The nation’s first and only fully integrated family medicine and obstetrics medical residency program recently celebrated its 20th anniversary.

Known as the UC Davis Family Medicine/Obstetrics (FMOB) Residency, the program trains doctors in the “whole family” approach of family medicine together with the intricacies of labor and delivery, including surgical and high–risk deliveries such as Caesarean sections and vacuum– or forceps–assisted deliveries.

Unlike the only similar option – a traditional three–year family medicine residency followed by a yearlong obstetrics fellowship – FMOB residents learn both specialties at the same time, starting on day one and throughout the entire four–year program.

“If I had done it the other way, I might have lost touch with the family practice side of my training while I was learning obstetrics,” said Heather Diaz, a 2003 graduate and medical director of the Yakima Valley Farm Workers Clinic in Salem, Ore. “I am truly equally passionate about both fields.”

The program was launched in 1997 by Lloyd Smith, professor emeritus of obstetrics and gynecology, and Jim Nuovo, professor of family and community medicine and associate dean of Graduate Medical Education. The goal, according to Nuovo, was to bring high–quality, full–spectrum obstetrical care to communities where access to maternity care can be problematic.

“This program was a natural fit for UC Davis,” Nuovo said. “No other school of medicine is as recognized as we are in primary care medicine, maternal–fetal medicine and reducing gaps in health care access.”

While most FMOB graduates are like Diaz and practice in small or rural communities, some are in urban areas. Most recent graduate Megan Ash is now at Sutter Health in Sacramento, practicing family medicine and taking obstetrics call.

“I love delivering babies but didn’t want to spend all of my time in labor and delivery,” Ash said. “I want to care for entire families, from the youngest to the oldest, and be the doctor who is always there for them.”

During her UC Davis training, for instance, Ash was the primary care provider for three generations of female patients in one family, including a newborn she delivered after caring for the mom throughout pregnancy and delivery.

“This is exactly what I want to do as a physician,” she said.

Smith was chair of the Department of Obstetrics and Gynecology when FMOB began and recalls some faculty wondering if training residents from different specialties side–by–side was a good idea. He advocated for the program and ensured participants were welcome in his department, because he knew it would improve patient care.

“FMOB addresses a very basic fact in medicine,” Smith said. “You can’t have healthy families without excellent and complete women’s health care.”