UCSF Fresno offers a unique blend of training with distinct urban and rural family health centers.   Residents select from a hospital affiliated primary care training site adjacent to Community Regional Medical Center (CRMC), a community-based family health center in southwest Fresno (Clinica Sierra Vista), or a rural health center located in an agricultural community about 25 miles from CRMC (Adventist Health Community Care Selma).  Family medicine residents have an outstanding reputation in our community and are in great demand in rural, urban and suburban settings.



The CMC Family Health Center is located in the newly opened, state-of-the-art Deran Koligian Ambulatory Care Center (ACC).  The Family Health Center consists of 15 exam rooms each equipped with a wall-mounted computer in order to easily review labs and other studies with patients.  In addition, there is a large resident conference room equipped with several computers and an AV system routinely used during Morning Report and teaching in the clinic held daily with residents, medical students, and faculty.  The ACC medical office building borders Community Regional Medical Center and the UCSF Fresno Center.   In addition to the family medicine center the new, two-story building includes Women’s Health, Children’s Health, Internal Medicine, HIV Special Services, Ophthalmology and Dental services.  CMC residents have easy access to rotations and lectures taking place at CRMC or the neighboring UCSF Fresno Center.


CMC residents have the opportunity to care for many patients with a wide spectrum of clinical pathology from diverse cultural backgrounds.  This includes Hispanic and Southeast Asian ethnic groups, as well as African-Americans, Native Americans, and others.   A bilingual staff and translation services facilitate access to health care for the area’s diverse population.


Family medicine faculty based at CMC are quite experienced and have skills in inpatient care, HIV/AIDS management, Hepatitis C, and research methodology. Volunteer faculty from the community regularly precept residents and medical students at the CMC Family Health Center.  Many of these preceptors are graduates of the UCSF Fresno family medicine program and are in private practice, work in correctional medicine, or in community health centers and other practice settings in the community.  They are eager to share information with residents about the many exciting practice options available to family physicians after graduation.


Adventist Health Community Care Selma presents a unique opportunity for residents who are interested in clinical training and practice in a rural site.  Selma is a predominantly Hispanic, agricultural community of 23,000 people located 25 minutes from CRMC.


The Selma pathway is housed at the Adventist Health Community Care Selma (AHCC Selma) where six full-time attending family physicians see patients and provide teaching for family medicine residents.  AHCC Selma utilizes a multidisciplinary team practice which includes nurse practitioners and physician assistants as well as advanced practice nurses, health educators, and social workers.  Medical students also rotate through AHCC Selma.


Selma provides residents with a stimulating educational environment in a challenging clinical setting.  In this rural community setting, residents manage prenatal and well child care, as well as perform procedures in the outpatient setting. Residents manage and deliver 50 or more obstetric patients a month including cesarean sections, which is provided by our Selma faculty and community physicians, increasing the learning opportunities for residents.


Selma residents especially enjoy the small town flavor of their training site.  Faculty and staff often know the extended families of their patients.  Most families are low income.  A typical mix of patients includes all ages, with many women and children.  There are also large numbers of patients with a variety of chronic medical conditions including diabetes, hypertension, emphysema, and congestive heart failure.


AHCC Selma patients are admitted to Selma Community Hospital where they are followed by family medicine residents and faculty.  It is a busy, friendly, rural hospital, adjacent to AHCC Selma and administered by the well-established Adventist Health system.  It has up-to-date services including a CT scanner, MRI services, and a variety of specialists who visit on a regular basis.  Residents assist on a variety of surgeries, including gynecologic procedures, general surgery, caesarean sections, and tubal ligations.  Family medicine residents are the only residents working at the hospital and the hospital medical staff is dominated by family physicians.  Residents are encouraged to work directly with patients in all of the hospital’s patient care areas.


The Selma pathway offers family medicine residents the opportunity to develop an independent practice style in a rural setting.  There are also many opportunities to obtain surgical experience in procedures in which family physicians can later obtain privileges.  At the same time, Selma residents are fully integrated into the tertiary care experience and the family medicine education provided at Community Regional Medical Center. Few family medicine residencies offer this mix of education, experience, and training.



Clinica Sierra Vista (CSV) is located in southwest Fresno, a vibrant, multi-cultural community.  Supervision comes from core UCSF Fresno faculty.


CSV cares for a large Hispanic population.  Serving a primarily Hispanic population, translation services and bilingual staff facilitate access to care at the federally qualified health center.


CSV emphasizes a health care team approach and maintains nutritional, social, and health education services.  CSV is committed to meeting the health care needs of the community. This is manifested through outreach efforts at local schools, providing team physicians, and offering weekend services for their patients. 


The clinic is operated by Clinica Sierra Vista.  Completed in 1987, the Health Center's 11,000 square foot facility is located ten minutes from CRMC.  It includes a procedures suite, a modern laboratory with a full-time technician, x-ray services, as well as library and conference areas.  A 5,000 square foot Women's Health Center is devoted to the health care needs of women of all ages.  Patients requiring inpatient medical services are admitted to Community Regional Medical Center.


The CSV pathway offers residents an excellent education that incorporates community-oriented primary care.  CSV residents have a diverse patient population with ample opportunities for prenatal care, deliveries, post-partum care and outpatient procedures.  The acquisition of ambulatory care skills in a multicultural setting is also emphasized providing a practical and relevant education.