Over the next few years, as many as 18 residents will work at both UC Davis Medical Center and Adventist Health Ukiah Valley Medical Center as part of a new family medicine physician training program.

The Accreditation Council for Graduate Medical Education recently completed a site visit to the Sacramento campus of UC Davis and reviewed the voluminous documentation required of any new residency program — in this case, the Adventist Health Ukiah Valley Family Medicine Residency Program.

“This was a big undertaking, and it wouldn’t have been successful without the help of our UC Davis colleagues in pediatrics, emergency medicine, ob-gyn, internal medicine, psychiatry and at the VA,” said Jim Nuovo, professor and residency program director for the Department of Family and Community Medicine. We’ve also got a terrific partner in Ukiah with Adventist Health, and a wonderful site director, Dr. Noemi Doohan.”

Nuovo said the real benefit of the new program, which if approved would officially begin in July 2019, is the pipeline it creates for new primary care providers in and around Ukiah, about 150 miles northwest of Sacramento in Mendocino County. Physicians will start there as residents but could potentially find the work and community so rewarding they decide to settle into a practice in the region, which is facing a significant shortage of primary care providers.

Residents in the program will spend their first year in Sacramento and their second and third years in Ukiah, with clinical rotations at UC Davis in ob-gyn, pediatrics, emergency medicine and internal medicine. A total of 18 residents, six in each year of the program, will participate at any one time.
From the smaller, rural-area perspective, having highly skilled and motivated UC Davis residents holds great promise for the community.

“We are delighted to partner with UC Davis in training family medicine physicians,” said Doohan, a family medicine physician who completed advanced primary care psychiatry training at UC Davis. “Here, they will be exposed to unique models of delivering and financing health care in rural settings that encompass population health, mental health and private-public partnerships that build healthy communities.”

Doohan, whose efforts to improve local health care include the nonprofit organization Family Medicine Education for Mendocino County and an annual “Rural Health Rocks” fundraising concert, is looking forward to having new physicians coming to town.

“Our region was once host to a thriving medical community, but our great doctors have been retiring and are not being replaced,” she said, adding that traditional recruitment efforts have not been effective.

The new strategy is for Ukiah to “grow its own family doctors,” something the UC Davis program is uniquely positioned to do, according to Doohan.

“UC Davis has made it possible for us to launch and sustain our big vision of lifting health care for our own community and north to the rural communities all the way to the Oregon border,” Doohan said.
The new program adds to the UC Davis Department of Family and Community Medicine’s network of clinical sites for family medicine residents, which encompasses seven locations from Modesto to Shasta. The department has a 40-year history of providing excellent health care and outstanding clinical education in all aspects of family medicine.

“Residency programs are one of the best ways to expand the health care workforce in underserved communities,” Nuovo noted. “Rural areas like Ukiah are in desperate need of more primary care services. This new family medicine program fits perfectly with our efforts to help communities encourage physicians to practice and live where they trained.”

​Adventist Health Ukiah Valley (AHUV) is taking the next step in securing a family medicine residency program in Ukiah. The first step was completed in October, 2016, when AHUV was approved as an official teaching hospital. The secondary step in launching the residency program is the approval of the program itself. On Feb. 7, 2018, the Accreditation Council for Graduate Medical Education (ACGME) will visit AHUV for an official site visit. If successful, the residency program will be accredited by May 1st and residents will join the practice in July 2019.

Following completion of medical school, our residents will receive their first year of training at UC Davis and then come to Adventist Health Ukiah Valley for their second and third year of family medicine residency including training in emergency medicine, surgery, pediatrics and women’s health, all under the supervision of a board-certified physician. Once their residency is complete, these new physicians will be qualified to become board certified family physicians.

The family residency program is a long-term solution to enhance access to primary health care in Mendocino County. Recent projections from the US Health Resources and Services Administration (HRSA) indicate that without significant changes to primary care, the growth in the field will not be adequate to meet the demand in 2020. This is even more prominent in rural communities such as Mendocino County. A Robert Graham Center study showed that over 50 percent of residents stay and practice within 100 miles of their training. This is due to the physician’s knowledge and comfort working in the area and their desire to be near their mentors. This program will help provide needed primary care physicians for our region.

Bringing a family residency program to our community has other benefits for the entire community. Physicians know that residency programs are an indication of healthcare growth and are excited at the opportunity to be part of a forward-thinking organization. The residency program also has positive economic impacts on the local economy. A recent Robert Graham Center study found that in California family physicians have a positive economic impact of almost $1,000,000 per year per doctor. Family physicians generate significant economic activity as they provide employment for support staff, purchase goods and services and generate other health care income for hospitals and nursing homes. With an aging physician population and a greater need for family medicine physicians, the residency program will make a positive impact on our community.