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Community Medicine and Advocacy

The community pediatrics experience is interprofessional and interactive, designed to introduce residents to several different Fresno and Madera community service organizations that serve the patients of Valley Children’s Hospital. Our primary goal for this rotation is to understand and identify the social determinants of health that impact the patients of the residents throughout their careers as pediatricians and teach them how to advocate effectively for them. The rotation includes an Interprofessional Advocacy Workshop developed by Dr. Jolie Limon, Chief of Pediatrics and Executive Director of Medical Education, and Dr. Janae Barker, our first chief resident, with the assistance of the Advocacy Training Grant from the California American Academy of Pediatrics.

In addition to hands-on experience with an underserved population, residents learn how to refer patients when needed. Partner organizations in this program include: 

We included a longitudinal aspect so that a PGY2 pediatric resident will supervise an intern and both will provide direct patient care such as:

  • Immunization clinics
  • School/sports physical clinics
  • Provide education on health topics and school physicals
  • Migrant youth clinics    

Working with the Fresno Economic Opportunities Commission, residents observe with the Head Start/Early Head Start team, the Sanctuary Youth team and the health clinic. Exceptional Parents Unlimited (EPU) teaches the interns the services that are appropriate for referral to pediatric physical, occupational and speech therapists.

Because our catchment area is very large, concurrent, palliative and hospice care are very important to improving patients’ quality of life. During the experience with Hinds Hospice and the Palliative Care Team, residents experience home visits as well as learn the continuum of care from hospital to home. Centro La Familia and Madera Public Health/Community Action Team experiences consist of learning about social services available to disadvantaged families.

The Community Pediatrics and Advocacy rotation is unique because of the variety of people and communities residents meet. The curriculum is designed to have hands-on experiences primarily through MHU and EOC free health clinic, as well as home visits. It also exposes residents to both rural and urban experiences. Finally, the curriculum expands as PGY2 to be taking care of patients in those settings rather than merely observation. Finally, as PGY3, there are opportunities throughout the Central Valley in Valley Children’s Heathcare system to have community pediatrics rotations in which the senior and graduating resident may work in a rural underserved area to manage patients in inpatient and/or outpatient settings.   

Finally, residents have the opportunity to partner with community and hospital leaders for advocacy projects.