Wilderness Medicine

fellowship program.

UCSF Fresno Wilderness Medicine Fellowship

Welcome to the UCSF Fresno Wilderness Medicine Fellowship Program

The UCSF Fresno Emergency Medicine Residency has been committed to and actively involved in wilderness medicine and prehospital care since its inception.  Wilderness medicine – that is, the practice of medicine in remote and austere environments – is a growing and evolving field, with more and more people engaged in recreation in remote environments every year.  The Wilderness Medicine/EMS Fellowship was created in 2005 to allow individuals to delve deeply into all aspects of wilderness medicine and prehospital care and to develop the knowledge and skills to become a leader in this growing field.  Our four-county EMS system and our involvement with the National Park Service (NPS) through the Parkmedic program provide a unique opportunity for learning, training, and working in both wilderness medicine and EMS.

The fellowship is a one year program with the option to extend to two years for individuals who wish to pursue an advanced degree (MPH).  The goals of the fellowship are to provide physicians with the cognitive knowledge and hands-on skills needed to be leaders in the field of Wilderness Medicine.  There are also many opportunities for the fellow to hone their teaching skills by training fellow physicians, medical students, prehospital providers, and laypeople in wilderness medicine. The curriculum and experiences available during the fellowship are designed to be flexible to allow each individual the opportunity to explore the areas of wilderness medicine and prehospital care that interest them the most.  We encourage not only the acquisition of academic knowledge but also the pursuit of technical skills proficiency in an area of the fellow’s interest (e.g. high angle rescue, dive medicine, etc.).

The Curriculum
The fellowship curriculum is designed to be flexible to allow each fellow to create an experience that best meets his/her needs.  For both wilderness medicine and EMS, there are required and optional experiences for the fellow to choose from.

EMS Requirements

  1. Complete the Base Hospital Physician Course and serve as a base hospital physician at CRMC, answering radio calls from our local EMS system as well as the National Parks (EM-trained physicians only)Develop an understanding of the local EMS system by participation in:
    • Monthly Central California EMS Agency (CCEMSA) meetings
    • Monthly Parkmedic meetings
    • Ride-alongs with local EMS ground or supervisor units
    • EMS dispatch experience
  2. Medical direction of a local marathon
  1. Attendance at and participation in monthly Wilderness Medicine meetings. These meetings provide an opportunity for the fellowship director and other wilderness medicine/EMS faculty to track the fellows’ progress and to encourage personal and professional development.
    Participation in the Parkmedic program, which includes:
  • Writing protocols for the National Park Service EMS providers;
  • CQI for Sequoia and Kings Canyon National Parks;
  • Monthly CE sessions for Sequoia and Kings Canyon National Parks;
  • Online medical control for Sequoia and Kings Canyon National Parks;
  • Parkmedic education
  • Participation in the wilderness medicine medical student elective in Yosemite (lectures and hands-on teaching)
  • Participation in the UCSF-Fresno Wilderness Medicine Conference (conference planning, lectures, and small group teaching)
  • Participation in the annual multicasualty incident (MCI) training in Sequoia and Kings Canyon National Parks
  • Attendance at a national or international wilderness medicine conference
  • Participation in education of residents, medical students, nurses, paramedics, Parkmedics, EMTs, and first responders

Optional Experiences
Many of these can be funded fully or partially through a departmental stipend for CME.

  1. Air ambulance experience and ride-alongs
  2. Tactical medicine involvement
  3. International wilderness medicine experiences
  4. Training opportunities with the National Park Service
  5. Search and rescue participation and training
  6. Involvement in a Continuous Quality Improvement (CQI) project
  7. Involvement in disaster planning and drills
  8. Advanced Wilderness Life Support Course
  9. Diploma in Mountain Medicine training

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:

  • Altitude Medicine
  • Environmental Exposure
  • Toxicology
  • Wilderness Trauma
  • Infectious Disease in Remote Settings
  • Disaster and Tactical Medicine
  • Marine Medicine
  • Wilderness Expertise/Experience
  • Development of an Effective EMS System (Wilderness, Rural, or Urban)
  • Effective Leadership Skills
  • Educator Development

A scholarly project is required for completion of the fellowship.  This can consist of research, case report, book chapter, etc. Although a traditional research project is not required, it is strongly encouraged as further study of the field of wilderness medicine and EMS is greatly needed.

The Institution

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 Emergency Medicine 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, including Family and Community Medicine (http://www.fresno.ucsf.edu/fpc); and many fellowships including pulmonary, critical care, cardiology, and GI.

Clinical Job Description

  • The fellow will work a minimum of 64 hours per month at CRMC. These shifts will be a mix of clinical and academic experiences depending on the fellow’s career goals.
  • The fellow’s salary is covered by working their assigned shifts in the emergency department  (for those from an EM residency) or urgent care (for those from a FCM residency).
  • The fellow will be a Central California Faculty Medical Group (CCFMG) employee with benefits commensurate with clinical position.
  • The fellow will hold a UCSF title of Clinical Instructor.
  • If desired, a one-month field work experience can be arranged, depending on the fellow’s goals.
  • Salary of approximately $100,000.
  • Spending account of $2,500 for academic endeavors
  • Financial support to attend at least one national Wilderness Medicine or EMS conference.
  • Office, computer, administrative, and research support.

  • Graduate of a United States or Canadian Emergency Medicine or Family and Community Medicine Residency who is board eligible or board certified.
  • A letter of intent, CV, and at least two letters of recommendation.
  • Emergency Medicine Application must be submitted by October 1 annually.  Decisions regarding the fellowship will be made by November 1.
  • Family and Community Medicine applications are open year-round.  We will begin offering positions by December 15 for the following academic year.

The UCSF Fresno Wilderness Medicine Fellowship Program does not have a formal application.  Please e-mail the Program Director for application materials.

Interim Program Director- Susanne Spano, MD, Wilderness Medicine Fellowship

For information about our application requirements please see below.  For answers to specific questions, please contact:
Susanne Spano, MD
UCSF Fresno Emergency Medicine Residency Program
155 North Fresno Street
Fresno, CA 9370
Telephone:  559-499-6440
E-mail: sspano@fresno.ucsf.edu

Application Requirements:  ( Program Specific Information)
Submit CV,  letter of intent, and 2-3 letters of recommendation including one from current program director.

Greg Richardson, MD
Clinical Instructor of Emergency Medicine
Undergraduate:  Marquette University
Medical School:  Chicago Medical School
EM Residency Training:  Presence Resurrection Medical Center

Brian Horan, DO
Current position – P.T. Faculty with UCSF Fresno
2009-2010, Susanne Spano, MD
Current position – UCSF Fresno Faculty
2011-2012, Ross Hooker, MD
Current Position, clinical instructor at the University of British Columbia
2011-2012, Megann Young, MD
Current Position – UCSF Fresno Faculty
2012-2013, Conal Roche, MD
Current Position, University of Cincinnati Faculty
2013-2014, Desiree Crane, DO
Current Position: Undecided
2014-2015, Ben Luck
Current Position: Undecided

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; 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
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, Program Director, WM/EMS Fellowship, Medical Advisor, Parkmedic Program