Continuity Clinic 

Outpatient continuity clinic is a major component of Family Medicine training.  At the present, all residents are required to have 1650 encounters by the time they reach graduation.   In order to preserve continuity of care, all residents will rotate through their continuity clinic once to twice weekly when assigned to a non-continuity clinic rotation block.  If a resident is assigned to be on a continuity clinic rotation for that particular block, they will remain in clinic for 4 out of 5 days of the 5-day workweek.     

Inpatient Family Medicine Service

Our inpatient family medicine service is run by our own Family Medicine residents and Family Medicine attendings.  We admit general internal medicine patients that come in through the emergency department as well as our clinic patients.  The service runs 365 days a year, 24/7 to ensure continuity of care.  Every resident is assigned on this service and consists of two PGY-1 level residents and one senior level resident at the PGY-2 and PGY-3 years.  Nights are covered by a night float senior resident that is integrated onto the service. 

Nursing Home Care

All residents are assigned nursing home patients to care for starting during their PGY-2 years.  Residents will follow and care for their patients through their PGY-2 and PGY-3 year on a monthly basis.  Every effort is made to ensure that residents follow the same patients throughout their last two years of training to maintain continuity.  Our family medicine faculty round with residents at their assigned nursing homes within the community.

Obstetrics

Residents will rotate at St. Agnes Medical Center’s Obstetric Ward.  The OB rotation is staffed by the hospital’s OB hospitalist service.  Residents will learn the basics of acute OB care.  This includes management of obstetrical urgencies/emergencies, NSVD, C-Sections, pre-mature labor, assisted delivery (vacuum delivery), and post-partum care.  Our program also cares for low-risk OB patients in our continuity clinics.  We also have a Family Medicine faculty who also performs low-risk deliveries with our residents. 

Pediatrics/Newborn

Residents rotate through Valley Children’s Hospital (VCH) during their PGY-2 year for 4 weeks for their pediatric inpatient rotation.  VCH is the only major pediatric hospital between the Bay Area and Los Angeles and is a major referral center for subspecialty pediatric care.  Residents also rotate through VCH’s Emergency Department during their PGY-3 year in order to gain a solid experience in pediatric emergencies.  Overall, VCH has a very strong educational experience for our residents due to the broad range of pediatric pathology they encounter.   

For community-based outpatient pediatrics, our residents rotate with various community pediatricians who provide our residents with a good foundation of well-child care and sick visits.  Additionally, our continuity clinic cares for children of all ages.  

Residents are required to rotate on our hospital’s newborn nursery.  Aside from expectant care, they will gain experience in diagnosing and treating newborn issues such as hyperbilirubinemia and neonatal sepsis. 

Specialty Care Rotations

To ensure our residents are receiving a broad-based educational experience, residents must receive training in various specialties including, but not limited to general surgery, psychiatry, gynecology, sports medicine, and dermatology.  Dedicated specialists within and outside of the St. Agnes Medical Center system provide an in-depth hands-on learning experiences for all of our residents.

Scholarly Activity 

Our program requires residents to complete two scholarly projects, which consists of one QI (quality improvement) project and one additional scholarly project such as a case report or original research.  With the help of our institutions research coordinator and faculty, residents will have the support they need to complete their projects prior to the end of their training.  Our graduate medical education departments hold an annual in person research day in May where all residents from all SAMC residency programs will present and showcase their scholarly activity.     

Mobile Health Curriculum

Residents will travel to rural communities around Fresno County to provide basic primary care services.  In conjunction with California State University, Fresno’s School of Nursing, residents and faculty will work side by side with members of the Nursing School to assess and care for patients in the community with the aid of point of care diagnostics, a state of the art mobile health trailer, and ancillary staff support.