UCSF Fresno | Family Medicine Residency Program

RESEARCH

UCSF Fresno Department of Family & Community Medicine supports a range of research activities including:

Comprehensive research curriculum with emphasis on applying evidence-based medicine to clinical care;
Dedicated research team that assists in research design, statistical analysis, presentation and scientific writing;
MPH degree;
Research faculty mentors;
International research opportunities;
Access to UCSF’s ancillary research development courses (on-site in Fresno).

OVERVIEW
UCSF Fresno Department of Family & Community Medicine has made a special commitment to the development of community-based primary care research. The research team conducts original research, guides and supports the research interests of clinical faculty and residents, and implements formal evidence-based medicine and community oriented primary care curriculum for residents.

EBM
The evidence-based medicine curriculum is focused on the practical applications of using electronic information and critically appraising the evidence on which clinical decisions are made. Residents and faculty submit clinical questions, receive individualized training in literature search skills to find answers to those questions, discuss evidence pertaining to their questions and apply scientific evidence to improve diagnosis and treatment of patients. This innovative approach is designed to teach residents the skills they need to become life-long and self-directed learners.

SCHOLARLY ACTIVITY
During the three-year residency program, residents complete a scholarly project by choosing a topic of interest and forging community connections to provide services or conduct research related to that topic. They receive extensive support, encouragement, and specialized training for their projects from the Research Coordinator. Previous scholarly projects include: teen asthma camp director, teacher in a high school medicine camp, physician for a high school football team, and invited speakers on health topics to specific community organizations.

MPH
Residents who are interested in a more intensive research experience have an additional option. UCSF Fresno offers an innovative combined residency Masters in Public Health (MPH) program developed in collaboration with the California State University Fresno (CSUF) Health Sciences Department. It develops family physicians with training and skills to conduct research and implement community based programs that will improve the health status of underserved populations. MPH courses are offered in the evening to maximize educational opportunities and minimize conflicts with clinical responsibilities. MPH students are required to complete a research thesis that can be identical to the scholarly project in Family Medicine. Recent examples of work done by FP/MPH students include Tuberculosis in the Hmong Population of Fresno, Asthma Rates among Fresno Unified Elementary Schools, and Smoking Cessation in an Underserved Population.

RESEARCH FACULTY
The Research Director is Susan Hughes, MS, whose training in biostatistics is utilized on many research projects. She is responsible for overseeing research activities and working with faculty in the department. Ms. Hughes has an article currently in press at the Annals of Allergy, Asthma and Immunology that began as a randomized double-blinded placebo controlled resident project on the efficacy of echinacea. Other members of the research team include Roger Mortimer, MD, Victoria Kubal, MS, BCBA, and Rebeca Lopez, BS. Dr. Mortimer is the clinical expert of the research team. He directs the HIV clinic at University Medical Center and does research there on cryptococcal meningitis and case management. Ms. Kubal has expertise in behavioral analysis and therapy. She works with medical students and residents coordinating their community based primary care projects and has her own research project on behavioral approaches to pain management. Ms. Lopez is completing her MPH at CSUF and is working with Dr. Mortimer to study why pregnant women do not test for HIV. She also assists on medical student and resident projects.

Other faculty members conduct research activities as well. In the past ten years, Family Medicine faculty have been awarded the UCSF Fresno Medical Education Program Faculty Research Award four times. Research and other scholarly activity is ongoing in such areas as asthma, cultural diversity in health care, diabetes, pain management, pediatric deaths, and provider-patient communication.

UCSF RESOURCES
In addition, residents have access to UCSF programs offered on-site in Fresno including research methodology courses and writing workshops.

2006-2007 PUBLICATIONS

Mortimer R. Intravenous Fluid Warming with Body Contact in a Wilderness Setting. Wilderness and Environmental Medicine. In press.

O’Neil J, Hughes S, Lourie A, Zweifler J. Effects of echinacea on the frequency of upper respiratory tract symptoms: a randomized, double-blind, placebo-controlled trial. Annals of Allergy, Asthma, and Immunology. In press.

Zweifler J. The Missing Link: Improving Quality with a Chronic Disease Management Intervention for the Primary Care Office. Annals of Family Medicine. 2007 Sep-Oct;5(5):453-6.

Luman K, Zweifler J, Grumbach K. Physician Perceptions of Practice Environment and Professional Satisfaction in California: From Urban to Rural. Journal of Rural Health. Summer, 2007.23(3):222-8.

Paul S, Javed U, Tevendale R, Lanford J, Liu R. Acquired factor VIII inhibitor in an HIV-infected patient after treatment with pegylated interferon-alpha 2a and ribavirin. AIDS. 2007 Mar 30;21(6):784-5.

Ramos, KD, Youngclarke DM. Parenting advice books about child sleep: cosleeping and crying it out. Sleep. 2006 Dec 1;29(12):1616-23.

Hughes S, Zweifler J. Re: Impact of ACOG Guidelines on VBAC is Underestimated. Annals of Family Medicine. Electronic letter published Oct 6, 2006.

Zweifler J. Could pregnancy complications confound the relationship between route of delivery and outcomes? Annals of Family Medicine. Electronic letter published June 14, 2006.

Blossom HJ. Preparing Rural Health Professionals for Disasters. Rural Roads. Summer 2006;4(3).

