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Downtown ST. Louis
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Downtown Urgent was founded in 2009 with Dr. Sonny Saggar's vision for and values of access, affordability, respect, integrity, inclusion, excellence, and diversity. These values have withstood the first ten years and still ring true today. We are proud to serve, train, and employ people that represent the real world in which we live. All life is precious and we take our duty to care for everyone very seriously, regardless of their ability to pay. These values continue to provide us with inspiration and direction. We remain committed to our founding values and stand together to support each other.
Pathway Overview
The mission of this pathway is help as many licensed assistant physicians secure a place on a residency program by proving themselves as doing something useful with their 'off pathway' time, and having something to show for it, both when applying and when being interviewed.
Our typical pre-resident will be a Missouri-licensed Assistant Physician. The 24/7 Urgent Care and the associated residency prep program was created specifically and deliberately for these assistant physicians, such that they have a legally licensed opportunity to directly care for patients, regardless of whether they are still applying to traditional residencies or not.
Because of the nature of this learning opportunity, a pre-resident may join our program at any time during the calendar year, upon successful completion of Three UNPAID Shadow Shifts and an offer letter from our program director.
Our 'stepping stone' pathway will accommodate any needs to get away for interview elsewhere (such as with a residency program) and it is our goal to help all our pre-residents get to where they really want to be. Similarly, if the pre-resident commits to our pathway until such a time that full licensure is awarded by the State Of Missouri, then we will be honored to have you on board for the duration, and we will do our best to train, teach and hone your clinical skills as much as possible. We pride ourselves on being credited for the skills and clinical acumen of the people who have received their training with us.
Our typical pre-resident will be a Missouri-licensed Assistant Physician. The 24/7 Urgent Care and the associated residency prep program was created specifically and deliberately for these assistant physicians, such that they have a legally licensed opportunity to directly care for patients, regardless of whether they are still applying to traditional residencies or not.
Because of the nature of this learning opportunity, a pre-resident may join our program at any time during the calendar year, upon successful completion of Three UNPAID Shadow Shifts and an offer letter from our program director.
Our 'stepping stone' pathway will accommodate any needs to get away for interview elsewhere (such as with a residency program) and it is our goal to help all our pre-residents get to where they really want to be. Similarly, if the pre-resident commits to our pathway until such a time that full licensure is awarded by the State Of Missouri, then we will be honored to have you on board for the duration, and we will do our best to train, teach and hone your clinical skills as much as possible. We pride ourselves on being credited for the skills and clinical acumen of the people who have received their training with us.
Curriculum
The rotations of the ambulatory care internship are designed to fill the needs of those planning for either an internal medicine career or an urgent care career or both, and emphasize acute care, chronic care, time management and the development of requisite clinical skills. Having said that, a basic grounding in hundreds of history and physical assessments should prepare a pre-resident for any residency.
Training is chiefly in outpatient internal medicine and urgent care.
Educational competencies, goals, and objectives are achieved through required learning experiences. The required educational competencies are as follows:
Required Learning Experience
Teaching Requirement
Seminar attendance is mandatory and mostly occurs in the form of 1 to 1.5 hour seminars on Tuesday and Thursday mornings. A minimum of 40 seminars must be attended in each calendar year, this number including the seminars delivered by the 1st year pre-resident.
The pre-resident will be expected to deliver a minimum of 12 presentations, each being a minimum of 15 minutes, in each calendar year. The presentations must be scored out of 10 by a minimum quorum of 3 recipients, achieving a minimum of 20 points (out a maximum of 30) for each presentation.
The pre-resident will also provide lectures, presentations, and in-services to physicians, nurse practitioners, medical assistants and other healthcare staff.
Merit Scores
The Merit Score system was introduced in November 2019, as a means to motivate staff as well as increase/improve efficiency, clinical skill and patient satisfaction. The fact is, these 3 things matter very much with regard to a physician's success, and are taken very seriously by residency selection committees. Those with a higher Merit Score will be rewarded with moving up the 'pecking order' with regard to their pick of the shifts on the schedule, working as much or as little as they wish. More shifts means more opportunity to augment the Merit Score. This also means that those with lower Merit Scores will have fewer, and possibly zero, shifts on a given month's schedule. The Merit Score will also reflect a physician's performance during the initial 120-hour mandatory orientation.
