UCSF Fresno is Training Medical Students and Residents to Address Increasing Need for Child Mental Health Services
L to R: Jasmine Singh, DO and Karen Kraus, MD
By Barbara Anderson
UCSF Fresno child and adolescent psychiatrists Karen Kraus, MD, and Patrick Shea, MD, are training medical school students and residents to address mental health needs of children and teenagers as increasingly youths are being hospitalized for self-harm injuries and suicide rates have reached their highest in nearly six decades.
Suicide now is the second leading cause of death for young people ages 10 to 24 in the United States; and in California, about 7.5 of every 100,000 youths ages 13 to 21 died by suicide in 2017, up from a rate of 4.9 per 100,000 in 2008.
Incidents of self-harm by youths also have sharply increased with more than 85,000 youths ages 13 to 21 being seen for mental health diagnoses at California hospital emergency departments in 2018, according to Kaiser Health News.
The trends in youth suicide and self-harm behavior are disturbing, Dr. Kraus said. “Over the span of five years, there has been an enormous increase in the number and severity of psychiatric problems that we are seeing at Community Regional Medical Center (CRMC),” she said. “In 2014, there was only one or two kids a month on the general pediatric service who were being referred for a psychiatric consultation, and now it’s seven a month.”
UCSF Fresno’s psychiatry residency program places an importance on child/adolescent psychiatry to address the mental health needs of young people in the San Joaquin Valley, where there is a dearth of child psychiatrists. “Our mission has to do with training physicians uniquely committed and qualified to work in challenging practice environments – and any psychiatrist who remains in the San Joaquin Valley has to be able to help adolescents,” Dr. Kraus said.
California and the San Joaquin Valley are identified as being severe shortage areas for child and adolescent psychiatry. California has 13 psychiatrists per 100,000 children and in the San Joaquin Valley there are only 5 psychiatrists per 100,000, according to the American Academy of Child and Adolescent Psychiatry. A ratio of 47 psychiatrists to 100,000 children is considered sufficient.
The severe shortage of child/adolescent psychiatrists makes it necessary for general psychiatrists to have an understanding of child/adolescent psychiatry, Dr. Kraus said. “As a general psychiatrist you are not a sub-specialist and you don’t need to know everything, but you need to know what the child/adolescent guidelines are and you need to follow them,” she said. “You need to be able to assess what a child’s needs are and to be able to orchestrate the treatment.”
All UCSF Fresno psychiatry residents, regardless of their interest in child/adolescent psychiatry, do at least a minimum of a year (equivalent to a day a week) working with children and adolescents as part of their core rotation that runs from the middle of the third year to the middle of the fourth year of residency, Dr. Kraus said. And residents who express an interest in child/adolescent psychiatry have opportunities for a two-year longitudinal experience with child/adolescent psychiatry, she said.
Psychiatry residents provide consultation to pediatric patients admitted to CRMC and can attend hospital psychosocial rounds with Dr. Kraus who provides psychiatric consults for children and adolescents who have mental health diagnoses and have been admitted to the hospital.
Psychiatric consults also are made for pediatric patients who are admitted for traumatic injuries, including once-a-week rounds at the burn unit. Children with burns often have protracted stays in the hospital and long courses of medical treatment, Dr. Kraus said. The focus is on trauma-informed developmentally responsive care with a secondary goal of prevention of post-traumatic stress disorder (PTSD), she said.
Psychiatry residents also work with Dr. Kraus at University Psychiatry Associates (UPA), an outpatient clinic. At any one time, the residents’ caseloads of pediatric patients at UPA averages around 10 and over the course of a year, they will have evaluated approximately 20 children and adolescents total. “They’re collaborating with other therapists, other kinds of providers so this is an opportunity for them to really cultivate not only diagnostic skills but management skills,” Dr. Kraus said.
Working with Dr. Kraus has been fascinating and eye opening, said UCSF Fresno psychiatry resident Jasmine Singh, DO. Many children come from very difficult situations and difficult conditions, and I have learned that medication with therapy can make a significant difference, she said.
Drs. Kraus and Shea also participate in Collaborative Office Rounds with the UCSF Fresno Department of Pediatrics. For two hours a month, they address the kinds of psychiatric, developmental and social issues common in pediatric primary care. “This is an important part of our educational outreach as these issues affect roughly 25% of children seen in primary care settings,” Dr. Kraus said. “Pediatricians and family practitioners truly constitute the front line in our mental health system, and from a prescribing standpoint, they provide far more care than either general or child psychiatrists,” she said.
