Obstetrics/ Gynecology

UCSF Fresno Obstetrics and Gynecology Residency

Welcome to the UCSF Fresno Obstetrics and Gynecology Residency Program

It is the mission of the UCSF Fresno Department of Obstetrics and Gynecology to promote Women’s Health in the Central California by providing innovative and excellent patient care, training the next generation of physicians and advancing patient-centered research.

Our accredited academic program blends evidence-based clinical training, in-vivo and laboratory based simulation, research, and formal didactic educational experiences to prepare graduates for private practice, academic positions, or subspecialty fellowships. We are a regional campus and major teaching site of the University of California, San Francisco, School of Medicine, teaching 3rd year OB/GYN clerkships as well as 4th year elective students in general OB/GYN as well as maternal and fetal medicine. Our faculty members hold appointments at the University of California, San Francisco, School of Medicine, and have received numerous awards for distinction in teaching.

The residency program is based at Community Regional Medical Center, a 685-bed regional academic medical center that serves a large and diverse patient population. Our hospital is the only tertiary care center in our region and operates the largest emergency room in California and the only level one trauma center between Los Angeles and Sacramento. More than 5000 births occur annually at CRMC, and high risk OB patients are referred from fifteen hospitals in a region delivering 50,000 babies per year. Plans are underway to add another 100 beds to the medical center as well as to build an 800 bed replacement hospital with a Women and Children’s Tower.

The Obstetrics and Gynecology Residency Program at UCSF Fresno is committed to serving women’s health care needs by providing a wide range of routine, complex and highly individualized services. From basic obstetrical and gynecological care to high-risk prenatal care and delivery management and urinary incontinence evaluation and treatment. As the only referral center for a 100 mile radius, we provide care to many underserved patients in both rural and urban communities. Community Regional Medical Center strives to provide the support we need to care for our patients including; a state of the art Emergency Department, Cyber knife, 84 bed level III NICU, 22 bed L & D with 3 dedicated ORs and dual console da Vinci Robot surgical system.

The Deran Koligian Care Center, a 28,000 square foot building conveniently located on the Community Regional Medical Center campus, houses our Women’s Health Clinic where residents provide ambulatory care to their patients. We provide a variety of services in our clinic including well women/preventive care, prenatal visits, IUD placement, implantable contraception, office hysteroscopy and Essure placement, and pelvic floor diagnostic testing. In addition to weekly continuity clinics, residents also rotate through a variety of specialty clinics including oncology, colposcopy/dysplasia, REI, emergency room follow-up, drop-in, and FPMRS (female pelvic medicine and reconstructive surgery).  High risk obstetrical outpatient experiences are gained in the University Women’s Specialty Center, a 5,000 square foot office immediately adjacent to the hospital providing comprehensive ultrasound services, antenatal testing, prenatal diagnosis and genetic counseling services, and perinatology consultation and continuing care.

Primary Care – Obstetrics 

The residency training program delivers approximately 2,800 infants a year, one third of which are high risk. In conjunction with our staff of mid-level practitioners, residents deliver a full range of low risk prenatal care services. Our L & D unit consists of 22 L/D/R (labor / delivery / recovery) rooms, 3 dedicated OR suites and a 10 bed triage unit. Both low and high risk patients are primary patients of the resident service and all management decisions and procedures are the responsibility of the residents with consultation and assistance from the general OB/GYN faculty and perinatologists. Faculty members are always present at board rounds and in-house faculty members are available for consultation and assistance 24 hours a day.

On the gynecologic service, residents become proficient in a comprehensive set of diagnostic and therapeutic procedures including laparotomy, vaginal, straight-stick laparoscopy, and robotic hysterectomy techniques. The hospital houses a 2-console DaVinci robot with simulator capabilities for resident education. The inpatient GYN service is led by two senor residents and the GYN attending for the month, who conducts regular teaching rounds as well as consulting on patient care. We provide consultation services to a wide variety of providers including the Emergency Department, Pediatrics, Internal Medicine, and Family and Community Medicine. In addition to the surgical experience from operating on our primary patients, senior residents receive extensive procedural experience with volunteer community faculty members during dedicated community surgery rotations, increasing the breadth and depth of surgical training as well as allowing residents to become familiar with the community physicians and their practices.

