Greetings from UCSF Fresno FamilyMedicine!

Once again, we have started inter-viewing for the next incoming residen-cy class! This time we have complete-ly revamped the interview experienceand made a concerted effort to max-imize applicant contact with residentsand faculty, including group sessions.Residents now directly participate inthe interview process alongside pro-gram faculty. Great feedback thusfar! UCSF Fresno Family Medicine haseven more highly qualified applica-tions this year, with over 800 applica-tions as of November 1 and counting!Our mission to train physicians to workin rural and underserved settings andtrain in the full scope of what FamilyMedicine has to offer is ever empha-sized in the curriculum, with new andexciting opportunities for current residents.

This year, important changes in theprogram will help us to further address

the education needs of the programand the care needs of our communi-ty. Our successful program last year infaculty development will continueand be offered to senior residents,and we have developed a new rota-tion experience for PG3 residents toinform our newest community docsabout teaching, leadership, and therole of health care advocacy in ourcommunity.

UCSF Fresno Family Medicine is grow-ing! We continue to recruit for 12 resi-dents again this year. We expandedour Hospice and Palliative CareFellowship program to 2 fellows. Anew Maternal-Child Fellowship inFamily Medicine has started this yearwith 1 fellow, and a part-timeHIV/AIDS care fellowship are amongthe new programs available.

Many thanks to all the alumni thatcame to the group event at the AAFPScientific Assembly Meeting in SanDiego! It was great to see so manyfamiliar faces and reconnect with allof you. Hope to see some of you atthe next event!

We are on FaceBook! Check it outonline. UCSF Fresno Family &Community Medicine.

We are making a concerted effort todevelop an active alumni group thatcan meet at national meetings, stayin touch with us and each other tokeep involved in program events andhelp us better prepare residents forthe real world of family medicine.Any suggestions for future events? Letus know! Please e-mail Lois Ceja atlceja@fresno.ucsf.edu to update yourcontact information and if you knowthe addresses of any other alumni

ProgramDirector’s Corner:Ivan Gomez, MD

The Scope Vol. 4, Issue 15Fall 2013

The Scope is published by the UCSF Fresno Familyand Community Medicine Residency Department.

Any inquiries or comments about content should bedirected to Vanessa Gonzalez at

vgonzalez@fresno.ucsf.edu

please let us know so we can contactthem as well.

Welcome Ila Naeni, DO

Dr. Ila Naeni joined the Department ofFamily &CommunityMedicine inSeptember, 2013. Aformer ChiefResident, Dr. Naenicompleted residen-cy training at UCSFFresno in 2010. Shewas selectedOutstandingResident of the Year when she gradu-ated. She had a busy practice atClinica Sierra Vista on Elm before leav-ing to precept residents at CMC’sAmbulatory Care Center. Dr. Naeni isa graduate of Western University ofHealth Sciences. When she isn’t work-ing Dr. Naeni enjoys spending timewith her twins, Ryan and Layla.

Please welcome Dr. Naeni back toUCSF Fresno!

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DepartmentUpdates

Congrats to Drs. Joan Rubinsteinand Alex Sherriffs!

Dr. Joan Rubinstein was recognized byAdventist Health in September 2013 at anawards ceremony in Sacramento forreceiving the Adventist 2013 PhysicianMission Award.

On Nov 6, 2013 Dr. Alex Sherriffs receivedthe 2013 Fresno Madera Medical SocietyLifetime Community Service Award for hiswork in air quality, chairing the FMMS PublicHealth Committee, obtaining the first grantto fund a position at FMMS to focus on airquality issues, and his appointment by Gov. Brown to serve on the SanJoaquin Valley Air Pollution Control District Board and the California AirResources Board.

