Focus on UCSF Fresno Newsletter, December 2018

Top L to R: Loren Alving, MD; Mohammed Elhassan, MD; Brian Morgan, MD, Bottom L to R: Ivance Pugoy, MD, Sarah Stender, MD, Juan Carlos Ruvalcaba, MD

As a branch campus of the consistently top-ranked UCSF School of Medicine, UCSF Fresno is focused on improving health in California’s San Joaquin Valley through excellence in teaching and patient care, innovative clinical research and community partnerships. UCSF faculty contribute greatly to the institution’s distinction. Several UCSF faculty physicians at Fresno were honored recently for their dedication to innovation and excellence in medical education.

UCSF Fresno’s Loren Alving, MD, director of the UCSF Fresno Alzheimer and Memory Center and director of the UCSF San Joaquin Valley Program in Medical Education, was recently elected to the Academy of Medical Educators. In 2000, UCSF established one of the first two Academies of Medical Educators in the U.S., alongside Harvard University.  This honorary society recognizes the most outstanding medical educators and brings them together to provide a resource for all teaching faculty and faculty development. Dr. Alving joins 10 other members of the Academy at UCSF Fresno. 

In addition, four faculty members in Fresno were selected for and recently graduated from the UCSF School of Medicine Teaching Scholars Program (TSP). The Class of 2018 includes Loren Alving, MD, UCSF Department of Neurology; Mohammed Elhassan, MD; Ivance Pugoy, MD, both in the UCSF Fresno Department of Internal Medicine, and Sarah Stender, MD, with the UCSF Fresno Department of Pediatrics. The TSP develops educational leaders and scholars through an intensive seminar series, mentored projects, a network of educational colleagues and collaborative learning. Participation is by competitive application.

UCSF Fresno’s Brian Morgan, MD, with the UCSF Fresno Department of Obstetrics and Gynecology, and Juan Ruvalcaba, MD, with the UCSF Fresno Department of Family and Community Medicine, were recognized with the UCSF 2018 Excellence in Teaching Award by the Haile T. Debas Academy of Medical Educators. This award highlights a group of outstanding teachers of students and residents across all specialties who stand out across all UCSF training sites. The award requires a peer-nominated submission as well as a review process by the Academy to determine recipients.

“We applaud and congratulate these faculty physicians for their commitment and dedication to medical education excellence,” said Michael W. Peterson, MD, MACP, associate dean and chief of medicine at UCSF Fresno. “Thank you for your outstanding representation of UCSF Fresno.” 

One in 2,500 babies is born with craniosynostosis, a birth defect where one or more of the bones in the skull fuse prematurely, preventing the skull from growing and developing properly. For Greg and Melody Swarthout of Tulare, their baby, Troy, was that one.  

Melody noticed something was different early on.

“At birth, he had a ridge down the center of his head that our other boys didn’t have,” she said.

Initially, they took a watch and wait approach, but the mother of three observed Troy’s head was growing in an oval shape at almost seven months.

Worried and scared, Greg and Melody looked online for other parents dealing with the same issue. That’s when they learned about craniosynostosis. While the exact cause is unknown, there may be a genetic link.

“A lot of families went to the Bay Area for care,” said Greg.

The Swarthouts followed up with their pediatrician, who referred them to the UCSF Fresno/Community Medical Center Cleft and Craniofacial Center after hearing a presentation by George Zakhary, DDS, MD, FACS.

A CT scan confirmed what they had suspected. Troy’s skull was developing in an oblong shape. If not fixed, the head shape deformity would persist, causing complications ranging from permanent head and facial deformity to developmental delays, cognitive complications, blindness or other eye problems, seizures, and in rare cases, death. 

Dr. Zakhary, a faculty member with the UCSF Fresno Oral and Maxillofacial Surgery (OMFS) Residency Program, reassured the Swarthouts that Troy’s condition could be fixed.  The surgical scope of the OMFS program at UCSF Fresno includes trauma, head and neck cancer/malignancies, benign head and neck pathology, microvascular/head and neck reconstruction, dentoalveolar surgery, dental implants, outpatient anesthesia, facial cosmetic surgery, TMJ surgery, orthognathic surgery, cleft lip and palate, and reconstructive craniomaxillofacial surgery.

Within weeks, Troy was scheduled for surgery. Zakhary along with Yu-Hung Kuo, MD, interim chief of neurosurgery at UCSF Fresno, performed the operation mid-week and by Saturday, Troy was home.

Troy’s condition required a cranial vault reshaping surgery, performed by Dr. Kuo, and involved removing the affected parts of Troy’s skull. Dr. Zakhary then reconstructed the pieces into the correct shape and positioned them with resorbable plates and screws. Resorbable plates and screws hold the pieces of skull together and completely dissolve after the bones have healed. Once the bones healed, three to six months after surgery, his skull is as strong and typical as any other child.

The surgery lasted four hours and required a pediatric anesthesiologist and nursing team.