UCSF Fresno provides an introduction to child/adolescent mental health to UCSF medical students and students in the San Joaquin Valley Program in Medical Education (SJV PRIME). The students spend rotations at UCSF Fresno.
“Even though a lot of the medical students are not going to go into psychiatry or pediatrics, if they are going to be primary care providers, they are going to see folks of all ages for care,” said Dr. Shea, clerkship director for UCSF medical students and SJV PRIME students.
“Given the spike of suicides in adolescence, it’s very important that primary care providers know what to look for and how to react,” he said. “I put a premium on suicide prevention, talking about risk factors in adolescents and what to look for and what to do if you are worried about someone.”
SJV PRIME students are with Dr. Shea at the Fresno County Department of Behavioral Health, where he sees children and adolescent patients. “The SJV PRIME students definitely are seeing depressed adolescents who they have to assess for suicidal thoughts,” he said.
Liliana Samano, an SJV PRIME student who grew up in Fresno and went to Edison High School, began working with Dr. Shea in September. “I’ve been able to see patients on multiple times and be able to see how they’re progressing,” she said. “This is a very unique experience. It’s not very common for students to be able to interview and directly talk to children who are being seen by a psychiatrist.”
UCSF medical students also have opportunities to be present at psychiatry consults at CRMC. Most students will see at least one adolescent who has attempted suicide, Dr. Shea said. Providing medical students and residents hands-on experiences with young patients and lectures on child and adolescent mental health are essential to building a physician workforce for the Valley that is prepared to address the rise in suicides and self-harm behavior among young people, Drs. Kraus and Shea said. UCSF Fresno is committed to providing that vital education and training in child/adolescent psychiatry.
Faculty Play Vital Role in Helping to Reduce Preterm Births in Fresno County
Subhashini Ladella, MD, FACOG
By Barbara Anderson
Faculty physicians in the UCSF Fresno Department of Obstetrics and Gynecology have led local work groups, provided services and led research projects for the Fresno County Preterm Birth Initiative (PBTi-Fresno), which works in partnership with the UCSF Preterm Birth Initiative California (PBTi-CA).
PTBi-CA is working to reduce preterm birth and improve outcomes in San Francisco, Oakland and Fresno. PBTi-Fresno and PBTI-CA are part of a 10-year Preterm Birth Initiative funded by philanthropists Lynne and Marc Benioff.
Five years ago, when PBTi-Fresno launched, Fresno County had among the highest preterm birth rates in the nation at 11.1%. Since then, UCSF Fresno has worked with Fresno State, community organizations and moms with lived experience to reduce that rate toward achieving the initiative’s goal of 7% by 2025. Most recent Fresno County data show the overall preterm birth rate in 2018 was 9.4%, but disparities continue to exist. The rate for African American women was 13.2%; the rate for Hispanic women was 9.4% and for Asian women it was 9.3%. In comparison, the rate for white women was 8.5%.
PTBi-CA and PTBi-Fresno have focused on developing strategies in three areas to reduce preterm birth in high-risk populations: 1) health and education before pregnancy, 2) care and support during pregnancy and 3) coordination of care after pregnancy.
Subhashini Ladella, MD, FACOG, director of Maternal-Fetal Medicine at UCSF Fresno, co-chaired the Fresno County work group for care and support during pregnancy. Dr. Ladella has led many research projects on preterm birth, and in September 2019 was invited to speak at the World Congress of Perinatal Medicine in Istanbul, Turkey. Dr. Ladella presented her research on “Maternal Anemia a Risk Factor for Adverse Pregnancy Outcomes is Associated with Greater Health Disparities in African American Women.”
With help and support from the March of Dimes organization, Dr. Ladella developed a “Preterm Birth Prevention Toolkit” for the state of California. And in November 2019, she was invited to speak and present the Preterm Birth Prevention Toolkit at the March of Dimes California Birth Equity Summit held in Los Angeles.
“I think UCSF Fresno has played a vital role in PTBi-Fresno and PTBI-California,” Dr. Ladella said.
Glow!, a prenatal care program with wraparound services for low-income women that takes place in a group setting, was launched as a result of the care and support group that Dr. Ladella co-chaired, for example.
