UCSF Fresno Hospice and Palliative Medicine

Training compassionate advocates for patients and families in hopsital and outpatient settings

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.

Patrick Macmillan, MD
Chief, Hospice and Palliative Care

UCSF Fresno

The one-year Hospice and Palliative Medicine (HPM) fellowship is an integral part of the fully accredited Family Medicine Residency Program.  The HPM program director, Dr. Alireza Soleimani Fard, and other palliative-care trained physicians work with a team 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 1,800 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.  Community Regional Medical Center provides inpatient and comprehensive outpatient services to patients of all ages.  Special hospital services include a level one regional trauma center, a level one regional burn center, and the only birth center in the region designated to handle high-risk pregnancies. 

UCSF Fresno HPM fellows begin with an introduction to our inpatient consultation services along with an intensive month of didactics. Monthly academic half days begin in August and are comprised of case conferences, interactive lectures from multiple disciplines, and journal club. Part of our yearlong curriculum include board reviews as well as sessions in wellness and selfcare. Clinical rotations include palliative care inpatient consultations, home hospice, and general inpatient, visits to our affiliated nursing home, and electives with medical and radiation oncology, psychiatry, and hepatology. 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. 

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.

Fellows also have the opportunity to train at the VA Central California Health Care System (VA) and within the Kaweah Delta Healthcare District. At the VA, fellows have exposure to outpatient, inpatient, and electronic palliative consultations daily.  Fellows receive formal weekly didactics and board reviews under close supervision of palliative faculty and in collaboration with the interdisciplinary palliative team. Fellows will have exposure to resources and services unique to the veteran population and are expected to serve as palliative care team leaders during this VA rotation.   

The Kaweah Delta Healthcare District is located in the beautiful town of Visalia. Fellows will benefit from a unique experience working at the local community hospital where they will serve as a crucial member of the inpatient palliative care team. Kaweah Delta Medical Center is the site of 6 other residency programs and its strategic vision for graduate medical education is to provide a supportive and exemplary experience with intent to promote physician retention and future practice in the Central Valley. The current medical director of Kaweah Delta Hospice and Palliative Medicine, Dr Ryan Howard, directly benefitted from this fellowship training partnership and he hopes you will, too!

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. Four highly qualified fellows will be selected each year through the NRMP match.

Fresno is a large metropolitan city with a small-town charm. Fresno is known for its farmers markets, community events, world class hospitals, and award-winning school districts. Another perk to living in Fresno is the affordable housing and proximity to many recreational opportunities in the area that include three nearby national parks — Yosemite, Sequoia and Kings Canyon. The Central Valley is only a short drive to the beach or the mountains and approximately 3 hours away by car to San Francisco or Los Angeles. Fresno has the best street tacos, farm-to-table dining, and diverse cuisine including Asian, European, Mexican, and Mediterranean food. You can visit an art museum, see a concert/event at the Save Mart Center, visit the Fresno Chaffee Zoo, watch a Grizzlies baseball game or cheer on our Fresno State Bulldogs, relax at a local winery or craft brewery, and much more!