Training is chiefly in outpatient internal medicine and urgent care.
Educational competencies, goals, and objectives are achieved through required learning experiences. The required educational competencies are as follows:
- Patient care
- Leadership and management
- Advancement of community-based practice and improving patient care
- Teaching, education, and dissemination of knowledge
Required Learning Experience
- Orientation (typically a minimum of 120 hours, as set by the Missouri Board of Healing Arts), typically 10 shifts of 12-hours each, never working alone.
- Diabetes, Hypertension, Hyperlipidemia Management for Primary Care patients
- Annual Physicals and Follow-Up Visits for Primary Care patients
- Other Primary Care Conditions
- Management of Common Conditions in the Urgent Care patient
- Management of Worker Injury Cases in Occupational Medicine
- Management of Telemedicine Cases
- Understanding the Business of Medicine, specifically how to run an outpatient practice in Internal Medicine and/or Urgent Care
- Teaching Requirement (see below)
Teaching Requirement
Seminar attendance is mandatory and mostly occurs in the form of 1 to 1.5 hour seminars on Tuesday and Thursday mornings. A minimum of 40 seminars must be attended in each calendar year, this number including the seminars delivered by the 1st year pre-resident.
The pre-resident will be expected to deliver a minimum of 12 presentations, each being a minimum of 15 minutes, in each calendar year. The presentations must be scored out of 10 by a minimum quorum of 3 recipients, achieving a minimum of 20 points (out a maximum of 30) for each presentation.
The pre-resident will also provide lectures, presentations, and in-services to physicians, nurse practitioners, medical assistants and other healthcare staff.
Merit Scores
The Merit Score system was introduced in November 2019, as a means to motivate staff as well as increase/improve efficiency, clinical skill and patient satisfaction. The fact is, these 3 things matter very much with regard to a physician's success, and are taken very seriously by residency selection committees. Those with a higher Merit Score will be rewarded with moving up the 'pecking order' with regard to their pick of the shifts on the schedule, working as much or as little as they wish. More shifts means more opportunity to augment the Merit Score. This also means that those with lower Merit Scores will have fewer, and possibly zero, shifts on a given month's schedule. The Merit Score will also reflect a physician's performance during the initial 120-hour mandatory orientation.
elective rotations
In addition, there will be concurrent 1-month-long rotations in the following 8 areas (in addition to the usually scheduled shifts), and an approved essay is required in each except #8 to summarize understanding of the rotation:
The goal is for the pre-resident to function independently as an internal medicine or urgent care physician by conceptualizing and integrating accumulated experience and knowledge and incorporating both into the provision of patient care or other advanced practice settings.
- Supplies Management
- Coding & Billing
- Marketing
- Staffing
- Training support staff
- Policy development and application
- Budgeting: drafting and presentation for new/existing projects
- Leading the Tuesday/Thursday Morning Meetings
The goal is for the pre-resident to function independently as an internal medicine or urgent care physician by conceptualizing and integrating accumulated experience and knowledge and incorporating both into the provision of patient care or other advanced practice settings.
certifications during the appointment
All our Assistant Physicians are required to take and pass: BLS, ACLS and ATLS. They will pay for these certifications themselves, and then be reimbursed" by the program. UpToDate subscriptions for up to 1 year at a time, can be purchased by the AP themselves, and then reimbursed* by the program.
*Reimbursements will made as long as the AP is officially on staff when the certification was paid for and they are still on staff when they request reimbursement.
After 1,000 scheduled hours of patient care and 6 months, the AP will be permitted to apply for a DEA license. This however, is entirely at the physician's expense and will not be reimbursed.
*Reimbursements will made as long as the AP is officially on staff when the certification was paid for and they are still on staff when they request reimbursement.
After 1,000 scheduled hours of patient care and 6 months, the AP will be permitted to apply for a DEA license. This however, is entirely at the physician's expense and will not be reimbursed.
diploma
A diploma will be awarded to any pre-resident that has completed and demonstrated the following:
The diploma qualifies pre-residents to apply for full licensure after 3 years with Downtown STL Medicine, having satisfied all the above requirements.
- 6,000 hours of scheduled shifts (this does not include overtime or traded shift acceptances), typically over a 3-year period.