The gynecologic oncology service provides consultation and surgical expertise for a large number of community physicians and practices in the region. Resident experiences include diagnostic procedures, GYN oncology surgeries, and end of life care. Residents operate one-on-one with the gynecological oncology faculty and provide surgical services at Community Regional Medical Center, and Clovis Community Hospital, as well as staffing a busy outpatient gynecologic oncology clinic at the Deran Koligian Center.

Patients are referred to our pelvic floor medicine clinic from both our primary care practice and from private community physicians and receive a comprehensive urologic and pelvic floor evaluation. Both medical and surgical treatment options are provided by our 2 pelvic floor faculty members. Our residents receive one-on-one education in urodynamic studies and cystoscopy as well as in a variety of pelvic floor and incontinence surgical procedures and techniques.

At UCSF Fresno, REI care occurs at two sites: the Deran Koligian Women’s Health Center and the Women’s Specialty & Fertility Center. The clinic at the Women’s Health Center, supervised by Dr. Carlos Sueldo, is where residents provide hands-on medical and surgical care to the underserved population during their 2nd year of training. In the 3rd year, residents rotate to the Women’s Specialty & Fertility Center in the private practice setting to gain more extensive experience in infertility care and in-vitro fertilization. This facility not only provides state-of-the-art clinical care but is also highly productive in research.   Sueldo and Dr. Michael Synn, a former OB/GYN graduate of UCSF Fresno, teach residents surgical and medical management of a diverse complement of patients and conditions. In addition, numerous research studies have been completed by residents in collaboration with the Women’s Specialty & Fertility Center.

The UCSF Fresno OBGYN Department is staffed with three MFM faculty who provide perinatal services throughout the Central San Joaquin Valley. In addition to providing services in a rural health clinic located in Visalia, our department operates two local perinatology practices: University Women’s Specialty Center and University Perinatal Associates.  We accept outpatient referrals and maternal transports from more than fifteen hospitals in the region resulting in one of the largest perinatal practices and inpatient services in the San Joaquin Valley. The perinatal practice and hospital serve as the hub of a growing regional perinatology and transport program serving six counties with a combined delivery volume of approximately 50,000 deliveries per year.

Through the University Women’s Specialty Center and the inpatient service, residents fully participate in the care of our high risk patients and receive hands-on training in cervical cerclage, external cephalic version, amniocentesis and other high-risk procedures. As a California approved prenatal diagnostic center, we receive a large volume of genetic screening and nuchal translucency referrals. Consultations are provided for medical complications of pregnancy, preconception counseling, diabetes in pregnancy, fetal medicine, isoimmunization, and fetal and genetic abnormalities.

Under the direct supervision of the faculty and sonographers, Residents receive ultrasound training during their 1st and 4th program year at two locations: University Women’s Specialty Center and the University Perinatal Associates.  This experience includes training in cervical length, nuchal translucency, basic and targeted transabdominal, Doppler, and 3-D assessment as well as fetal echocardiography. The University Women’s Specialty Center is accredited by the American Institute of Ultrasound in Medicine in both obstetric ultrasound and fetal echocardiography and performs more than 500 non-stress tests and 2500 ultrasound procedures per month.

OBGYN residents rotate through the 84 bed NICU during their intern year to develop knowledge and skills that will assist in the management of our high risk OB patients. Monthly, we collaborate with neonatology and genetics faculty to provide a Perinatal Morbidity and Mortality Conference which covers a wide variety of topics including state-of-the art reviews of evidence-based care.

Through this diverse high risk obstetric population, numerous ongoing research projects in preterm labor, diabetes, ultrasound, and other aspects of maternal and fetal medicine are available.