The UCSF Fresno Emergency Medicine Residency has been committed and actively involved in pre-hospital care since its inception. Our unique four county EMS system, which includes a gamut of environments, ranging from remote wilderness to inner city urban, and our involvement with the National Park Service (NPS) through the parkmedic program provide a unique opportunity for training and working in wilderness medicine and EMS. In 2005 the Wilderness Medicine/EMS fellowship was created to allow individuals to delve deeply into all aspects of pre-hospital care and to develop the knowledge and skills to become a leader in this exciting field.
The fellowship is a one year program with the option to extend for two years for individuals who wish to pursue and advanced degree (MPH). The fellow works as a junior faculty at Community Regional Medical Center (CRMC) eight shifts per month, which allows plenty of time to develop the cognitive knowledge and skill sets necessary to become an expert in wilderness medicine and EMS. The curriculum and experiences available during the fellowship are designed to be flexible to allow each individual the opportunity to explore the areas of pre-hospital care that interest them the most.
CRMC is a 626 bed hospital that serves as the only Burn Center and Level 1 Trauma Center between Los Angeles and Sacramento. The training programs at CRMC are affiliated with the University of California, San Francisco. The 96 bed emergency department has approximately 120,000 visits per year and is the home of one of the oldest emergency medicine residencies in the nation. The residency is a four year, fully accredited program that has 10 residents per year. There are a full range of other residency programs at CRMC and many fellowships including pulmonary, critical care, cardiology and GI.
Again, the curriculum is designed to be flexible to allow each fellow to create an experience that best meets his/her needs. For both EMS and wilderness medicine, there are required and optional experiences for the fellow to choose from.
Successfully complete the Base Hospital Physician Course and serve as a base hospital physician at CRMC
Develop understanding of the local EMS system and its many special environments by participation in:
Monthly Central California EMS Agency Meetings (CCEMSA)
Monthly Parkmedic (PM) meetings
Ride alongs with local EMS (ground or supervisor units)
EMS dispatch experience
Involvement in a continuous quality improvement (CQI) project
Providing educational opportunities to residents, medical students, nurses, paramedics, parkmedics, EMTs and first responders
Involvement in disaster planning and drills
Air ambulance experiences/ride alongs
Urban/rural EMS research
Participation in the medical student elective in Yosemite
Participation in the UCSF Fresno Wilderness Medicine Conference
Participation in the yearly multicasualty incident in Sequoia and Kings Canyon (SEKI) National Parks
Search and rescue (SAR) participation and training
National Ski Patrol participation and training
Attendance at a national/international wilderness medicine conference
Involvement in the Parkmedic Program (this is an exclusive opportunity of our fellowship)
International wilderness medicine experiences
Training opportunities with the National Outdoor Leadership School (NOLS) or the Wilderness Medicine Society (WMS)
3. Academic Topics: The fellow is to use the year to develop or further his/her
knowledge in the realm of wilderness medicine and EMS. The fellow can use
the above resources or develop their own plan to cover the following topic areas:
a. Altitude Medicine
b. Environmental Exposure
d. Wilderness Trauma
e. Infectious Disease in Remote Settings
d. Disaster and Tactical Medicine
e. Marine Medicine
f. Wilderness Expertise/Experience
g. Development of an Effective EMS System (Wilderness, Rural or Urban)
h. Effective Leadership Skills
i. Educator Development
4. Scholarly Activity: Although a research project is not required for the fellowship,
it is strongly encouraged as further study of the field of wilderness medicine and
EMS is greatly needed. If a research project is not feasible then another
scholarly project (case report, book chapter, etc) will be required.
Clinical Job Description
1. The fellow will work a minimum of eight, eight hour, shifts per month at CRMC.
These shifts will be a mix of clinical and academic experiences depending on the
fellow’s career goals.
2. The fellow will be a Central California Faculty Management Group (CCFMG)
employee with benefits commensurate with clinical position.
3. The fellow with hold a UCSF clinical instructor title.
4. At least one month devoted to field work dependent on the fellow’s goals
5. Salary of approximately 90,000 dollars
6. Spending account of 2,000 dollars for academic endeavors
7. Financial support to attend at least one national EMS or WM conference
8. Office, computer, administrative, and research support
Requirements for Fellowship Application
1. Graduate of a United States or Canadian Emergency Medicine Residency who is board
eligible or board certified.
2. A letter of intent, CV and at least two letters of recommendation will be required for
the application process.
3. Applications must be submitted by November 15 annually. Decisions regarding the
Fellowship will be made by December 15.
Desiree Crane, DO
Medical School: Western University of Health Sciences, College of Osteopathic Medicine of the Pacific
Brian Horan, DO
Current position – P.T. Faculty with UCSF Fresno
2010-2011, Susanne Spano, MD
Current position – UCSF Fresno Faculty
2011-2012, Ross Hooker, MD
Current Position, Private Practice in British Columbia
2011-2012, Megann Young, MD
Current Position – UCSF Fresno Faculty
2012-2013, Conal Roche, MD
Current Position, University of Cincinnati Faculty
Wilderness Medicine/Parkmedic/EMS Faculty
Janak Acharya, MD: Clinical Instructor of Emergency Medicine; Medical Director American Ambulance and Skylife
Jim Andrews, MD, FACEP: Associate Clinical Professor of Emergency Medicine; CCEMSA and Merced EMSA Medical Director
Danielle Campagne, MD: Assistant Clinical Professor; Fellowship Director; Base Hospital Physician Medial Director and Parkmedic Faculty.
Rawnie Ruegner, MD: Assistant Clinical Professor of EM, UCSF
Marc Shalit, MD, FACEP, FAAEM: Clinical Professor of Emergency Medicine: Associate Medical Director CCEMSA; Medical Director Parkmedic Program
Susanne Spano, MD, FACEP, FAAEM: Assistant Clinical Professor of Emergency Medicine; Director of Wilderness Medicine Education
Geoff Stroh, MD: Associate Clinical Professor of Emergency Medicine; Assistant Medical Director CCEMSA; Medical Director Parkmedic Program
Lori Weichenthal, MD, FACEP: Professor of Clinical Emergency Medicine; Associate Residency Director; Wilderness Medicine/EMS Associate Director
Megann Young, MD, Assistant Clinical Professor of Emergency Medicine, WM/EMS Fellow
2012 Wilderness Medicine Conference