1) A lot of social work and scut work
2) Residents don't get experience running codes on the floor because the EM residents do all of them (the EM department at LAC/USC is very powerful)
3) Residents don't get to decide what patients to admit (the ED does)
4) Nurses and ancillary staff are the worst- they are unionized county employees (impossible to fire) so the vast majority of them are lazy and many are rude, and they take pride in sticking it to the MDs because they can. Year after year residents state that the ancillary staff is the worst aspect of the residency program but nothing will ever change.
5) USC medical students avoid the IM program like the plague, and most that stick around either couldn't match anywhere else or they were enticed with the promise of a competitive fellowship (nepotism at USC is huge). Also, USC students who stick around for LAC/USC IM residency get an extra 1500 dollars per year.
6) Last year only 80% of IM graduates passed the IM boards
7) The charting system(s) are garbage
8) Most of the attendings are straight out of residency (inexperienced but tend to be very laid back)
9) The IM department gets very little respect from the other departments at LAC/USC ("...but at least the Med/Peds residents are smart" -Urology resident)
On the plus side of things, you get to see a bunch of interesting and rare cases.
Seems to me that no one should talk unless they give the real facts. Wannabemd - you are just that. Perhaps you are 4th year student unhappy because you did not get that Honors or High pass on your rotation and feel the need to lash out. In any case, one should be fair when giving an opinion and provide all the facts.
I have personal experience at USC and completed my residency there. Some of the things you have stated may have been the case 5-8 years ago, not now. Here is the real deal:
1) Social Work and Scut Work - You do as much social work or scut work as you want to do. Every ward has social workers who do their job. Remember, you are dealing with the underpriveleged and indigent - and it sometimes takes an extra day to get placement on discharged. You DO NOT do blood draws, fax paperwork to the lab, etc etc. That is all nonsense. In fact, if you are a good communicator and discharge planner you are efficient in dealing with the other ancillary services and get your job done quickly! Your job as a physician? You write the orders, care for your patient, and follow on studies - LIKE ANY OTHER HOSPITAL. Flabs, as a student rotating on medicine, perhaps you had the unfortunate job of doing most of the social issues on your team?
2) Codes: The ER GETS THERE LAST!!!! When a code is called the medicine residents are there FIRST! By the time the ED resident arrives it is only for backup and to intubate the patients. The IM residents do not intubate any patients on the floor. The codes, however, are run by the resident who is there first, or the primary team if they arrive during the code. Everything is already running by the time the ED resident arrives!! If anything, you get a great deal of experience with codes!
3) IM Admissions - this is true, the ED decides who to admit. This is a blessing - this is a MAJOR county facility. Med Consult would need to be a team of residents posted in the ED 24 hours a day to run this job. The USC ED alone has over 120 BEDS!!!!! It is almost a favor that they triage and admit those who need to be admitted!!!!
4) Nurses and ancillary staff - this, as with any institution, is hit and miss. There are amazing nurses and lazy ones. Simply put, its again a matter of how you deal with people. The nurses (and this is not just at USC) can be offended or angry when you treat them like second class citizens. If you are polite and show appreciation for the hard work and care they are providing the patient, you will get results. It is not fair to stereotype as "county" workers.
5) USC Medical students staying on for IM - 20% of the current intern class is from USC. MANY have Step scores of 99/99 (245+). The above information is incorrect. In fact, from what I heard, even more are likely to remain this year.
6) Board Pass Rate - USC is serious about the boards. They purchase every single resident MKSAP 15 complete and provide a comprehensive and intensive in-house board review. Perhaps wannabemd misunderstood about pass rate - I heard several residents did not take their exam last year for varying reasons, what does that have to do with pass rate? In fact, the graduating class you are speaking of had around a 90% fellowship match rate.
7) Charting system at USC - all electronic including consult notes with access from practically any computer in the hospital. All medical records are viewable electronically, every computer has amazing access to information including uptodate (on every system). Radiology can be viewed on any computer as well....if anything, the system make your life very easy.
8) Attendings - there are both young and seasoned attendings. There are many world class attendings in the specialites - look up the names Rahimtoola, Kaplowitz, Laine, Heinz, LoPresti, or Om Sharma to name a FEW off the top of my head. In medicine, its a 50/50 split and the young ones are not only approachable and laid back on rounds but work hard/are active at teaching.
9) IM Department Respect - I don't know where that comes from except for the usual issues any hospital has with certain services (do I really have to name the specialty, we all know who I am talking about).
Look, I have nothing to gain from this considering I am already a graduate and am not doing any subspecialty training at USC. Simply put - the program that is at USC now is NOT what was even 5 years ago. There is an amazing new facility, NO MORE overnight call on medicine with a night float system, comeraderie among the housestaff and WORLD CLASS cases. I am so thankful to have had the training experience I did - I can walk into any situation now and know it won't be a problem for me to handle. I hope others who have had first hand experience at USC can give their input - if you disagree with what I am saying please state your opinion, but if you agree please set the record straight.
My step one was great, not derm or plastic surgery good, but it wouldn't not have been a limiting factor for any other specialty . . . so . . . what I'm saying is that when it comes to IM southern california medical students tend to be little, elitist, prick, snobs about it . . . no wonder they are not interested in sticking around LA county and working their ass off.