- Seminar attendance (as above): 40 as 1st year, 50 as 2nd year, 50 as 3rd year.
- Presentation deliveries (as above): 12 as 1st year, 20 as 2nd year, 20 as 3rd year.
- Completion of the 8 rotations as 2nd and 3rd year pre-residents, as well as all 16 essays, that are deemed acceptable to the Program Director.
- Strong work ethic, including fairness to coworkers, including fellow providers and all support staff.
- Sharing the workload, with regard to housekeeping during shifts, including Lab Review, Chart Review, picking up shifts for others and being perceived as an all-round helpful person who is appreciated by one's fellows.
- Has worked hard to augment the patient experience and to promote the facility as a desirable place to visit, be it for internal medicine or urgent care matters.
- Professionalism in all matters, with regard to fellows, support staff and patient care.
- Has always endeavored to do the best for each and every patient, and has treated them "like a loved one".
The diploma qualifies pre-residents to apply for full licensure after 3 years with Downtown STL Medicine, having satisfied all the above requirements.
Commitment to work
If an AP successfully matches to a Residency Program, they will contractually commit to remaining on staff with us until May 31st of the year, thereby advancing to their Residency Program in June.
There is a 3.5 year non-compete non-poaching clause during the AP's time with us, effective from contract signing.
There is a 3.5 year non-compete non-poaching clause during the AP's time with us, effective from contract signing.
Current Pay & Scheduling
Because this is a "residency prep program" and chiefly designed for unplaced medical school graduates, namely Assistant Physicians licensed in Missouri, the pay is not salaried, but based on actual clinical hours worked. This may change if we partner with an overseeing umbrella residency program.
The hourly pay is rather low. If you're interested in a higher income, then this is not the place for you. There is no guarantee of a minimum number of shifts. Assistant Physicians might work from zero to 36 hours a week. An AP who is popular with patients, and coworkers will likely be rewarded with a greater number of shifts.
Downtown STL Medicine is working hard with various legislators at the State level to streamline and provide a clear pathway for full unrestricted licensure as a physician in the State of Missouri, upon completion of the above criteria and having been awarded certification accrediting the Assistant Physician.
The hourly pay is rather low. If you're interested in a higher income, then this is not the place for you. There is no guarantee of a minimum number of shifts. Assistant Physicians might work from zero to 36 hours a week. An AP who is popular with patients, and coworkers will likely be rewarded with a greater number of shifts.
Downtown STL Medicine is working hard with various legislators at the State level to streamline and provide a clear pathway for full unrestricted licensure as a physician in the State of Missouri, upon completion of the above criteria and having been awarded certification accrediting the Assistant Physician.
ALUMNI testimonials
Here are some of our alumni and "what they're doing now":
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MATCHED TO: INTERNAL MEDICINE AT UHS WILSON HOSPITAL, JOHNSON CITY, NY.
"Downtown St. Louis Medicine's Residency Prep Program improved me as a provider and a person. Gave me the knowledge and the confidence I needed to support my residency application! Working in a fast-paced office and the exposure to different cases will definitely enhance your skills. Especially, you have a wonderful team you can depend on whenever you need them. Dr. Saggar was always available to give you the advice and guidance. Your colleagues (also Assistant Physicians) are the best that I have worked with. The Medical Assistants are enthusiastic and ready to provide help."
Ramy Hassan MD November 2019 |
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MATCHED TO: FAMILY MEDICINE AT LARKIN PALM SPRINGS CAMPUS, HIALEAH FL.
"I came as an US international medical graduate with very little us clinical experience and in two years my skillsets as a diagnostician as well as performing procedures had greatly improved. The work culture was healthy and the experience invaluable in helping me decide my career trajectory."
James P Chiou MD March 2021 |
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MATCHED TO: FAMILY MEDICINE AT LARKIN SOUTH MIAMI CAMPUS, MIAMI FL.
“ I needed a platform to enhance my skills and boost my confidence in patient care and management. Dr. Sonny Saggar is one of the few doctors who is sincerely providing a launch pad to most of the students who have graduated and losing their valuable time waiting to be matched.
