UCSF Fresno | Family Medicine Residency Program

FAMILY HEALTH CENTERS

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 near Community Regional Medical Center (CRMC), a community-based family health center in southwest Fresno (Sequoia Community Health Center), or a rural health center located in an agricultural community about 25 miles from CRMC (Central Valley Family Health Center-Selma). During their second year residents work at all three sites, preparing them for a wide variety of practices. Family medicine residents have an outstanding reputation in our community and are in great demand in rural, urban and suburban settings.

CRMC FAMILY HEALTH CENTER

The CRMC Family Health Center is located one mile east of Community Regional Medical Center and the UCSF Fresno Center. CRMC residents have the opportunity to care for complex patients from exceptionally diverse cultural backgrounds. This includes Hispanic and Southeast Asian ethnic groups, as well as African-Americans, Native Americans, and others. Fluency in Spanish or Southeast Asian languages is an asset, but not a requirement as translators are readily available.

CRMC residents value the ease of consulting with specialists in other disciplines and the many opportunities for interdisciplinary co-management of patients. In many ways, being a resident in the urban track is like joining a multi-specialty group which cares for patients with a wide spectrum of clinical pathology. Urban track residents at CRMC have easy access to rotations and lectures because most take place at CRMC or the neighboring UCSF Fresno Center.

Family medicine faculty based at CRMC are quite experienced and have particular skills in inpatient care, AIDS management, evidence based approaches, and research methodology. Volunteer faculty from the community regularly precept residents and medical students at the CRMC Family Health Center. Many of these preceptors are graduates of the UCSF Fresno family medicine program. They are eager to share information with residents about the many exciting practice options available to family physicians after graduation.

SELMA COMMUNITY HEALTH CENTER

Central Valley Family Health Center-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 Central Valley Family Health Center-Selma (CVFH-Selma) where four full-time attending family physicians see patients and provide teaching for family medicine residents. CVFH-Selma utilizes a multidisciplinary team practice, utilizing nurse practitioners and nurse midwives. Medical students also rotate through CVFH-Selma.

Selma provides residents with a stimulating educational environment in a challenging clinical setting. Although family medicine residents at each family health center site have similar rotations, Selma residents receive exceptionally strong obstetric training. Residents and faculty manage and deliver 75 obstetric patients a month. C-section coverage is provided by our Selma faculty, 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. There is a good mix of patients of 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.

CVFH-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 CVFH-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 orthopedics, 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 practitioners 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.

SEQUOIA COMMUNITY HEALTH CENTER

The Sequoia Community Health Center (Sequoia) is located in southwest Fresno, a vibrant, multi-cultural community which is federally designated as medically underserved. Supervision comes from both core UCSF Fresno faculty as well as family physicians based at Sequoia, many of whom are UCSF Fresno graduates. Sequoia cares for a large Hispanic population. Fluency in Spanish is an asset, but not a requirement as many of the patients speak English and translators are readily available.

Sequoia emphasizes a health care team approach and maintains nutritional, social, and health education services. Sequoia 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 evening and weekend services for their patients.

The clinic is operated by the Sequoia Community Health Foundation. Completed in 1987, the Health Center's 11,000 square foot facility is located ten minutes from CRMC. It includes a special procedure room, a modern laboratory with a full-time technician, x-ray services, a library and a conference room. Obstetricians, pediatricians, and internists are on-site and available for consultation. A 5,000 square foot Women's Health Center is devoted to the health care needs of women of all ages.

Patients from Sequoia are admitted to Community Regional Medical Center which has undergone a quarter billion dollar renovation and is the home of the UCSF Fresno Medical Education Program.

The Sequoia pathway offers residents an excellent education that incorporates community-oriented primary care. Sequoia 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.