Curriculum
Ambulatory Care
UCSF Fresno offers a unique blend of training with distinct urban and rural family health centers. All family medicine residents have an identified continuity clinic, which they select from 3 federally qualified health centers (FQHC) - United Health Centers Ambulatory Care Center- ACC, United Health Centers -Parlier, or Clinica Sierra Vista (see teaching sites for additional information on each site).
In addition to continuity care clinics, residents also partake in a wide variety of outpatient experiences, including pediatrics, women’s health, medical subspecialties, surgery/procedure-based services, behavioral health, geriatrics, and palliative care. These outpatient experiences take place at various teaching sites including UHC-ACC, Veteran’s Administration Central California Health Care System, Alzheimer and Memory Center, Community Cancer Institute, and more.
Our family medicine faculty have many areas of expertise and specialty clinics where our residents can rotate through and expand their medical knowledge. These specialty clinics include:
All residents rotate through the colposcopy clinic during their family medicine clinic rotation in intern year and their women’s health rotation in their 3rd year. During this clinic, residents have the opportunity to perform colposcopies, endometrial biopsies, and IUD placements.
The family medicine physician provides holistic, patient-centered care, ensuring each patient feels respected, understood, and supported. By working in the Central Valley, the primary care physician also plays a critical role in addressing health disparities and improving access to quality healthcare for the transgender and gender-diverse community in the region.
We are proud to offer access to culturally competent, inclusive gender affirming care. All residents rotate through the gender affirming care clinic during their outpatient medicine rotation in their 2nd year of residency. In this clinic, residents learn how to provide comprehensive medical care for transgender and gender-diverse patients.
Addiction is a psychiatric illness that has a deep impact on the individual, their families and the community at large. Despite being one of the most common chronic illnesses, it is not well treated in primary care settings. Addiction is a stigmatizing disease, which in the real world almost always translates to significant barriers for patients in obtaining care and for physicians in providing care. Our mission is to help remove these barriers by training family physicians to treat patients with addiction.
Our Addiction Medicine team at the UCSF Frenso FCM is a leader in providing addiction care in Fresno County. We serve our patients through our several outpatient clinic sites, and at the Community Regional Medical Center through our bedside consult service and collaborations with the Emergency Department. Our team also provides continuous education, training and awareness to all cadre of healthcare professionals in Fresno County throughout the year.
We also lead initiatives for linking pregnant patients with substance use disorder to addiction care through the Perinatal Substance Use Disorder Taskforce. Residents are provided with both didactical training during the educational half-days and hands-on experience in our harm reduction clinics. We encourage deeper learning for interested residents through elective rotations in our clinics and on the consult service. We also have a broad portfolio of faculty and resident research projects that are aimed at having a better understanding of the needs of our patients and their disease.
For learning more about harm reduction: https://harmreduction.org/
For learning more about UCSF Fresno Harm Reduction clinic: //news/close-ucsf-fresno-increases-access-care-and-improved-treatment-patients-opioid-use-disorder
Reach out to faculty lead, Dr. Khan: [email protected]
Chronic hepatitis C is a chronic, life-threatening infection that disproportionately affects the marginalized communities. These include people who are suffering from poverty, homelessness, or addiction. The prevalence is reported as high as 26% in these communities, compared to 1-2% nationally. The good news is that, if found early, it is a curable disease, and our mission is to train family physicians to be able to treat these patients from their primary care offices.
The Centers for Disease Control and Prevention (CDC) encourages primary care physicians to treat chronic hepatitis C infections. The UCSF Fresno FCM is a leader in treating patients with chronic hepatitis C from our primary care clinics. These referral clinics are embedded within our harm reduction clinics in two large health systems in Fresno County that allow us to provide state-of-the-art treatment in an efficient way to patients in both urban underserved and rural areas. Residents rotate through these clinics, and they can choose to do deeper learning by choosing elective rotations in these clinics. We also encourage residents to conduct research studies and are currently reviewing outcomes of chronic hepatitis C care from our co-located rural clinic.
Hepatitis C treatment Guidelines: https://www.hcvguidelines.org/
Reach out to faculty lead, Dr. Khan: [email protected]
The HIV specialty office provides HIV care to people of Fresno and surrounding counties in a team-based approach with physicians, social workers, nurses, and medical assistants all working together to provide care to our patients.
In addition to HIV care, physicians provide primary care to individuals without a primary care physician. All our FM residents rotate through the HIV clinic during various outpatient rotations throughout their time here where they work alongside FM faculty, infectious disease faculty/fellows, and IM residents.
Residents learn how to initiate antiretroviral agents, monitor patients taking antiretroviral agents, and the basics of preventative care in patients with HIV/AIDS.
All 3rd year residents have the opportunity to work on a mobile unit during their family medicine clinic rotation. While working in the mobile unit, they provide care to unhoused patients currently residing in transitional homes.
All residents rotate through the sports medicine clinics at both the FHCN and UHC clinics during their sports medicine rotation during their 3rd year of residency with an opportunity to have additional training through elective time. Residents learn how to complete a comprehensive musculoskeletal examination, key elements of a sports physical, concussion management, US-guided steroid injections, and splinting.
The walk-in clinic provides a unique and impactful experience for residents allowing them to gain experience in an urgent care setting while also having the opportunity to serve as a crucial safety net for patients who cannot access their primary care providers on a same-day basis.
The clinic serves a vital role in the community. It offers residents an opportunity to engage directly with a diverse and underserved population, including individuals from lower socioeconomic backgrounds and migrant workers. Many of these patients lack insurance coverage, making the clinic an essential resource for addressing urgent healthcare needs and providing compassionate, accessible care. Working in this environment allows residents to develop a deep understanding of the challenges faced by these populations, from navigating healthcare disparities to managing a broad range of acute conditions without the benefit of comprehensive insurance. Residents will gain valuable experience delivering high-quality care under pressure, often with limited resources.
Inpatient Care
UCSF Fresno provides intensive, structured inpatient learning opportunities. Family medicine residents are assigned to teaching services at Community Regional Medical Center (CRMC) and Valley Children’s Health Care, the only pediatric hospital in the San Joaquin Valley.
The bulk of inpatient training is provided at Community Regional Medical Center (CRMC). Residents are supervised by family physicians skilled in inpatient and obstetric care on the Med D, FMI, and FMOB inpatient services. In addition, they work with a variety of outstanding specialists while on outside rotations.
Scholarly Projects
During their three years of training, residents complete one scholarly and one quality improvement project with extensive support and individualized expert assistance for their projects by family medicine research faculty and staff. They present their projects to their peers and members of the UCSF Fresno academic community during their third year of training. Residents have many opportunities for regional and national dissemination of their scholarly work, which is encouraged by the program.
Curriculum Committee
UCSF Fresno pays careful attention to its curricular offerings. A curriculum committee consisting of residents and faculty meets monthly to critically appraise our curricula. Each curricular area is reviewed every six months, and an in-depth analysis is done annually. Resident evaluations of rotations are reviewed, and the curriculum modified and updated as necessary.
