University of California (San Francisco)/Fresno Program

The UCSF Fresno Surgical Critical Care Fellowship is an ACGME-accredited training program designed to provide advanced training in the management of critically ill surgical patients. Situated at the Community Regional Medical Center (CRMC), the largest Level 1 trauma center between Los Angeles and Sacramento, the program provides comprehensive coverage to a diverse population within a sprawling catchment area. The center itself has 650 beds, with 68 designated for intensive care, and handles over 4,000 annual trauma-related visits, making it an ideal environment for fellows to enhance their critical care skills.1

The fellowship comprises two years, with the first year focusing on Surgical Critical Care (SCC). The second year is an Acute Care Surgery fellowship. It is important to note that the first year is not available as a stand-alone program, ensuring a continuous, well-rounded educational experience.2

Curriculum and Rotations

The curriculum is structured around extensive clinical rotations that cover various aspects of critical care. Fellows participate in rotations within:

• Trauma Intensive Care Unit (TICU): Focused on the comprehensive management of trauma patients.
• Surgical Intensive Care Unit (SICU): Managing preoperative, operative, and postoperative care of surgical ICU patients.
• Cardiovascular Critical Care: Involves the critical management of cardiothoracic surgical patients.
• Medical Intensive Care Unit (MICU): Participation in managing medically complex patients.
• Pediatric Intensive Care Unit (PICU): Specialized care focused on critically ill children.
• Burns Unit: Involvement in both inpatient and outpatient care for burn injuries.

These rotations allow for increased responsibility as fellows progress, ensuring they develop the skills necessary for independent practice.3

Research Opportunities

Participation in research is a critical component of the fellowship. Fellows utilize clinical and trauma registry data for high-quality research projects, which are encouraged to be presented at major scientific meetings and published in esteemed medical journals. The program facilitates access to necessary resources for this research, including collaborating with the Trauma Program and the Clinical Research Specialist.4

Faculty and Educational Environment

The program boasts a dedicated faculty with extensive experience in critical care and trauma surgery. Each faculty member is board certified in critical care, many having significant teaching and clinical roles within the department.5

As part of their role, fellows are also responsible for educating medical students and residents, which is integral to their growth as leaders in the field of surgical critical care.6

Application Process and Requirements

To apply for the UCSF Fresno Surgical Critical Care Fellowship, applicants must complete their applications through the Surgical Critical Care and Acute Care Surgery Fellowship Application Service (SAFAS). The program accepts one PGY-6 Fellow each year. Candidates must be either U.S. citizens, green card holders, or bring in an ECFMG-sponsored J-1 visa. Note that the UCSF Fresno does not typically sponsor H-1B visas.7

Applicants should possess a California medical license by specific timelines depending on their training background. Additionally, international medical graduates are required to obtain a Postgraduate Training Authorization letter prior to joining the residency.8

Competitiveness

The fellowship is competitive, being well-regarded within the surgical community. Prospective fellows are encouraged to have substantial experience in critical care or related specialties prior to application.

Visa Sponsorship

UCSF Fresno provides visa support primarily through J-1 visa sponsorship for international medical graduates. This allows qualified foreign citizens to participate in the fellowship program, ensuring compliance with U.S. residency training regulations. However, they typically do not sponsor H-1B visas, so it is crucial for international applicants to verify their eligibility for a J-1 visa sponsorship.9