Prenatal care groups have been shown to be effective in delivering prenatal care nationwide, there is high patient satisfaction, an increase in patient compliance and an improvement in patient outcomes. The Glow! group in Fresno is unique, however, because it includes high-risk pregnant patients, where programs elsewhere are limited to low-risk patients, said Christopher Downer, MD, assistant clinical professor, Department of Obstetrics and Gynecology director of obstetrics and director of the residency program at UCSF Fresno. UCSF Fresno provides the medical providers for Glow! patients.
This year, UCSF main campus was awarded a $5.6 million research grant by the Patient-Centered Outcomes Research Institute (PCORI) for Glow! Dr. Downer is the principal investigator of a feasibility study to see if high-risk patients who develop complications can remain in the prenatal group program. “We want to see if it is feasible to provide adequate care to be able to continue the group prenatal care model and not have to exclude patients who develop complications, such as gestational diabetes,” Dr. Downer said.
He also hopes to study, in conjunction with UCSF, the outcomes of patients in group prenatal care compared to those who receive traditional prenatal care.
UCSF Fresno has been active in so many different ways with PBTi-Fresno, Dr. Ladella said. With a PBTi grant, she researched the suspected under-utilization of various available evidence-based interventions to preterm birth. The barriers have been identified at provider, patient and system levels. The abstract of this research study was submitted and accepted to the annual Society of Reproductive Investigation meeting and will be presented at the March 2020 annual Society for Reproductive Investigation meeting in Vancouver, BC.
Palliative Medicine Reduces Hospital Charges and Stays
Patrick J. Macmillan, MD
By Barbara Anderson
A UCSF Fresno retrospective-case control study at Community Regional Medical Center (CRMC) found palliative care consults initiated within 24 hours of hospital admission significantly reduced the length of stay and reduced total hospital charges in patients with a variety of life-limiting illnesses.
The retrospective case-control study, conducted between April 2014 and June 2016, looked at 295 patients and compared those who received early palliative care consults with a matched control group who had been referred for consults at 24 hours or longer. The researchers found the median length of hospital stay of the patients who had early consults was 4.2 days as compared to 9.7 for the control group.
The study also found cost savings for hospitals associated with early palliative care consults. Total hospital charges in patients with early consults was $38,600 ($22,700-$66,900) compared to $95,300 ($55,200-$192,700) in the control patients.
The study, previously presented at the 2017 Center to Advance Palliative Care National Seminar Poster Session, was published in 2019 in the online “Journal of Palliative Medicine.”
Lead researcher Patrick J. Macmillan, MD, chief of Hospice and Palliative Care at UCSF Fresno and UCSF associate clinical professor of medicine, said the study captured length of stay and total hospital charges, but actual savings could be more. “Some of the costs are hard to quantify,” he said. “Possibly we saved a bunch of unnecessary tests, unnecessary consultations, a trip to the Intensive Care Unit, a lengthy stay in the ICU?”
The UCSF Fresno study adds to research about the benefits of palliative medicine in hospital patients, Dr. Macmillan said. Past studies have looked at palliative care for patients with advanced cancer. “In our study these were hospitalized patients with a variety of illnesses, anywhere from dementia to heart failure and organ diseases,” he said.
Palliative care consults can be from 30 minutes to two hours, involving discussions of pain management, care goals, patient end-of-life wishes and hospice, Dr. Macmillan said. “That’s the value in what we do. We understand that what we do takes time. And these type of difficult discussions often take time for patients and families to process – sometimes to grieve and sometimes to sort out family dynamics.”
CRMC and UCSF Fresno have been supportive of palliative care, Dr. Macmillan said. UCSF has three faculty physicians and one part-time faculty at the hospital. “And we have five teams that have a social worker, a nurse and a chaplain,” he said.
The UCSF Fresno study showed early palliative consult is high-value and cost effective, but Dr. Macmillan said CRMC and UCSF Fresno, working together, recognize that more is at stake. “Our motivation, what we really care about, is the patient satisfaction and the family satisfaction,” he said. “Hopefully we’re saving trauma to the families and we’re saving agony and suffering to the patient.”
UCSF Fresno Global Health is Growing: Partnerships Improve Diabetes Care in Afghanistan, Myanmar
L to R: Alya Ahmad, MD, and Tim Brox, MD, at a recent global health social
By Brandy Ramos Nikaido
Advancing health worldwide is an overarching mission at UC San Francisco. As a branch campus of the UCSF School of Medicine, UCSF Fresno extends that mission to Fresno, the San Joaquin Valley and most recently, to places as far as Afghanistan, Myanmar and elsewhere.
