VA Residency: Anatomy of a Day in Greater Los Angeles

Part of a series on the chiropractic residency program in the VA health care system

The saying goes: If you’ve seen one VA hospital, you’ve seen one VA hospital. Across the board, there are many similarities between the chiropractic residency sites. However, each has its own flavor – making them unique in their own way.

As a New Jersey native, moving to the opposite side of the country wasn’t even a question when I discovered my acceptance to the VA chiropractic residency program in Los Angeles (although retiring my snow shovel for year-round sunshine made the decision quite acceptable, let me tell you…). The opportunity to treat our nation’s veterans in this setting was a dream come true, and almost four months in, I couldn’t be happier.

The Greater Los Angeles Healthcare System is the largest in the country. Similar to my fellow chiropractic residents, I frequently encounter questions regarding my day-to-day routine from colleagues, friends, and family. SO – the short story is – day to day changes…day to day. However, a typical week is broken up into a consistent blueprint that allows my day-to-day schedule to fill in quite nicely.

The majority of my time is spent at the West Los Angeles campus, with one to two days a week at the Sepulveda Ambulatory Care Center. Collectively, I work under the mentorship of Valerie Johnson, DC, Paul Barkmeier, DC, Benjamin Liang, DC, and Robb Russell, DC.

The chiropractic clinic lives within the Physical Medicine and Rehabilitation Department (PM&R), where we are very much embedded. PM&R residency director Dixie Aragaki, MD, in collaboration with others, has developed a culture of education that is incredibly rich, collaborative and open-minded.

Each morning, I am greeted by medical residents and students during daily hour-long lectures on varying topics, with didactic courses Tuesday afternoons, as well. On any given week, we (the PM&R residents) may participate in journal club presentations, the annual UCLA Research Day, pain lecture series, or morbidity and mortality discussions (M&M’s) with additional emphasis on quality improvement and patient safety (QI/PS).

During M&M’s, the most complicated cases are presented and discussed to learn from procedural and administration difficulties or diagnostic and management issues; the goal being to improve patient outcome and experiences. Journal club is used to present and discuss current literature, and during the Pain Lecture Series different topics applicable to pain management are presented.

Monday, Tuesday and Thursday are dedicated to patient care, where I work under the direct supervision of my attending physicians, presenting each case and developing a management plan after careful discussion. While some patients are very straight-forward, the majority are more complex – having a multitude of psychosocial factors and co-morbidities. Having some experience in private practice before coming to California, I can say that my first month at the VA hospital surpassed all prior experience related to managing and treating highly complex patients. And boy, it has been the most rewarding (and challenging) experience to date!

Wednesday and Friday are dedicated to both scholarly duties as well as rotations through other departments. The ability to work closely with physiatry, neurology, geriatric and other physical medicine departments has been extremely beneficial in helping me appropriately guide patients to achieve the best outcome.

Thursdays, we have our weekly resident call, where we discuss a multitude of topics and learn from each other’s experiences. I always look forward to learning from my colleagues and sharing ideas as we expand our VA family and develop comradery throughout the country!

As a chiropractic resident at the VA hospital, this experience is truly one of a kind. Every day, I am challenged. Every day, I learn. Every day, I am excited to go to work (how lucky am I?!). I am eager to continue making a difference for our veterans’ health, and I encourage you all to continue checking back as we share our experiences along the way!

Dr. Mooers is the chiropractic resident at the VA Greater Los Angeles Healthcare System under site director Dr. Valerie Johnson. Her professional interests include rehabilitation exercise, professional advocacy, and pain management for veterans.