Recovery was fast. Not long after the surgery, Troy started walking at nine months.

“Troy’s outlook is great,” said Zakhary. “He is developing like any other child without craniosynostosis.”

“It’s amazing looking at the before and after CT scans,” said Melody. “It’s also amazing how quick it was (the whole process). If he didn’t have a scar, I don’t think you’d be able to tell he had surgery.”

“We think he’s perfect,” she said.

Indeed, as he celebrated his first birthday this year, Troy’s cheerful personality, inquisitive nature and a dimple on his cheek when he smiles are his most noticeable features.


The Community Cancer Institute opened recently on the Clovis Community Medical Center campus. By partnering with UCSF Fresno, consolidating services into one facility and with cutting-edge technology, the Community Cancer Institute easily rivals centers in northern and southern California, offering cancer patients in Central California the very best care close to home.

Faculty physicians and fellows at UCSF Fresno provide comprehensive cancer care and conduct clinical trials and research in the Valley that significantly advance cancer treatment.

In an effort to provide the local community access to innovative clinical trials, UCSF Fresno and Community Medical Centers partnered to create a joint Clinical Trials Program at the new Community Cancer Institute. Nearing the conclusion of the first year, enrollment to clinical trials has tripled and recruitment is still going strong. Plans to continue growing and providing services to as many patients as possible are underway. Access is available to cooperative clinical trials (National Institutes of Health/National Cancer Institutes), industry or pharmaceutical clinical trials as well as investigator-initiated studies (research led by faculty physicians at UCSF Fresno) in various areas of solid tumor cancers as well as blood cancers.

As a fundamental partner in the new cancer institute, UCSF Fresno is pleased to provide patients with access and opportunity to participate in studies and proud to contribute to the body of knowledge to fight and beat cancer.


UCSF Fresno is taking health care and medical education on the road thanks to American Ambulance’s donation of an ambulance. With support from Anthem Blue Cross and the Central Valley Community Foundation, the ambulance was converted into a mobile health clinic and learning vehicle. UCSF Fresno Mobile Health and Learning or Mobile HeaL is now providing basic health screenings and vaccinations as part of initial outreach in Fresno and surrounding rural communities. Equally important, UCSF Fresno will link patients with follow-up care when full-service mobile clinics begin.

The effort involves faculty physicians at UCSF Fresno, residents, medical students and regional college and university pre-health students. Participating pre-health students gain valuable clinical skills – experiences that are needed to be successful applicants to health professional schools and essential to developing the skills needed as practicing physicians. To build and enhance their skills, pre-health and medical students work alongside experienced medical residents and faculty physicians.

UCSF Fresno Mobile HeaL is the brainchild of emergency medicine physician and UCSF Fresno Assistant Dean for Undergraduate Medical Education Kenny Banh, MD. Dr. Banh was honored recently by the California Medical Association (CMA) for creating UCSF Fresno’s first mobile clinic. Banh was nominated by Nicole Butler, executive director of the Fresno Madera Medical Society, for his unique efforts to train and retain the next generation of San Joaquin Valley physicians and provide care where it is needed most.

“There are so many physicians working to improve their communities and California,” said Banh.  “I am humbled and honored to receive the CMA’s Compassionate Physician Award for doing what I truly enjoy – taking care of patients and paying back the encouragement and opportunities that I was afforded as an aspiring physician.” 

UCSF Fresno Mobile HeaL recently participated in outreach such as the Know Your Numbers health fair sponsored by CalViva Health at Washington Elementary in Madera. In addition, Legacy Health Endowment is funding clinics that will serve 19 ZIP codes in Merced and Stanislaus counties.

Mobile HeaL is a win-win. The program takes health care to communities where residents may not have easy access to care and provides learning opportunities for future physicians.

UCSF Fresno’s success and growth over the past 43 years are a direct result of the dedication and inspiration of our faculty, staff, residents, fellows, students, partners, donors and friends. Starting with this issue of Focus on UCSF Fresno, we will introduce you through fun, informal interviews to the people who contribute to the greatness of UCSF Fresno.

Please meet:

Virginia Contreras Coningsby, who growing up didn’t have a middle name, so she added her maiden name as a middle name when she got married. Virginia is Graduate Medical Education (GME) Analyst. 

How long have you worked for UCSF Fresno?

Since February 2012 when I started as an administrative assistant in Neurology in the Department of Internal Medicine.

What is your current title and role at UCSF Fresno?

I serve as the institutional coordinator, which is like a program coordinator, but for all of UCSF Fresno. The GME office supports program staff, residents, and faculty with their educational program needs – accreditation, credentialing, policies, human resources, and more.     

What was your very first job?

I worked in the china and bridal registry department at Gottschalks Department Store.  It’s fun to hear how many people worked at a Gottschalks store or the corporate office at some point in their careers. Gottschalks was so prominent in the community and I was sad to see them close.

