own patients in a primary care clinic (i.e., continuity clinic).
  3. Involvement in the didactic core program as listener, participant and teacher.
  4. Active participation on the perioperative consultation service at the Fellow's base institution.
As junior attending physician, the Kennamer Fellow will share responsibility with the senior attending, but the emphasis will be on learning to teach. Teaching sessions between the junior attending and the housestaff and students will be monitored and critiqued by the senior attending in action.

The core curriculum is in the form of formal teaching sessions 1/2 day per week. These sessions consist of lecture, demonstrations and discussion groups. Examples of topics to be covered include principles of health maintenance, alternative medical therapies, clinical epidemiology, introduction to computers and their use in clinical practice, medical complications of pregnancy, cultural medicine, substance abuse, pre- and perioperative consultations, career options, teaching techniques and discussions on how physicians fit into modern society.

The remainder of the Kennamer Fellowship will include a rich array of choices including the following:
  1. Subspecialty Rotations: Rotations of one to two months duration can be arranged in any of the 10 recognized subspecialties of Internal Medicine. In each case, work and responsibility will be at an advanced level, comparable to a person starting a fellowship in the field, but the aim will be to give extra strength to the Kennamer Fellow's future practice as a generalist, NOT as a subspecialist. For this reason, no more than two months can be spent in any one subspecialty. Rotations may be at the Fellow's base hospital or, by arrangement, at one of the other hospitals participating in the Kennamer Fellowship Program.

  2. Important Topics: One to two month rotations will be made available in a variety of "new" fields that represent special areas of expertise within Internal Medicine, but which are not organ-system subspecialties. Rather, they are components of what a fine general internist offers to his/her patients. Included are bioethics, clinical pharmacology, clinical preventive medicine (i.e., health promotion), critical care medicine, emergency medicine, genetics, geriatric medicine, and rehabilitation medicine. Teaching programs or structured rotations are available in each of these fields at one or more of the UCLA hospitals. It is unlikely that any entering Kennamer Fellow will have had more than two or three of these experiences during the residency years. For many candidates, these programs will be a strong reason for undertaking the fourth year of training.

  3. Topics Outside of Internal Medicine: It is axiomatic that the general internist deals with symptoms and diseases in organ systems not characteristically included under the rubric of Internal Medicine. These include dermatology, office gynecology and family planning, occupational medicine and employee health, ophthalmology, office orthopedics, office urology, otolaryngology, pain management, physicial medicine and rehabilitation and psychiatry, particularly behavioral medicine.

    Planned courses or clinical rotations of one month's duration can be arranged at the Kennamer Fellow's base hospital or elsewhere in the UCLA consortium. In some hospitals one or more of these teaching programs has already been planned as part of a residency in Internal Medicine. In other cases, the offering to the Kennamer Fellowship will be by special arrangement.

  4. Special Courses or Rotations: Special courses or rotations may be requested by a particular Kennamer Fellow. An effort will be made to meet any perceived need, if it is appropriate to a career as a general internist and if the resources are available.

  5. Creative Projects: Additionally, each fellow is strongly encouraged to participate in a "creative project," which may be clinical research or participation in any special project of the participant's choice.

Process of Application and Selection
Applications are accepted year-round on a rolling basis.

Applications are encouraged from board-certified or board-eligible internists who will have completed three years of residency anywhere in the United States or Canada. Applications from other countries may be considered under special circumstances. Applications for positions beginning in July may be submitted through October of the previous year. The Policy Committee will review candidates as their applications and interviews are completed through December. Interviews will be conducted in Los Angeles by invitation. Criteria for selection will include (1) board eligibility or certification in Internal Medicine: (2) degree of interest in securing advanced training in Internal Medicine: (3) appropriateness of career goals to the objectives of the Kennamer Fellowship Program: (4) excellence of performance as student and resident: (5) strength of recommendation by residency program director and two other referees. Candidates generally will be notified of the Policy Committee's decision by December 31st.

The Stipend for all Kennamer Fellows, regardless of base institution, is based on the UCLA PGY scale. Health insurance, workers compensation, and malpractice insurance are supplied to all fellows by their home institution.

Institutional Directors

Oleg Melamed, M.D.
UCLA-Olive View

Kathy Mostafaie, M.D.
Harbor-UCLA Medical Center

Mark Noah, M.D.
Cedars-Sinai Medical Center

Moises I. Cruz, M.D.
Kaiser Permanente

Neil Wenger, M.D.
Ronald Reagan UCLA Medical Center

For Further Information and Application

Victor Gonzalez
Office of Neil Wenger, M.D.
Division of GIM/HSR
UCLA Department of Medicine
Box 951736
Los Angeles, California 90095-1736
(310) 794-2288
e-mail: vgonzalez@mednet.ucla.edu

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