“Our goal is to establish a Valley Children’s-sponsored pediatric residency program and over time pediatric subspecialty fellowships,” said Dr. David Christensen, the hospital’s chief medical officer.
The decision by Valley Children’s to go its own way to teach residents is not a reflection on the University of California at San Francisco-Fresno Medical Education residency program, Christensen said. “We want to expand on the great work that’s already been done and move forward.”
The hospital’s decision, however, came as a surprise to UCSF-Fresno officials and the motivation for it was unclear, an official said. But pediatric residents currently split their training time between Valley Children’s and Community Regional Medical Center — two hospital systems that recently have been embroiled in a battle over control of pediatric patients in the central San Joaquin Valley.
Valley Children’s denied any connection to the hospitals’ fight: The idea of starting a standalone residency program has been discussed for several years, said hospital spokeswoman Zara Arboleda. “We are a free-standing children’s hospital so we can provide all the pediatric rotations that the residents would need at the hospital.”
Community Regional CEO Craig Wagoner said the downtown Fresno hospital is assessing the potential effect, but “it’s given us no choice but to step up to help our UCSF partner and discuss the further expansion of our pediatric residency program.”
Community financially supports some of the pediatric residents, Wagoner said. “So them canceling with UCSF is essentially canceling with us as well.”
Wagoner said the potential exists for there to be two competing pediatric residency programs, “which doesn’t make sense.”
Christensen said Valley Children’s is willing “to take over the responsibility, both financially and programmatically, of the UCSF-Fresno pediatric residency program.” The financial support would continue until the hospital’s residency program is established, which could be another year or two, he said.
And Valley Children’s also is willing to remain a teaching site for general residents in the UCSF-Fresno program, Christensen said. The residents are training in family practice, cardiology, pulmonary, emergency medicine, surgery, orthopedics and sleep medicine, he said.
Whether UCSF-Fresno will accept those offers remains to be seen.
“We are disappointed that our partnership with Valley Children’s will be ending,” said Dr. Michael Peterson, interim associate dean.
Peterson said he learned of Valley Children’s decision to start its own residency program Wednesday afternoon; he said Thursday it’s too soon for UCSF to make a decision on the future of its program. “There are hundreds of scenarios to play out,” he said.
The university’s concern now is making sure current medical residents get the experience they need, Peterson said. “We are not going to walk away from them, whatever we need to work out in the interim.”
Valley Children’s said the announcement gives prospective residents, who select programs in mid-January, time to make a decision and also for current residents to be informed that changes will likely occur during their training time.
Pediatrics is a three-year residency. UCSF-Fresno trains 12 residents a year. In any year, seven spend their time at Valley Children’s and five are based at Community Regional.
As for letting Valley Children’s take over the pediatric training program from UCSF-Fresno, Peterson said that decision would have to be made at higher levels of UCSF.
The strength of the current pediatric residency program is the opportunity residents are given to train in a lot of settings, such as at the region’s only trauma and burn centers at Community Regional, as well as at Valley Children’s, the area’s only children’s hospital, Peterson said.
Arboleda said Valley Children’s emergency department has 100,000 visits a year and has the clinical services for pediatric residency and fellowship programs. “We’d be able to provide all the necessary rotations that the residents would need to get a first-rate education in pediatric medicine.”
A standalone residency program at Valley Children’s would not affect pediatric residents in programs other than UCSF-Fresno, Arboleda said. Valley Children’s is a teaching site for residency programs based at hospitals up and down the Valley, from Modesto to Bakersfield.
Valley Children’s wants to remain a teaching site, she said, but it wants to take the lead in teaching doctors and specialists.
A Valley Children’s Pediatric Fellowship Program would be the first of its kind in the region and would train doctors who have completed a three-year pediatric residency to become subspecialists in areas such as gastroenterology, pediatric surgery and emergency medicine, Christensen said. The fellowship program could be easier to get up and running than a residency program, he said.
Peterson said UCSF-Fresno offers a pediatric fellowship in population health, which trains doctors in public-health management and how to manage a population of patients instead of individual patients. It has not proposed other fellowships because “no one has made the request to do that,” he said.
Christensen said the mission of Valley Children’s is to provide care to children, and training doctors is part of that. “This is our drive to really take responsibility for training these new physicians and attracting physicians to the Central Valley and keeping them here to practice long-term.”
The development of any fellowship program will bring more subspecialists to the region, Peterson said, and they’re more likely to stay and practice where they’ve been trained. But it will take time for Valley Children’s to develop a program, and it won’t have a university affiliation, he said. Such an affiliation can help with recruitment, Peterson said.