About 422 million people worldwide have diabetes and that number is on the rise, according to the World Health Organization. Earlier this year, UCSF Fresno partnered with the Alliance for Medical Outreach & Relief (AMOR) to deliver diabetes education to clinicians at the Afshar Hospital in Kabul, Afghanistan.
Mark Scoffield, DPM, director of hospital operations for AMOR, approached UCSF Fresno’s Rais Vohra, MD, and Steve Stoltz, MD, for help. Dr. Scoffield had initiated a program between AMOR and the World Diabetes Foundation to improve diabetes care in Afghanistan through a public awareness campaign. He soon discovered a need among physicians, nurses, midwives and other health care providers for the latest information on how to prevent diabetes and how to best care for people living with the disease.
“We always wanted to do telemedicine to somehow connect Afghans with our world,” said Dr. Scoffield. “That’s when UCSF (Fresno) just became a natural fit.”
Dr. Vohra, a toxicologist and emergency medicine faculty member at UCSF Fresno, wears many hats. One of them is director of UCSF Fresno Global Health education. Dr. Vohra recently was appointed Interim Health Officer for the Fresno County Department of Public Health. His interest is toxicology in Asian countries. Dr. Stoltz, faculty in the UCSF Fresno Department of Internal Medicine and chief of the Division of Hospital Medicine, also has an interest in global medicine with an emphasis on Latin American countries.
Drs. Vohra and Stoltz turned to Soe Naing, MD, director of the UCSF Fresno Endocrinology Division, to lead the Afghanistan diabetes education project. UCSF Fresno and AMOR considered how to make diabetes education in Afghanistan a reality. There are 7,472-miles between Fresno and Kabul and a 12-hour and 30-minutes time difference. In-person lectures weren’t possible. But, technology presented a solution when quality internet became available in the Afshar Hospital in 2017.
To bring the project to fruition Dr. Naing enlisted a group of faculty and IT staff at UCSF Fresno, including Director of Information Technology, Jennifer Dodd Camacho. A test Zoom videoconference was held in March of this year. Dr. Scoffield traveled to Afghanistan to participate alongside the Aghani clinicians. The response was very positive, he said.
In August, Dr. Naing presented step-by-step guidelines for diabetes management via Zoom. Faculty at UCSF Fresno gathered online in the evening while the Afghani clinicians assembled at their hospital in the morning.
“Most of the medicines available here aren’t available there,” said Dr. Naing. “So I tailor-made protocols for testing and medication based on what’s available there.”
Originally from Myanmar, Dr. Naing understands what it’s like to work in an environment with limited resources. Myanmar, also known as Burma, is a country bordered by Bangladesh, China, Laos and Thailand.
In November, endocrinologist and faculty member in internal medicine at UCSF Fresno, Shreela Mishra, MD, presented on diagnosis and management of diabetes during pregnancy in a videoconference lecture to Afghanistan. Drs. Naing and Scoffield, along with two observers from Myanmar, joined Dr. Mishra for the UCSF Fresno videoconference lecture.
Dr. Naing and Dr. Mishra’s lectures were well received and two additional lectures are being planned; one on Type 1 diabetes and another on inpatient diabetes care.
“Even when you can’t physically travel somewhere you can still trade a lot of lessons and a lot of learning online,” said Dr. Vohra. “They have such a need for diabetes education in Afghanistan and Dr. Naing, to his credit, is really going to help improve and save a lot of lives by spearheading this really important project.”
In addition to the Afghanistan project, Dr. Naing recently mentored two observers, endocrinologists from Myanmar, whose goal it was to learn from him and share and implement what they learned back home. A college classmate had reached out to Dr. Naing to ask if endocrinologists could spend time at UCSF Fresno learning advanced endocrinology, ultrasound and thyroid and diabetes management.
“Our country has a big problem with diabetes,” said Kyar Nyo Soe Myint. “According to the National Survey in 2014, it is around 10.5% of the population has diabetes.”
Myint said she especially enjoyed observing advanced endocrinology care such as insulin pumps and thyroid ultrasound.
Thet Mon Zaw said she was excited to be at UCSF Fresno. “I want to learn from the clinic experience and how Dr. Naing is practicing and the advanced practices that are provided here.”
The pair spent six weeks shadowing Dr. Naing and other faculty at UCSF Fresno, including faculty in the Department of Surgery Kelvin Higa, MD, bariatric surgeon, and endocrine surgeons Christina Maser, MD, and Farah Karipenini, MD. Myint and Saw also spent time with UCSF Fresno’s librarians Sharon McClain and Robin Aguiar learning how to use library resources for evidence-based medicine and research.