Other than working for UCSF Fresno, what would your dream job be?

Travel photographer. Imagine getting paid to travel and take pictures of beautiful places.

Which famous person or celebrity was your childhood crush?  

Mario Lopez – it was the dimples!  If you grew up in the 80s and 90s, you might remember him from Kids Incorporated and Saved by the Bell. I’m giving away my age now.

List three to five things on your bucket list?

Backpack through Europe. I checked it off my list this past summer when my family and I hiked the Camino de Santiago (Way of St. James) in Spain. It was only 120 km, but I think it counts.  I had blisters to prove it.

Cross-country road trip. I think driving across the U.S. would give me a chance to see some rare, off-the-beaten-path sights while spending quality time with my family. We all enjoy traveling.

Hike Half Dome in Yosemite. A recent addition to my list after I heard about a colleague who hiked it.                           

The zombie apocalypse is coming, which three people at UCSF Fresno would you want on your team and why?

Juan (security). We’re going to need some protection, plus he’s a nice guy!

Dr. Lori Weichenthal (Emergency Medicine). In addition to being a physician, she teaches yoga and meditation, which would definitely come in handy during the madness.

Kristi Hoelzel (GME). She’s pretty handy and resourceful.  I bet she could find a way to build us a shelter without any tools.

What’s the most rewarding aspect of your job at UCSF Fresno?

I like that I don’t have to look far for inspiration. I’m inspired daily by the people I work with – to push myself to the next level, to challenge myself physically, and to be a better person. I decided to hike the Camino de Santiago after one of our faculty, Dr. H. Terry Hutchison, hiked it in his 70s. I added Half Dome to my bucket list after hearing about a colleague’s experience a few months ago (way to go Nick Dennie). I challenged myself professionally and completed a special certification for graduate medical education, TAGME, after seeing Valerie Pamatmat earn the certification. I get to witness and be on the recipient of random acts of kindness – like when the person ahead of you at Starbucks pays for your drink and you realize it’s a colleague (thanks, Heather Stokes). We’re surrounded by so many neat, kind, and caring people at UCSF Fresno.

What’s the most important thing you’d like people to know about you?

I love living in the Central Valley and taking an active role in the community. While a lot of people bash Fresno and can’t wait to leave, I’m here to stay! I enjoy all the local amenities and activities available to us – bands and concerts, theater, festivals, food trucks, farmers’ markets, etc. Volunteering with local non-profit organizations also helps me feel more connected to the community.  

Gifts of Good Health


With your support, we can make tremendous progress together in improving the health of Valley residents. Help is needed in four key areas: scholarships for medical students, support for our mobile clinic, support for pipeline programs that prepare students for careers in the health professions and endowments.  

Here’s how you can help:

Provide scholarships to attract and retain medical students at UCSF Fresno. Starting in 2019, students in the newly designed UCSF San Joaquin Valley Program in Medical Education (SJV PRIME) will spend 18 months at UCSF in San Francisco and then spend the remainder of their medical school training at UCSF Fresno. Medical training is demanding and expensive. In addition, the cost of medical school can be a barrier for Valley students who come from disadvantaged backgrounds. Medical students in the U.S. graduate with an average $200,000 in education-related debt, according to the American Association of Medical Colleges. Your gift will help defray the cost of tuition and living expenses while attending medical school.

Support UCSF Fresno’s Mobile HeaL clinic. The new mobile medical outreach clinic relies on private support to provide free health care services to those in need. Gifts of all amounts will help purchase necessary supplies, vaccinations and technology to treat patients with limited or no access to care in rural areas and provide an additional training ground for future physicians. In addition to supplies, donations will help offset the cost of vehicle maintenance and gasoline costs to ensure the clinic serves people in need in outlying areas of the Valley. 

Contribute to programs that academically prepare Valley students for careers in health and medicine and give them firsthand experiences. Statistics show that physicians tend to practice where they grew up or near where they complete residency training. The UCSF Fresno Latino Center for Medical Education and Research Doctors Academy is an academic enrichment program that aims to increase the academic preparedness and number of underrepresented students in health professions schools. The UCSF Summer Biomedical Research Internship Program matches high school students with faculty members at UCSF Fresno who are working on research projects to increase the students’ understanding and interest in the biomedical sciences. Gifts to these programs help ensure that students can continue benefiting from them.  

Make a major gift or a bequest in your estate plan and help build the UCSF Fresno endowment. Your gift will help recruit and retain distinguished faculty members by incentivizing them with a prestigious donor named, endowed professorship. Your gift also will help attract the best and brightest students, conduct groundbreaking research and enable us to continue providing the best clinical care. All prestigious institutions rely on endowments to provide a reliable source of funding for growth and sustainability of programs and talent. Gifts to a new or existing endowed fund have a lasting impact.

To make a gift, visit To learn more about giving to UCSF Fresno, please contact Kathleen Smith, Development, UCSF Fresno at (559) 499-6426 or