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Schedule Request for Interns 2020-2021

Dear Incoming Intern,

Please complete this form to submit your requests for your block schedule for the 2020-2021 academic year.  We do our best to accommodate requests that impact your medical education, career, and significant personal life events.  Day-to-day scheduling (e.g. attending an important wedding) will be arranged in the future by the Chief Residents.  Requests will be prioritized based on the order they are received.

Required responses are marked “required.” If the form does not submit on the first click, click Submit again until it goes through.  You will receive a confirmation email. If you have any trouble with this form, please email Dr. Ta at vta@dhs.lacounty.gov.

The deadline for schedule requests is Sunday, April 5, 2020.

    Let's start with your information

    Personal Email:(required)
    Please use an email address that you will continue to use after graduating medical school. Medical school emails may be deactivated or are often left inactive or unchecked after graduation. You will be assigned a new work email once you start at Olive View.

    Residency Track:(required)

    We'd like to learn more about you

    ...because you're here to be become an outstanding physician and we're here to help get you there. As part of our mentorship program, we'd like to gather some information that will help us pair you with a mentor during internship. Don't worry, nothing is set in stone. We know interests and future plans change, and you may seek additional mentors. But this will give us a start.

    Hobbies and interests:(optional)

    Important things in your life:(optional)

    Career Plans: Which career paths are you most interested in?

    Subspecialties:

    Specialty and institution for PGY-2 training:

    Other Interests:

    Now, let's consider some factors for scheduling

    Do you have ACLS certification through next year (June 2021)?
    ACLS is required for housestaff. It usually lasts two years, so you will need to be certified through June 2021. We will have ACLS training during orientation week. (response required)

    Do you have a preference for the site of your panel of primary care patients?
    (A set number of interns will be assigned to each site, so we cannot guarantee your preference) (response required)
    Either Olive View or Mid-ValleyOlive ViewMid-Valley

    VA: Are you interested in the General Medicine Ward rotation at the West Los Angeles VA?
    (You would be assigned 2-4 weeks of wards at the VA to replace wards at Olive View) (response required)

    Do you anticipate any personal life events?
    (response optional but may help with planning)

    When do you expect this? Please add any additional comments.

    And finally, let's discuss some specific scheduling requests

    We will continue with our 4+1 schedule, meaning your schedule will follow a pattern of a four-week rotation (or 2 two-week rotations) followed by one week of Ambulatory Medicine ("+1" or "Amb week") every fifth week.

    These rotations will follow the block schedule that you can view here. The chart identifies the block starting dates for the entire academic year. The blocks generally start on Thursday and end on Wednesday, with the exceptions being the first and last blocks of the academic year.

    Please use the rest of this form to place your vacation requests. Each housestaff receives 4 weeks of vacation per year, split into 2 two-week blocks. You may choose a specific set of blocks or a general time frame when you would like vacation. Please note that the number of vacationers during specific blocks will be limited, so please indicate if certain dates are very important (e.g. you're getting married). Thanksgiving, Christmas, and New Years are very popular, but only a small number will get vacation during this time. We will do our best to try to accommodate requests.

    Based on your vacation requests, you will be assigned to a Pod, which determines when you will be on +1 Amb week for the entire year and residency.

    Block Schedule Dates for 2020-2021

    First Request: Vacation 1

    Timing Option 1:
    Timing Option 2:
    Timing Option 3:
    Comment:

    Second Request: Vacation 2

    Timing Option 1:
    Timing Option 2:
    Timing Option 3:
    Comment:

    Prioritize your requests

    Arrange the requests above from most to least important.

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