Up until recently, there was no process for international medical observers to come to UCSF Fresno to learn. Michael W. Peterson, MD, associate dean at UCSF Fresno, opened the doors to them earlier this year and Paula DerMatoian, UCSF Fresno’s volunteer coordinator, processed the necessary agreements and paperwork in a short period of time to allow Myint and Zaw to observe at UCSF Fresno. They are the first of many observers Dr. Naing hopes can come to UCSF Fresno to learn.
International medical observerships enhance the reputation of UCSF Fresno, said Dr. Naing, “We’re not just local, we are global and we have the opportunity to help improve health in other countries.”
While global health education has been available at UCSF Fresno for the past 10 years or so, opportunities for involvement in international medicine are ramping up. Faculty and residents may apply for global health travel grants. During the 2018-2019 academic year, UCSF Fresno supported six travel grants for resident and fellows. This coming academic year, three learners have applied to travel to Australia, Japan and Latin America. In addition, a UCSF Fresno medical delegation to Cuba is being planned for next fall.
Meanwhile, a standing global health sub-committee comprised of faculty members from virtually all UCSF Fresno departments meets regularly. Partnerships with groups such as the Fresno Interdenominational Refugee Ministries and the Armenian community seek to improve health among local communities. Local gatherings also are held to discuss global health trips and share experiences and lessons learned. Tim Brox, MD, volunteer associate clinical professor in the UCSF Fresno Department of Orthopaedic Surgery, recently opened his home to faculty and learners to discuss his visit to Zomba, Mawali, and his observations of health care challenges and delivery there.
Global health is a bunch of interconnected puzzle pieces and they all work together, said Dr. Vohra. “You have to look at the social determinants of health in whatever health system you are in. You have to look at why people are getting sick. There’s the organism, the bacteria, the virus, but there’s also all of the other things that people have in their environment that predispose them to illness, whether its nutrition or air pollution or sanitation or general poverty. These are things that have to be taken into account if you’re going to have any impact.”
Dr. Vohra’s hope is for UCSF Fresno to offer even broader areas of global health education to countries that need it through additional partnerships and with adequate financial support.
Dr. Scoffield echoes that desire. His hope is to complete the Afghanistan diabetes education project and then have UCSF Fresno provide education and expertise on cardiovascular disease, respiratory illnesses and cancers.
Jasmine Singh, DO
UCSF Fresno’s success and growth are a direct result of the dedication and inspiration of our faculty, staff, residents, fellows, students, alumni, partners, donors and friends. In each issue of Focus, we introduce you to the people who contribute to the greatness of UCSF Fresno through informal interviews.
This month, please meet: Jasmine Singh, DO
What is your name? Nickname?
My name is Dr. Jasmine Malika Singh. My nickname is Jazzy, Jaz, The Jazzy Doc, Chicka, Jasu, and Panda (courtesy of my sister!)
Where did you grow up and where did you go to school (high school, undergraduate, medical school)?
I grew up in Lodi/ Stockton, California. I went to Saint Mary’s High School in Stockton, UC San Diego for my undergraduate degree in Economics (major) and Acting (minor). For medical school, I went to Touro University – California in Vallejo, CA. I have been educated entirely in California.
Who or what inspired you to become a doctor and why did you pick your specialty?
Seeing how tirelessly my father worked as a doctor to help other people inspired me to become a doctor so I could have the same positive impact on others as he did. I picked Psychiatry because when I would see those patients it moved me and awoke a desire to help that specific population.
Where are you in your training now and why did you pick UCSF Fresno for residency?
I am a fourth-year resident in Psychiatry, which is my last year of training. I picked UCSF Fresno because everyone I met was kind, genuine, smart, had a progressive outlook and was very welcoming. UCSF Fresno felt like home.
What would you like to do after completing residency training at UCSF Fresno? What are your plans post-residency?
I would like to have my own private practice one day, and I am still figuring out my exact plans after residency.
If you didn’t take the career path you’re on now, what career would you have pursued and why?
My dream was (is) to become a Bollywood actress! I love the stories, the ornate sets, the music, the dancing – I would love to be the female lead in a Bollywood movie and create amazing art with my favorite actors, filmmakers, and musicians.
What do you do for fun? How do you find balance personally and professionally?
