Program Director Message

Ivy Darden

Steven Tringali, DO

Program Director


Global Health Elective

Rural hospital


The experience of diversity and culture can be one of the most rewarding and enhancing opportunities for a physician-in-training. Stepping into another place and confronting unusual and new diseases can stimulate the learner and instill a lasting impression on their medical education training.

The focus of the elective is several-fold:

  • Offer exposure to disease pathology not always seen in the U.S
  • Provide an opportunity to gain more experience in tropical medicine.
  • Provide an opportunity to gain more experience in public health medicine.
  • Deliver a focused 2 to 4 week experience serving poor, disadvantaged, and underserved patient populations.
  • Provide an opportunity for the resident to develop clinical research ideas and projects based on his/her international experience.

This elective will only be offered to PGY2 or PGY3 internal medicine residents in excellent standing within the department who have shown outstanding abilities in medical knowledge, leadership, and independent clinical thinking. Resident(s) will be selected after submitting a formal proposal for this elective in the spring prior to the start of the academic year. The final decision on the selection of which resident(s) will participate will be up to the Program Director and the Responsible Faculty.

Dr. Stoltz with African physicians
UCSF resident with African nurses

Training Site:

The training site will vary from year to year at the discretion of the responsible UCSF Fresno faculty and based on availability of international sites that accept internal medicine residents. Previous training sites have included Honduras, Bolivia, India, Laos, Colombia, Uganda and Tanzania.

International hospital

Responsible Faculty:

Steven Stoltz, MD, FACP, Associate Clinical Professor of Medicine, UCSF Fresno


Since the training sites for the elective will vary from year to year, the goals of the elective might also change somewhat year to year. However, the following goals should be relatively standard for all experiences.

  1. To improve skills in the diagnosis and treatment of tropical diseases .
  2. To gain an understanding of health issues on an international scale.
  3. To gain more experience in interacting with patient populations with some or more of the following characteristics: poor, disadvantaged, underserved, non-English speakers, and/or rural.
  4. To better understand health care delivery systems outside the United States.
  5. To prepare residents for possible careers in public health and/or international health


Learning Objectives:

Since each elective will occur at different international sites, it will be difficult to determine a priority for the actual learning objectives. Site-specific learning objectives will be developed well ahead of the actual rotation and discussed individually with the resident.

Expectations and Responsibilities:

It is expected that the resident will independently help structure the rotation and the learning objectives based on their interests and goals. The resident will take an active day-to-day role, along with the supervising faculty member, in the treatment and diagnosis of patients. The resident will be expected to prepare for the elective by doing background reading about the site country and about diseases common to that region. In addition, the resident will be expected to give a 45 minute lecture to the Department of Medicine upon their return to Fresno, highlighting their experiences and accomplishments during the elective.

Reading List:

The resident on the elective will be given a focused reading list, background materials, journal articles, and any other relevant information in a binder prior to departure for the elective. The resident will be expected to review these materials prior to the elective, but the majority of the reading will occur during the elective.

Dr. Stoltz with Asian health care workers