The obstetric experience at USC is divided between LAC+USC Medical Center, California Hospital Medical Center, and Hollywood Presbyterian Medical Center, all overseen by the USC Perinatologists. Together, these facilities account for 17,000 deliveries attended by the residents each year. Residents spend the most time on the obstetrics service at LAC+USC Medical Center. Each resident spends four blocks--approximately six months--each year on the obstetric/gynecology service, making up a total of four teams, with a member from each class on all four teams. The daily schedule is based on a “q4” call rotation. Each weekday, one team is in the clinic, one is in the operating room, one is on-call, and one is post-call. During each day of the rotation, the residents on the team participate in activities that are most appropriate for their level of training. Most deliveries are performed by the junior resident under the supervision of the senior. The junior also is the primary surgeon for most of the cesarean sections. As LAC+USC Medical Center is a major referral center for high-risk pregnancies, residents learn to manage patients with medical conditions ranging from diabetes to cardiac disease, as well as complications of pregnancy such as preterm labor and severe preeclampsia. The fourth and first year residents will spend one block managing high risk antepartum patients.
At the other two facilities, residents perform a high volume of deliveries under the supervision of both USC full-time faculty and volunteer “private” attending physicians. At both private hospitals, the attendings encourage residents to participate actively in the deliveries, and the resident on-call is the primary surgeon for most cesarean sections on the attendings’ private patients. First year residents will spend one block at California Hospital Medical Center and second and third year residents will each spend one block at Hollywood Presbyterian Medical Center. On all obstetrics rotations, teaching by the Maternal-Fetal Medicine faculty is abundant, both at morning pass-on rounds and during conferences several times a week. Furthermore, there is extensive training in ultrasound at all three facilities, both in clinic and on L&D.