Faculty Awards and Recognitions

Dr. Jennifer Burnett, MS, MD, FAAFP, has been invited topresent her research, "A Safe, Efficacious & Cost-EffectiveHormone Protocol for the Tx of M2F Transsexuals" at theWorld Professional Association for Transgender Health 23rdInternational Symposium in Bangkok, Thailand in Feb of2014. She will be presenting 7+ years of data from her clini-cal research with Transsexual patients, whom she has beenseeing in her practice in Selma - at the same clinic site asthe Rural F.M. Residency Tract. This is the third time that Dr.Burnett has been invited to speak at the WPATH Symposia -the others being in 2009 in Oslo, Norway & 2011 in Atlanta,GA. She has also presented at the 2011 and 2013 NationalTransgender Health Summits and just gave a poster presen-

tation of her research at the AAFP National Scientific Assembly in San Diego lastmonth. Dr. Burnett is a member of the Medical Advisory Board of the UCSF Centerof Excellence for Transgender Health Care and was the recipient of the UCSFChancellor's Award for GLBT Leadership and the Champions of Diversity Award,both in 2010.

Goodbye Andy Alba...

Andy Alba will besorely missed. Hespent 4 years withour departmentand was alwaysa helping handwith a smilingface. He movedon to a new jobat OptimalHospice Care.

Graduate Survey

Congratulationsto Dr. MileidysGomez-Gonzalez, thewinner of a $50Amazon giftcertificate.Mileidys’ namewas pickedfrom a pool ofgraduates whocompleted ouryearly UCSF Fresno Family Medicinegraduate survey sent out earlier thisyear. Graduates should watch fortheir chance to give feedback tothe program & win a prize nextyear! It’s not too late to providefeedback if you received a requestthis year, but the prize is gone.

Congratulations to Dr. Muhammad Riaz

Dr. MuhammadRiaz was accept-ed at Universityof Michigan AnnArbor for a SleepMedicineFellowship in2014-15!!! Greatjob Dr. Riaz!

Goodbye Dr. Imanzahrai

Dr. AshkanImanzahrai hasaccepted aMedical Directorposition with VITASInnovative HospiceCare in LosAngeles. We wishhim all the best inhis future endeavors!

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Department Events

The UCSF Fresno Family Medicine programbegan graduating residents in 1973 andhas produced over 350 well trained FamilyDoctors. It seems odd that we have nothad an organized event to bring togetheras many of those grads as possible. In thefall of 2012 Cynthia Harris , the Director ofDevelopment and Alumni Relations atUCSF Fresno, came to me to suggest thatUCSF Fresno and the F. P. departmentorganize an event at a national FamilyMedicine gathering that would attract ourgrads from around the globe (or at leastthe region). We decided on the AAFP’sFall 2013 Scientific Assembly and Cynthiagot to work with planning, hunting downgrads and inviting as many alumni as possible.

September 25th saw the first international reunion of UCSF Fresno FamilyMedicine Residency Alumni. The reunion took place during the AAFP’sannual Scientific Assembly in San Diego and was hosted by program gradu-ates Steve Cowgill, Jennifer Wu, Alex Sherriffs, Joan Rubinstein, and myself.The event took place at the Rock Bottom Brewery in San Diego’s Gas LampDistrict. Cynthia Harris organized and co-hosted this spectacular event thatfeatured free food and drinks and a wonderful opportunity to re-connectwith classmates and mentors.

The reunion welcomed graduates from as early as 1980 and 81 (Drs.Rubinstein, Sherriffs and Tony Molina) and as late as 2010 (Drs. GeetaRamesh and Michael Wilson). We even enjoyed the presence of futurealumnus and current chief resident Mario Martinez (class of 2014) along withhis wife Adriana and their daughter Alana. The youngest partygoer was Dr.John Zwiefler’s daughter Lilly (age 7 months) followed by Drs. Wu and Cowgill’s son Zach(age 10 months). Overall we had 28 graduates and several faculty that were not fortu-nate enough to graduate from our stellar program. Non-alum faculty included our pro-gram director Ivan Gomez and Dr. Jennifer Burnett who attended the assembly to pres-ent a research poster.