Zweifler J, Garza A, Hughes S, Stanich M, Hierholzer A, Lau M. Vaginal birth after Cesarean in California: Before and after a change in guidelines. Annals of Family Medicine. 2006;4:228-234.

Davis JW, Bennink LD, Pepper DR, Parks SN, Lemaster DM, Townsend RN. Aggressive traffic enforcement: A simple and effective injury prevention program. The Journal of Trauma. May, 2006;60(5):972-977.

2006-2007 PRESENTATIONS

Susan Hughes, MS presented “Trends in Rural Mother’s Births: California 1998 – 2002” at the 35th North American Primary Care Research Group Annual Meeting, October 2007, in Vancouver, British Columbia, Canada.

Mathilda Ruwe, MD, John Capitman, PhD, John Zweifler, MD, MPH, Susan Hughes, MS, and Mary Wallace presented a poster “Fresno Breast Cancer Navigation Pilot Program” at the “From Research to Action: “Breaking New Ground” California Breast Cancer Research Symposium on September 7, 2007, in Los Angeles, CA.

Victoria Kubal, MS, and Amber Mahal, MD presented a workshop on “Behavioral Relaxation: Training and Scale” at the 33rd Annual Association for Behavior Analysis Conference, May 2007, in San Diego, CA.

Susan Hughes, MS was a panel member for the Innovations Discussion at the 3rd Annual UCSF FCM Colloquium, May 2007, in San Francisco, CA.

Six residents and four faculty presented posters at the 3rd Annual UCSF FCM Colloquium, May 2007, in San Francisco, CA.

Adriana Padilla, MD and Susan Hughes, MS presented “Teaching Physical Exam and Medical Spanish Simultaneously in Medical School” at the UCSF 6th Annual Medical Education Day, May 2007, in San Francisco, CA.

Adriana Padilla, MD and Susan Hughes, MS presented “Encouraging Rural and Underserved Interest in Medical Students at a Regional Campus: Impact of Model Fresno” at the UCSF 6th Annual Medical Education Day, May 2007, in San Francisco, CA.

Susan Hughes, MS, and Adriana Padilla, MD presented “Advocating for Change in the Health Care System: A Medical Student Clinical Innovation” at the 40th Annual Society of Teachers of Family Medicine, April 2007; in Chicago, IL.

John Monteleone, MD, MPH, Mimi Mott-Smith, FNP, MPH, and Mohammad Nezami, MD presented “Changing Behavior Using Personalized Exercise and Nutrition Prescriptions for Patients at Cardiovascular Risk” at the 40th Annual Society of Teachers of Family Medicine, April 2007; in Chicago, IL.

Adriana Padilla, MD and Susan Hughes, MS presented “Innovation-Funded Project Consultation - Maternal, Child and Family Health; Model Longitudinal Integration at UCSF Fresno” at the ESCape: Weekly Educational Scholarship Conference, April 2007, in San Francisco, CA.

John Zweifler, MD, MPH presented “Inequities in Health Care Quality: Can These be Quantified for Public Policy Purposes?” at the 18th National Conference on Primary Health Care Access, April 2007, in San Diego, CA.

Victoria Kubal, MS presented “California Statewide Family Medicine Preceptorship Program's Impact on Medical Students' Specialty Selection: A Seven-Year Analysis” at the 28th Annual Central California Research Symposium, April 2007, in Fresno, CA.

Jennifer Burnett, MD presented “Transgender Healthcare” at the Maripoza Azul- Hispanic TS Support Group, April 2007, in Fresno, CA.

John Zweifler, MD, MPH was part of the responder panel discussing “Access, Quality, and Utilization in California HMOs” at the Joint Policy Briefing for California Program on Access to Care; California Office of the President, February 2007, in Sacramento, CA.

John Zweifler, MD, MPH presented “Performance Measurement and Rewards Beyond HEDIS and CAHPS: Expanding Performance Measures at the Second National Pay for Performance Summit, February 2007, in Los Angeles, CA.

John Zweifler, MD, MPH presented “Moving Towards Childhood Obesity Policy in California” at the State of California Department of Health Services Childhood Obesity Conference, January 2007, in Anaheim, CA.

Alex Sherriffs, MD presented “Dementia: Challenges & Opportunities in the Clinic, ER and Inpatient Settings” as part of the UCSF Wednesday Special Lecture Series, January 3, 2007, in Fresno, CA.

Susan Hughes, MS presented “A Geographic Information System (GIS) use in Public Health: Ambulance Pickups for Breathing Problems During a Waste Processing Facility Fire” October 16, 2006 at the North American Primary Care Research Group Annual Meeting in Tucson, AZ.

John Blossom, MD presented “Advocacy at the National Level” June 10, 2006 at the National AHEC Organization Conference in Omaha, NE.

John Blossom, MD presented “Enhancing the Safety and Well-Being of Older Adults through Age-Specific Emergency Preparedness Programs” March 16, 2006 at the American Society on Aging and National Council on Aging Joint Meeting in Anaheim, CA.

For a more complete look at scholarly activity within the UCSF Fresno Department of Family and Community Medicine go to: http://connections.fresno.ucsf.edu/fpc/ and click on the Scholarly Activity link.