Fresno is an inland city located in California's Central Valley approximately midway between San Francisco and Los Angeles. In many ways, Fresno is very different from San Francisco...the median income for a household in Fresno is $32,236 vs. $57,833 in San Francisco according to wiki. There is a larger population of Hispanic and minority patients, and most of the Asian patients in Fresno are the legendary Hmong. (Legendary because Hmong culture is featured extensively in our required reading during medical school as part of lessons in cultural sensitivity, but rarely seen in San Francisco).
In Ob-Gyn, our female patients tend to be younger, healthier, poorer, and less educated than patients probably seen at other hospitals in the Bay Area. A fair amount of patients are illiterate. Many are immigrants from other countries. Learning medicine in a non-academic center has been new and refreshing for me, and I have been able to practice my medical Spanish. I had wanted to do obgyn in Fresno because 1) it seemed like a good idea to do an away rotation to see new settings; 2) Fresno has one of the highest birth rates in CA; 3) I've never been to Fresno; 4) I wanted to practice my Spanish.
I haven't spoken much Spanish since college, and have been amazed again at how beautiful the language can be. Honestly, Spanish is more expressive and beautiful than English or Mandarin...and this is coming from a pseudo-Asian American English major. There are so many shades of meaning, and interesting quirks to think about...like how the term for giving birth is "dar la luz" (literally: give light), or why someone can be "estar muerto" (dead) when the verb "estar" implies a temporary state. Or even why someone can be "ser joven" (young) when "ser" usually implies a permanent state. Don't get me wrong, my Spanish is still fairly poor.
Another interesting thing about Fresno is the lifestyle...the buildings are spread out, there are gazillions of chain stores like Target, Starbucks, Costco, and plenty of parking and free high quality food at the hospital. The people in Fresno tend to be more open, friendly, less pretentious and more humble. :)