Everyone present agreed that the event was a treat and a wonderful way to connect.We plan to continue hosting alumni reunions at future west-coast, AAFP conventions.–Stay tuned!

First Ever Global Reunion of UCSF FresnoFamily Medicine Residency Alumniby Alex Moir, MD

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Family MedicineNews

A physician’s job is to save and often prolong life. They will push on apatient’s chest; they will shock them, put tubes down their throats and nose;they will stick them with needles and other sharp objects, and fill them withmedications such as morphine, epinephrine, heparin, dopamine, etc. Theywill pump fluids in them; they will ice them down or heat them up. The finalresult is to save that life. Not so is the role of the Palliative Care team andproviders. Over the last 4 years, I have been working with some of the mostcaring and well-trained residents in the art of saving life. Last month I hadthe opportunity of spending time shadowing the palliative care team atFresno Community Regional Medical Center. I found the experience to beastounding.

When you do a Wikipedia search for Palliative Care (as I did), it comes upwith this: from Latin palliare, to cloak, an area of healthcare that focuses onrelieving and preventing the suffering of patients. I found this definition to beabout as accurate as I could have imagined it.

The “team” is comprised of physicians, FNP, RNs, social worker, chaplain(s),and some pretty amazing interpreters (either in person or via phone serviceswhen needed). Here is a brief summary of my first day with the service. Itbegan with an early morning meeting with the team. They pulled uprecords of the patients who had received a palliative care consult from theirattending physician. The patient’s charts were reviewed with a fine-toothedcomb. They examined physical symptoms, current medications, history, whothe family and care takers were, and discussed language barriers. Therewas a patient load of 10, so the team split up duties and decided whowould visit whom. Then the rounding began. The nurses and physiciansmoved from floor to floor, ICU to emergency room, and room to room toassess patients and make contact with their family members. Gloving andgowning-up was done before entering each room. The provider scannedthe chart for recent medications, feeding, and other important things hap-pening with the patient. If the patient was able to speak, the providerdescribed themselves as part of the palliative care team providing a consultper the request of their attending physician. They asked the patients severalquestions: if they knew why they were in the hospital, what their medicalcondition was, and who was making medical/health care decisions forthem. Many times it was not actually the patient but the family makingdecisions.

The day contained multiple family meetings where the team members lis-tened to determine the patient’s and family’s wishes. In each case, thepatient was treated with respect, dignity, and everything was done to makethe patient pain-free and comfortable. I was in awe at the respect andlove given to the patients. It was an impressive showing of health care andteamwork.

Hospice and Palliative Medicine: A day in the life by Andy Alba

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Family MedicineEvents

Family Medicine Tailgating at Fresno State vs. UNLV

Family Medicine sure knows how to have a great time! Our Annual tailgateand football game was enjoyable. Our chief residents Mario and Mike and for-mer chief resident Raul helped BBQ for the tailgate. Everyone who attendedshared their home cooked or store bought dish, salad or dessert with every-one. To top it off the Dogs won again with an incredible score of 38 to 14. Untilnext year, Go Dogs!

UCSF Fresno 2013 Halloween Potluck Celebration

Please join us in congratulating FCM staff for almost making a clean sweep of theHalloween Party awards.

Lois Ceja won for Best Entrée with Jeffrey Dahmer’s lunch – barbequed legs and thighs; Cheryl Gallo won for Best Dessert with a Kitty Litter cake which looked disgusting but waspretty tasty;Mary Fraijo dressed as Queen of the Nile and won for Best Individual Costume;Family Medicine staff won for Best Group Costume—not sure why cause we didn’t really coordinate what we were wearing,but we all looked pretty spooky.

The only award given that we didn’t receive was Best Appetizer. Maybe next year we will have a clean sweep!

In the words of residents, “this year’sretreat in Wonder Valley was the bestever!” The weather could not havebeen nicer, the venue was perfectwith an abundance of activities foreveryone to enjoy, including familymembers. Teams of 3 & 4 residentsamusingly competed in navigatingtheir canoes around the lake whilewearing a blind fold. High ropescourse revealed some amazing acro-batic skills of Drs. Jose Buenrostro,Bobby Aulakh, Mario Espindola andErica Delsman!

