USC/California Hospital
Family Medicine Residency

Fellowship in Maternity and Child Health Development

USC/CHMC Family Medicine Residency program has offered a one-year, full-time Maternity and Child Health Development Faculty Fellowship since 1997 that provides training in:

• Low-risk obstetrics
• High-risk obstetrics
• Family-centered perinatal care
• Surgical experience as both first assist and primary surgeon for Cesarean sections
• Obstetric ultrasound
• Colposcopy
• LEEP procedures

Following a one year hiatus in 2005, we are accepting 1-2 fellows per year. These fellows train on two hospital services within CHMC: the Family Medicine Maternity Service and the obstetric service. These patients comprise all levels of risk. The fellows gain a wealth of experience in the management of preeclampsia, pre-term labor, gestational diabetes, and other medical complications of pregnancy.

There is also plentiful experience as first surgeon and first assist for Cesarean sections and other operative cases. Our fellowship graduates have been quite successful at obtaining Cesarean privileges at outside hospitals and, for the first time, at CHMC as well. There are also opportunities to learn to perform post-partum tubal ligations and other gynecologic surgeries.

Family-centered perinatal care is emphasized. Fellows maintain a busy outpatient clinic where more complicated obstetric patients are followed with emphasis on childbirth education and comprehensive continuity care for mother, partner, family and infant.

There is also an emphasis on faculty development with fellows participating in:

1. The precepting of resident and medical students in both inpatient and outpatient setting.
2. Presentations and other curriculum development for residents, colleagues and faculty.
3. Opportunities for clinical research.
   

Maintenance of full-spectrum family medicine is possible through our partnerships with several community clinics and within the residency's family practice clinic.

The USC/CHMC Family Medicine Residency Program has successfully implemented the Maternity and Child Health Development Fellowship for the enhanced training of family physicians in coordinated maternity and family care, surgical preparation, faculty development and managed care administration. Our graduates' careers include faculty positions, C-section privileges, multicultural care, care for the under-served, and both urban and rural work.

The Senior Maternity elective through the USC/California Hospital Family Medicine Residency Program is a high-risk OB experience open to all family medicine residents in their third year of training. The elective is a one month rotation on the OB team, which consists of family medicine and obstetric residents. The service includes patients from family medicine, OB, high-risk OB, and nurse midwife clinics, as well as patients with gynecological problems. Residents are responsible for the labor and delivery deck, antepartum, postpartum, surgical assisting and GYN floor/post-op.

The service performs up to 100 deliveries per month, including SVD's, vacuum assisted deliveries and C-sections. Residents on the maternity elective may assist and possibly perform C-sections by the end of the month, and work closely with the Fellows on antepartum, as well as teaching interns and proctoring deliveries.

The requirement for the elective is a minimum of 30 unassisted SVD's, and the desire to become competent with the above functions. Call is between 7-9 nights per 4 weeks, and post-call days are off after morning rounds.

Maternity Fellows, 2004 - 2005 Joyce Nuesca, M.D. Beth Isreal Medical Center Family Medicine Residency Diana Lev, M.D. Eastern Maine Medical Center Family Medicine Residency Paramjot Mann, M.D. Kern Medical Center Family Medicine Residency