University of California (San Francisco)/Fresno Program

The Pulmonary Disease and Critical Care Medicine Fellowship Program at UCSF Fresno offers a comprehensive training model designed to cultivate proficient pulmonary clinicians, educators, and investigators. The program has been in existence since 2007 and is accredited by the ACGME. It integrates clinical training with scholarly research, ensuring fellows are equipped with the knowledge and skills necessary for a successful career in pulmonary and critical care medicine.

Program Structure

The fellowship spans three years and emphasizes both clinical and research training. Each year involves varied clinical rotations, participation in outpatient care, and engagement in a range of educational conferences.

Clinical Rotations

During the first year, fellows primarily engage in clinical service within the Medical Intensive Care Unit (MICU), consult service, and Pulmonary Function Testing (PFT) service. This arrangement provides fellows with extensive exposure to various clinical scenarios and a wide array of pulmonary and critical care techniques, such as flexible fiberoptic bronchoscopy and management of critical care procedures. The second year consists of additional rotations in the MICU, pulmonary consults, sleep medicine, and UCSF transplant services, transitioning fellows towards more specialized aspects of patient care.

Research Opportunities

The third year predominantly focuses on research. Fellows are expected to collaborate with a chosen research mentor to design studies and submit their findings for publication and presentation at national conferences. Electives during this year include sub-specialties such as trauma, neurocritical care, and cardiothoracic surgery.

Training Sites

The fellowship extensively utilizes Community Regional Medical Center (CRMC) and the VA Central California Health Care System. CRMC, known for its busy emergency department and being the only level 1 trauma center between Sacramento and Los Angeles, provides fellows with real-world experiences in the management of complex cases.

Curriculum and Conferences

Fellows attend a rigorous curriculum that includes core lectures, weekly clinical conferences encompassing various topics from mechanics of ventilation to diagnosis techniques and pathology reviews. The mandatory core curriculum series held in July for first-year fellows entails intensive lectures by faculty on critical topics within pulmonary and critical care medicine, including:

• Static and Dynamic Mechanics
• Spirometry and Lung Volumes
• Introduction to Bronchoscopy
• Cough and Hemoptysis
• Preoperative Pulmonary Evaluation

Weekly conferences further enhance training, with departments working collaboratively to ensure that fellows garner exposure to interdisciplinary care perspectives.

Application Requirements

To apply for the fellowship, prospective fellows should have completed an accredited residency in internal medicine. The program accepts two new fellows annually via the National Resident Matching Program (NRMP). The application must include:

• CV
• Personal Statement
• Three Letters of Recommendation
• USMLE transcripts
• Medical School transcripts
• Dean’s letter
• ABIM certification or board eligibility

UCSF Fresno requires applicants to either be U.S. citizens, have a green card, or hold an ECFMG-sponsored J-1 visa. Typically, the program does not sponsor H-1B visas.

Unique Aspects of the Program

One notable feature of the program is its focus on Extracorporeal Life Support (ECLS) and Extracorporeal Membrane Oxygenation (ECMO). The program has developed a multidisciplinary ECMO team at CRMC, which consists of physicians, nurses, therapists, and support staff aimed at delivering high-quality care for patients requiring ECLS. This specialized training equips fellows with the expertise to manage complex cases of patients experiencing severe cardiac or respiratory failure.

Diversity and Support

The UCSF Fresno program is committed to creating a diverse and inclusive environment. It actively works toward attracting candidates from varied backgrounds and experiences. Additionally, fellows are encouraged to balance their professional responsibilities with wellness initiatives to ensure lasting satisfaction and career growth in medicine.

Competitiveness

The fellowship program is competitive, attracting many qualified applicants. Background checks are mandatory components of the application process to maintain the integrity and safety of the training environment.

Fellowship Team

Fellows receive mentorship and guidance from a diverse team of faculty who are not only accomplished clinicians but also educators and researchers within the fields of pulmonary and critical care medicine.