The Wizard of Oz awards; “Lion Awardof Courage” went to Drs. SatjitSanghera, Shruti Joseph, with themedal of honor winner, AshlynnGordon. The “Tin Man Award forHeart” went to Drs. Mary McLain andIda Harris for being the greatest teambuilders! Pathway competition provedCSV to be small, but mighty coming inat 1st place, with CMC and Selma run-ning neck in neck for 2nd and 3rdplace, respectively. Costumes for theSaturday night high roller gamblingparty were incredible! Futuristic cou-ple, Mario and Adriana Martinezwalked away with a fine set of crystalwineglasses for “Best Costumes”!Huge thanks goes out to Dr. SatjitSanghera’s fiancé, Raj for being ourofficial awesome photographer.Everyone had a blast while learninghow to be a great sport!

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Spotlight onResidents

2013 Family and Community MedicineResident Retreat

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Chief ResidentsCorner

Message from the Chiefs

As the holiday season approaches, we reflect on another successful year for theFamily Medicine Department. We introduced a very strong and impressive internclass to our family. We have been very pleased with their progression as they con-tinue to gain confidence and sharpen their skills. We also had the pleasure ofwatching the second years take on the role of leading the Family Medicine serviceand managing the other services on-call on their own. The progression as a resi-dent is an amazing experience and likely one of the steepest learning curves ofany profession. Our fellow third years are also progressing and gaining autonomy aswe prepare for the work-world ahead.

The interview season is upon us and we have changed the whole structure of theinterview process. So far we have been getting positive responses from the appli-cants as well as the faculty and residents. Each Monday, we have the opportunityto meet up to twelve exceptional candidates. We are very confident in gettinganother promising class in 2014, who will continue to maintain the high-standard ofour program. As we do the tours, dinners, and interviews, we get reminded of howstrong our program is and the reasons we all joined this extraordinary program.

This academic year, we had to say goodbye to Rebeca Lopez and Andy Alba. Itwas very sad to see them leave our team but we wish them the best in theircareers and future, and we appreciate all the help and support they have provid-ed us. Despite our loss, we are grateful to welcome the new members of our team,Judy Ikawa and Lola Aguiniga, who are doing a wonderful job working with theresidents and faculty.

The retreat this year was another memorable one! We are very appreciative as aprogram to have this opportunity to get away from our clinical/hospital duties togrow as a collective team on these retreats. We would like to thank the staff whoorganized the event as well as the faculty who covered our services. As expected,we had a blast with the casino night, ropes courses, blind cannoning and groupactivities. We, as a group, really came together and we hope that these bonds webuilt will carry on throughout the year.

We wish you all a wonderful holiday season. This is the time of thanks, so thank youall for everything you do to make this year so successful. We look forward to thenew year here at UCSF Fresno!

—Mario Martinez, MD and Michael Moya, MD

Join us in welcoming thenewest member of FAMI-LY MEDICINE Faculty...Zoya Hassan Khan! Bornon Oct 7th at 11:03, sheweighed 6 lb 9 oz, & was19 inches long.

Congratulations to Dr.Farhat Khan & her hus-band on the birth of theirbeautiful baby girl, Zoya!

Join us in welcoming anew member of FAMILYMEDICINE! WelcomeCatalina NicoleHernandez, born to proudparents, Nidia Payan andOscar Hernandez onSeptember 27th. Sheweighed in at 9 poundsand was 21.4” in length.Big sister Valentina isdelighted with her newbaby sister!

Welcome New Family Medicine Babies!

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FCM 2013 EXPO Thursday, December 12, 2013 1:30 pm; UCSF Fresno Center Room 136

Family Medicine Holiday Party Saturday, December 14, 2013, 6 pm; UCSF Fresno Center