Hospice and Palliative Medicine
Chief of Hospice and Palliative Care
Program Director’s Message
The faculty and staff at UCSF Fresno Medical Education Program would like to thank you for your interest in our hospice and palliative medicine fellowship. Our mission is to provide compassionate advocacy for patients and families in the hospital and outpatient setting while helping them navigate the complexities of modern medicine. Our fellows enjoy a comprehensive training experience, and are shaping the program for the future. It’s our sincere hope that our vision for the growth of palliative medicine fits your training needs and you consider joining our program as a fellow here at UCSF Fresno Medical Education Program.
Patrick MacMillan, MD
The one-year HPM Fellowship exists in conjunction with and is an integral part of the fully-accredited Family Medicine Residency Program. The HPM program director, Dr. Patrick Macmillan, and other palliative-care trained physicians work with a cadre of specialists to provide a comprehensive approach to training in hospice care.
Our principle training site is Community Regional Medical Center (CRMC), a 733 bed hospital offering a full range of inpatient services including 1800 ICU admissions annually. CRMC is part of Community Medical Centers (CMC), a nonprofit, locally owned health care system that operates four acute-care hospitals and a variety of other health care facilities. The Regional Medical Center provides inpatient and comprehensive outpatient services to patients of all ages. Special hospital services include a level 1 regional trauma center, a level 1 regional burn center, and the only birth center in the region designated to handle high-risk pregnancies. Fellows also train at the VA Central California Health Care System.
UCSF Fresno HPM fellow will start with an intensive month of didactics and care of hospice patients under supervision. There is a monthly academic half day comprised of case conferences, interactive lectures from multiple disciplines and journal club. A monthly board review is also a part of the academic half day. The following months include doing palliative care consultations at CRMC for part of the day with time set aside for interdisciplinary team meetings, visits to affiliated nursing homes, and home visits to see hospice patients. The fellow is an integral member of an interdisciplinary team (IDT) that includes nursing, chaplaincy, and social workers all dedicated to the field of palliative care. Comprehensive care is provided to 4-6 patients each day.
As part of our pediatric training, each fellow will spend two weeks in San Francisco at the UCSF Benioff Children’s Hospital. The Integrated Pain and Palliative Care Program (IP3) faculty provide a comprehensive and continuity based training experience.
Research is built into the curriculum as part of a longitudinal experience. Supervision and guidance are provided throughout the year. Each fellow will have dedicated time to complete their research projects.
Fellowship applicants should have completed a residency in a specialty approved by ACGME and be board-certified or board-eligible. Applicants should have a demonstrated interest in palliative care. Two highly qualified fellows will be selected each year through the NRMP match.
Fresno is a medium-sized city and a cultural and financial center of California’s Central Valley. Some of the cultural offerings include a symphony orchestra, repertory theatres, art museums, and diverse cuisine including Asian, European, Basque, and Mediterranean. San Francisco and Los Angeles are approximately three hours away by car and the Monterey Peninsula and Morro Bay is approximately two hours. Recreational opportunities in the area are rich and varied, and include three nearby national parks — Yosemite, Sequoia and Kings Canyon.