Training Focus by Postgraduate Year
The first year of residency provides a broad experience in the specialty, with rotations in general obstetrics and gynecology, family planning and gynecologic oncology. Other rotations provide experiences in ultrasound, ambulatory medicine, surgical intensive care, anesthesiology, neonatal intensive care and emergency medicine.
The second year of residency includes rotations in obstetrics, gynecologic surgery, gynecologic oncology, family planning and reproductive endocrinology and infertility. The residents spend approximately three to four months at California Hospital Medical Center. Located near downtown Los Angeles, this institution is a busy, tertiary medical center offering high-volume obstetric service, with more than 4,000 deliveries per year, and complex gynecologic surgeries.
Third-year residents, in addition to the core rotations at Cedars-Sinai and California Hospital Medical Center, spend four weeks at Kaiser Permanente in Hawaii. This rotation provides a high-volume obstetrics and gynecology surgical experience in a different healthcare system. The third-year residents also have an elective rotation which is planned according to the resident’s needs and career plans and allows for away rotations, research experience, or focused experience in a chosen subspecialty.
Fourth-year (chief resident) rotations include ambulatory obstetrics and gynecology; inpatient obstetrics and gynecology; reproductive endocrinology and infertility; maternal fetal medicine; and urogynecology rotations. The chief resident supervises junior residents and students under faculty supervision.
On inpatient services of obstetrics, gynecology and gynecologic oncology, residents are responsible for patients of both full-time faculty and private attending physicians, with attending physician supervision. The residents operate with the faculty and private attending physicians and are responsible for patients' postoperative care, in consultation with the attending physician. The attending staff delegates responsibility that is appropriate to the resident's level of training and experience. Residents benefit from high-volume services at all three medical centers.
Residents participate in continuity clinics at the Saban Community Clinic locations in Los Angeles throughout their four years of training. Under supervision of Cedars-Sinai faculty and teaching attending physicians, residents provide the only obstetrics and gynecology services at Saban, a longstanding, established clinic for uninsured and underserved residents of Los Angeles. These services include specialty care for high-risk obstetrics, reproductive endocrinology and infertility, urogynecology and gynecology oncology. In addition, residents provide high-risk obstetric care in a subspecialty clinic at California Hospital Medical Center and a gynecology consultation clinic at Cedars-Sinai.
Each week residents have five hours of protected time for educational programming to cover the curriculum, journal article review, Morbidity & Mortality (M&M) Conferences and Grand Rounds. Educational activities include simulation exercises, hands-on experiences, and interactive "theme weeks." Other weekly conferences occur in gynecology, high-risk obstetrics, fetal monitoring, gynecologic oncology, gynecologic pathology, reproductive endocrinology and infertility, family planning and urogynecology.
Medical Student Education
Cedars-Sinai is actively involved in training UCLA medical students. Third-year medical students from UCLA complete the required obstetrics and gynecology clerkship at Cedars-Sinai, and there are several sub-internships available for fourth-year medical students.
Training Programs in Gynecologic Specialties
Cedars-Sinai is widely known for its special programs in surgical endoscopy and laser therapy. Several members of the full-time and attending staff are world leaders in this field. A laparoscopy course, offered annually, includes resident participation, and a new program for training and certification in robotic surgery is being piloted for resident physicians. Our Women’s Guild Simulation Center has state-of-the-art facilities for training, practice, and evaluations, including a virtual reality simulation room, where residents have around-the-clock access to ultrasound, robotics and laparoscopy simulators.
In October 2014, the Department of Obstetrics and Gynecology received a grant from the Kenneth J. Ryan Residency Training Program in Abortion and Family Planning. Under this program, residents receive specialized training from nationally recognized family planning faculty in all methods of uterine evacuation, miscarriage management, abortion care, evaluation of early pregnancy and contraceptive care.
Residents are required to complete a research project, under faculty advisor direction, that is suitable for publication. Residents present their research proposal in the fall of their second year and their completed study and results at a "Residents Research Day" in the spring of their third year. As a graduation requirement, residents prepare and submit a manuscript suitable for publication.
Patient Safety Curriculum
Each resident is required to complete one patient safety project or quality improvement project. Residents present their completed project and findings at a dedicated "Patient Safety" conference in the Spring of their chief year as a graduation requirement. Residents also participate in patient safety educational programming including lectures, simulations and drills, and attend root cause analysis and quality improvement/risk management meetings.