Downtown ST. Louis MEDICINE (DSM):
Ambulatory Internal Medicine & Urgent Care
Residency prep Program (rpp)
Downtown Urgent and Primary Care 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.
Program Overview
The mission of the RPP 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 Shadow Shifts and an offer letter from our program director.
The residency program 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 DSM 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 Shadow Shifts and an offer letter from our program director.
The residency program 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 DSM 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.
Pre-Residency Projects
The pre-resident is expected to help design and complete two major projects during each academic year. One project will be Internal Medicine based. The other project will be Urgent Care based.
Projects are presented at a Project Presentation Meeting held in the spring. The pre-resident will work with the residency prep program director to identify a potential project and for mentoring throughout the project period.
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.
Pre-Residency Projects
The pre-resident is expected to help design and complete two major projects during each academic year. One project will be Internal Medicine based. The other project will be Urgent Care based.
Projects are presented at a Project Presentation Meeting held in the spring. The pre-resident will work with the residency prep program director to identify a potential project and for mentoring throughout the project period.
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.
Final 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. Note: When we achieve a partnership with an umbrella residency, the certification would come from the overseeing program, just as any other resident therein.
- 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. Note: When we achieve a partnership with an umbrella residency, the certification would come from the overseeing program, just as any other resident therein.
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 nominal and increases after every 1,000 hours of scheduled patient care and 6 months. 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 nominal and increases after every 1,000 hours of scheduled patient care and 6 months. 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: UHS Wilson Hospital, Johnson city, NY (Internal Medicine)
"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: Larkin Palm Springs Campus, Hialeah, FL (Family Medicine)
"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: Larkin South Miami Campus, Miami, FL (Family Medicine)
“ 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. |
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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