I love to spend time with friends and family, go to the movies, paint, read fashion blogs, yoga, and Pilates. Finding balance is an ongoing process, which I am still learning and perfecting, but I try to check in with myself every so often and plan my schedule ahead to make sure that I am making time for myself and my interests.
If you could have dinner with a famous person (alive or deceased) who would it be and why?
I would love to have dinner with Oprah because I love that she promotes personal growth, learning and fulfillment. I find her and her story inspiring.
The zombie apocalypse is coming, which three people at UCSF Fresno would you want on your team and why?
I would want Kathy Perkins, Craig Campbell, MD, and Avak Howsepian, MD, PhD, on my team to survive the zombie apocalypse.
I want Kathy Perkins on my team because she always remembers everything for all of the residents and seems to know how to do everything so she would be an amazing asset to the team.
Dr. Campbell because he is smart, calm and collected and probably would know exactly what to say to the zombie to calm it down.
Dr. Howsepian because he has all kinds of unique knowledge. He likely already knows how to save the world from a zombie apocalypse.
What’s something people don’t know about you but you’d like them to know?
I love to organize and get rid of things, especially in my closet, and I am a huge fan of Marie Kondo’s philosophy on organization. I have read her books and I think she has great insights into how we ought to be living.
Supporting UCSF Fresno
UCSF Fresno Receives Gift to Enhance Clinical Skills and Simulation Training
L to R: Stacy Sawtelle Vohra, MD, and Jessica Mason, MD
By Barbara Anderson
The UCSF Fresno Clinical Skills and Simulation Lab has received a $50,000 gift from the Isnardi Foundation of Fresno.
The gift will allow UCSF Fresno to upgrade patient manikins with advanced technology, buy and make additional simulation body parts for use by learners in hands-on training exercises and to support team training and health drill situations.
Medical simulation training is an integral component of training at UCSF Fresno. It provides a safe environment for learners to acquire the knowledge, skills and attitudes needed for caring for patients in real-world settings. The UCSF Fresno Clinical Skills and Simulation Lab (Clinical Skills Lab) is used to teach and train more than 300 residents, more than 300 rotating medical students, faculty physicians and affiliated advanced health care practitioners.
“We are extremely grateful for the Isnardi Foundation gift,” said Stacy Sawtelle Vohra, MD, education director for the Clinical Skills Lab. “This gift helps to ensure that UCSF Fresno has the most up-to-date simulation equipment to train new medical professionals to achieve the highest technical and clinical proficiencies needed to care for patients in the Central Valley.”
During simulations, teams practice responding to common medical procedures, complex medical conditions and life-threatening emergencies. Using high-fidelity, interactive patient manikins and task trainers, learners practice specific skills such as lumbar punctures, intubation and suturing. Simulations are followed by debriefings to facilitate learning, and each simulation is evaluated with faculty oversight to ensure best practices are used.
“We were very pleased to receive the grant request for the Clinical Skills Lab at UCSF Fresno, said Peter Tocchini, one of the directors of the Isnardi Foundation and first cousin of Vincent Isnardi, for whom the foundation is named. “It appears that an amazing lab exists there, and our hope, too, is for some of the people who do their training in the lab to eventually remain in the Valley area for their practice,” he said.
The Isnardi Foundation serves as a legacy to Vincent Isnardi, who was born in 1918 and was raised in Fresno by his Italian immigrant father, Joseph Isnardi and mother Jennie (Genevive Tocchini). Mr. Isnardi graduated from Fresno High School, the University of California, Berkeley and the UCSF School of Pharmacy. After graduation from pharmacy school, he returned to Fresno to practice at his family’s pharmacy business, the International Drug Company.
Vincent Isnardi was well respected for his vast knowledge, professionalism and work ethic. His philosophy was “Treat everyone with dignity and respect, care for your patients as if they were your own parents, be a good listener, work hard, save for the rainy day, live modestly and be humble.”
In 2006, Vincent Isnardi created the Isnardi Foundation, which was his way of continuing to support those in need in Fresno and surrounding communities. Since the inception of the Foundation, more than 20 organizations have benefited from Vincent Isnardi’s generosity. Many of the gifts from the Foundation over the years have been to help improve the health and wellbeing of people in Fresno and surrounding areas.
Mr. Isnardi died in 2011.
Clinical skills learning opportunities are essential to educating current and future physicians and other health care providers to address the health care needs of local patients. “Expanding clinical skills learning experiences to keep pace with updated simulation is a priority, which requires support and investment to stay abreast of advances in technology,” said Jennifer Camacho, director of information technology at UCSF Fresno.