Program Director Message

Ivy Darden

Steven Tringali, DO

Program Director



All core rotations are completed at one of our 3 teaching sites: Community Regional Medical Center (CRMC), the Veteran’s Affairs Central California Health Care System (VA), and Family Healthcare Network (FHCN). The global health elective can be completed at an international site chosen by the resident and approved by the program director. Selected residents are also eligible for more electives offered at UCSF main campus. Housing and parking are provided for residents while in San Francisco. All blocks are 4 weeks in duration. Most rotations span 1 block, though some are 2 or 3 weeks in duration.

Primary Rotations

All residents rotate through the 78-bed intensive care unit at CRMC. These beds are shared between medicine, surgery, & trauma. Two medicine teams are supervised by a board-certified critical-care faculty. Teams consist of 1 pulmonary/critical care fellow, 1 senior resident, and 2 interns.

Over 3 years, categorical residents will have spent approximately 10 blocks on wards. 5 months will be at CRMC and 5 months at the VA. The VA wards include 4 ICU beds and 6 stepdown/telemetry beds which are cared for by the same resident team. The team takes new admissions every fourth day at CRMC and every third at VA.

Interns and PGY3s each spend 1 block on the CCU service at CRMC. As a leader of cardiovascular services in the central valley, residents will be exposed to a breath of cardiac cases. Teams typically consist of 1 cardiovascular fellow, 1 PGY3 resident, and 4 interns.

All categorical residents rotate through the VA for experience in emergency medicine. Preliminary interns are offered this as an elective, or they can rotate at the CRMC ED.

All residents complete an ambulatory block at Deran Koligian Ambulatory Care Center during internship. Constructed in early 2010, the state-of-the-art center features 104 exam rooms, an X-ray room, and three lab drawing stations. In the PGY2 year, categorical residents spend a month at the VA in the Department of Primary Care. They learn to work with the primary care faculty, nurses, pharmacists, social workers, and mental health professionals in a new model of primary care known as Patient Aligned Care Teams (PACT).

All residents will participate in night float. Interns will join a senior resident to cover the CRMC wards at night, including cross-coverage and new admissions. Senior residents will cover the VA wards at night as well as the MICU.

In the PGY3 year, residents rotate at the VA Community Living Center for 2 weeks of geriatrics.

Residents enjoy learning neurology in both the inpatient and outpatient settings at Kaiser Medical Center in Fresno.  They also have the opportunity to get additional training in lumbar punctures during their experience.

PGY2 residents are assigned 2 weeks of rheumatology clinic during one of their clinic blocks. They spend mornings in rheumatology and afternoons in their resident continuity clinic.

Each categorical resident is given 2 weeks of protected time for research. The time is taken during either the PGY2 or the PGY3 year.

Subspecialty Elective Rotations
Subspecialty elective rotations are available and provide greater in-depth knowledge and experience. Resident responsibilities include both inpatient consultations and outpatient clinics. By the completion of the three-year program, residents will have completed rotations in most of the subspecialty fields

Electives include:

  • Cardiology
  • Heart Failure
  • Pulmonary
  • Nephrology
  • Infectious Diseases
  • HIV
  • Rheumatology
  • Dermatology
  • Gastroenterology
  • Neurology
  • Neurocritical Care
  • Hematology/Oncology
  • Endocrinology
  • Diabetes
  • Sleep
  • Hospice & Palliative Care
  • Psychiatry
  • Procedure Service
  • Toxicology
  • Global Health Elective
  • Radiology
  • Anesthesia

IM Rotations