24/7 Urgent care (Downtown and Creve Couer) offered me to work independently and gain the experience, confidence, and hands on procedural skills, while still working on building my resume to the next level. My experience here has being amazing, not only did I master my Procedural skills but became a pro in doctor patient relationship. The work environment here is similar to a training program.” Jabeen Fatima, MD March 2021. |
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MATCHED TO: FAMILY MEDICINE AT SAINT AGNES MEDICAL CENTER, FRSNO, CA.
"Downtown Urgent Care provided me with the utmost needed clinical exposure and mindset in an intellectually and academically stimulating environment. It helped me develop personally and professionally and I was soon thinking as a clinical detective solving the trickiest of patient cases with the help of an outstanding mentor and clinical team. The Tuesday and Thursday didactics and the daily question bank sessions at noon with participants from all over the world, provided for a rather engaging clinical environment."
Abdul K Alcozie, MD March 2021. |
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MATCHED TO: FAMILY MEDICINE AT BAPTIST HEALTH NORTH, LITTLE ROCK, AK.
"24/7 Healthcare provides AP's a unique experience of clinical exposure and didactic education. In one year a provider can see 2000 patients. That exposure provides a phenomenal source of experience from which an interviewee for residency can answer questions with patient related stories. The clinic also provides a source of community, people in the same boat, which can help open avenues to unique paths to residency. Put simply, without 24/7 Healthcare, I would not have matched. In addition, without working in the crucible of an urgent care, I would not have grown into a competitive candidate."
Michael Moll, MD April 2021 |
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MATCHED TO: INTERNAL MEDICINE AT ST. MARY MERCY HOSPITAL, LIVONIA MI.
"Working at 24/7 Healthcare was an invaluable experience that gave me the opportunity to strengthen my skillset and CV before starting residency. This program gave me the confidence and knowledge to manage a wide variety of primary care, urgent care and general medicine cases. It does not end there though; I had many cases which required referral to specialists after making the diagnosis. If you like procedures, you will have more than enough exposure to become proficient at suturing, I&D, splinting, and reducing joints to name a few. The ancillary staff at each location are amazing and truly a pleasure to work with. Dr. Saggar, our program director, wants you to succeed and makes himself available to help make that happen."
Stefan Odabasic MD May 2021 |
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MATCHED TO: FAMILY MEDICINE AT UAMS ARKANSAS.
"After graduating from medical school, I looked to keep up my medical knowledge and sharpen my clinical skills. Working at 24/7 Health Care allowed me to give back to the community while maintaining my clinical competency and preparing me for residency. I enjoyed working with the team, collaborating with them, and discussing complex cases and patient management. Dr. Saggar is a fantastic supervisor who always made time for the providers and encouraged presentations, learning objectives, and board review. Overall, it was an invaluable experience throughout my medical journey and shaped me into a confident and competitive residency candidate."
Omar Alazzawi MD March 2022 |
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MATCHED TO: INTERNAL MEDICINE, ARNOT OGDEN MEDICAL CENTER, ELMIRA, NY.
"Working at 24/7 Health Care was a critical part to the development of becoming a resident physician. I was able to learn and practice my skills in a manner I never have before. The work space gave me an environment that included weekly didactics and practicals that helped sharpen my clinical acumen. The team is supportive and encouraging. I am grateful to Dr. Saggar and all the rest of the staff at 24/7 Health Care for an experience that I will never forget."
Rohail Baig MD March 2022 |
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MATCHED TO: FAMILY MEDICINE AT WELLMONT HEALTH SYSTEM, VA.
"A place to be if you wanna MATCH! 24/7 Healthcare is the best place to prepare yourself and stand out from other candidates during residency season. I was able to create a better application, just like a practicing physician with real-life clinical experience and skills. It helped me get interviews and interviewers were highly impressed by my work at 24/7 Healthcare. Dr. Saggar is simply amazing. He helped me create an impactful LOR, provided valuable tips during my didactics sessions, and helped me improve my communication and interpersonal skills. I treated thousands of patients and a variety of conditions. I learned the art of medicine, became a better clinician and person during the process. Overall, 24/7 Healthcare and Dr. Saggar not only helped me MATCH but created the mindset and skills necessary to shine during residency. I will be forever grateful for this place. Thank you 24/7 Healthcare and team!"
