Riverside County and San Bernardino County to the north form this metro area. Like many such metro areas in the Southwest, it extends far into uninhabited desert areas, in this case east through the Mojave Desert to the Nevada/Arizona border. Larger than nine U.S. states, it is often referred to as the Inland Empire.
I agree with tchrist that the word doctor in doctor appointment is a noun (attributive noun I believe), although the definition of an attributive noun is a noun used as an adjective, so maybe it's just semantics at some point.
Expands definition of career appointment: a limited appointment will be designated as a career appointment when the incumbent has attained 1,000 hours of qualifying service in any 12 consecutive months without a break in service of at least 120 consecutive calendar days.