Mufis Shaikh MD March 2022 |
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MATCHED TO:
"Working at 24/7 Healthcare was a terrific opportunity for me. It's a constructive learning environment where I could grow and develop as a physician. A wonderful group of professionals to work with, the experience I gained there helped propel me toward the residency I've been hoping for. I am grateful to have practiced medicine at 24/7 Healthcare"
Michael Johnson MD March 2022 |
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MATCHED TO: FAMILY MEDICINE AT CHARLES R. DREW UNIVERSITY, CA.
"Dr. Sonny Saggar, and everyone at 24/7 Healthcare were absolutely essential in helping me successfully MATCH. 24/7 Healthcare provided me with the one thing that I desperately wanted to add to my residency application: clinical experience! And the clinical experience here is second to none. During my time at 24/7 Healthcare, I learned to be comfortable with a wide array of procedures, further expand my clinical knowledge, and do my part to give back to the underserved community of St. Louis. Not only did this experience ultimately help me to MATCH, but it strengthened my resolve to dedicate my life to medicine. Again, I can’t say enough good things about this place, and the people who make it an ideal environment to learn how to become an outstanding physician."
Walter Anazonwu MD March 2022 |
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MATCHED TO: TY in HATTIESBURG, MS; then PREVENTIVE MEDICINE in LOMA LINDA, CA.
"24/7 Healthcare in St. Louis, MO is wonderful preparation for residency to sharpen your clinical skills and CV. As well, it's a great way to give back to the local St. Louis community after graduating from medical school. Working with the 24/7 team via discussing complex cases, giving presentations and patient management has adequately prepared me to start my residency career. Dr. Saggar is an enthusiastic physician and supervisor, who is always willing to teach, and truly wants everyone to succeed. Being an assistant physician was an invaluable experience as I gained confidence and competence in my ability to manage a variety of primary care, urgent care, and preventative medicine cases. I also improved my proficiency in certain procedures such as suturing, splinting, and lacerations. 24/7 Healthcare is an experience everyone should have after completing medical school. Thank you to the team."
Gagandeep Singh Anand MD March 2022 |
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MATCHED TO: FAMILY MEDICINE AT DETROIT MEDICAL CENTER, SINAI GRACE.
"If you are looking for a place to improve your clinical skills while also being able to improve your CV for Residency then this is the right place for you. 24/7 Healthcare allowed me to not only sharpen my clinical skills, but also give me the confidence I needed to show myself and others of the kind of doctor I could become. Dr. Saggar is not only a great doctor but a phenomenal human being who guides all of his students and gives them a fighting chance in this broken medical system. The preparation you get for residency here is unmatched compared to other electives and observerships with the procedures, lectures/presentations, and autonomy given. I can confidently say that this experience was the reason I matched into residency after many attempts at matching and has prepared me to be ready for residency. Thank you so much Dr. Saggar and the staff at 24/7 Health care."
Hammad Aftab MD March 2022 |
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MATCHED: FAMILY MEDICINE, MARSHALL COMMUNITY HEALTH CONSORTIUM, GALLIPOLIS, OHIO.
"I had been through two match cycles and worked as a professor, medical scribe and did research. Downtown St Louis Medicine’s Residency Prep Program gave me the opportunity to work on my clinical skills and raise my confidence in myself. You have shifts that are just you and the patients but you are never alone with the team environment and communication network that is put in place. I was able to make a difference in a lot of patient’s lives while enhancing my abilities. I can reach out to program directors and tell them I have full patient clinical experience where I was making the choices, writing the notes and doing the procedures.
On top of the clinical experience, there is the opportunity to enhance you presentation skills at the Tuesday and Thursday morning presentation sessions. Presenting or actively listening helps guide you on your way to residency. I had already taken the Step 3 going into this program but I was able to sit in on the noon daily question bank sessions and it was a beautiful addition to help your knowledge base both for step 3 or general practice. Without 24/7 Urgent Care I would not be able to be the competitive candidate I was for the match! Thank you for the time and I look forward to helping out as I move to a different path in my career." Joseph Casper MD March 2022 |
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please Contact Us If You want to learn more.
We are always accepting applications. To start, please send us your C.V. and cover letter or reach our with questions via the form below!
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If you are a licensed Assistant Physician in the State of Missouri and you have the ability, willingness to learn new skills, and desire to serve your community, we would like to hear from you. Please see the pre-residency milestones below for what you can expect:
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