Graduate Medical Education

The Department

Cleveland Clinic Florida's Department of Colorectal Surgery is a very busy clinical and research oriented department in which patients with a broad spectrum of colorectal pathology are treated. A one year comprehensive clinical colorectal residency is offered by our department. Four colorectal residents are chosen each year through the National Residency Matching Program. A preliminary optional research year is also offered for one of the four positions. In addition, there are between ten and twelve research residents whose appointments are on a staggered basis for six months to one year.

Approximately 5,200 patients were seen in the office clinic in 1997 and over 2,300 operations were done by the three full time, board certified faculty and staff colorectal surgeons, Drs. Steven D. Wexner, Juan J. Nogueras, Eric G. Weiss and Dana R. Sands, David Maron, Lester Rosen, and Giovanna Dasilva. Other staff includes nurse clinicians who facilitate patient care and help with the day-to-day patient management including assisting in the office and in the operating room. They also perform preoperative history and physical examinations, handle patient phone calls, and calling in prescriptions. Their invaluable assistance allows the residents more time for interaction in the operating room, the endoscopy suite, office, and physiology lab. There are also three dedicated colorectal clinic nurses, two enterostomal therapists, one biofeedback therapist, and two research nurses.

Clinical Procedures

Approximately 80-100 patients are seen in the office each week and evaluated for a wide gamut of colorectal complaints. Procedures such as rubber band ligation of internal hemorrhoids, excision of thrombosed external hemorrhoids, superficial fistulotomies, incision and drainage of abscesses, incision and drainage of pilonidal abscesses, rectal and perianal biopsies, and fulguration of lesions are performed in the clinic.

In addition, there are approximately 10-20 rigid proctoscopies and 15-25 flexible sigmoidoscopies performed in the clinic setting each week. In addition, approximately 15-20 colonoscopies are performed each week, approximately two-thirds of which are therapeutic, rather than diagnostic.

There are approximately 15-20 abdominal and anorectal surgeries performed in the hospital each week. The most frequently performed procedures are restorative proctocolectomy with J-pouch and ileoanal anastomosis and restorative proctectomy with colonic J-pouch and coloanal anastomosis. However, all major colorectal procedures are performed with regularity; a large portion of the practice includes reoperative surgery.

In 1991, Drs. Wexner and Jagelman became interested in the potential applications of laparoscopy to colorectal surgery. As a result, we now have one of the world’s largest series of laparoscopic colorectal surgical procedures. All residents gain intensive laparoscopic training. There is heavy emphasis on anorectal procedures relating to disorders of evacuation such as sphincteroplasty for fecal incontinence and perineal rectosigmoidectomy with levatoroplasty for rectal procidentia.

Our surgeons have the largest U.S. experience with the stimulated gracilis neosphincter for fecal incontinence and are also utilizing the artificial sphincter for fecal incontinence. Our published series of sphincteroplasty for fecal incontinence and colectomy for constipation are among the largest homogeneous series in the world. In addition, the standard spectrum of anorectal operations is also performed. Overall, there are over 200 anorectal, 400 abdominal, and 800 endoscopic procedures performed each year.

Anorectal Physiology Laboratory

One of the highlights in the department is a very busy Anorectal Physiology Laboratory. This multi-disciplined specialty unit allows the evaluation of disorders of evacuation, including chronic constipation and fecal incontinence. Included in the lab are anal sphincter electromyography, pudendal nerve terminal motor latency assessment, anorectal manometry with rectal compliance evaluation, anal ultrasonography, cinedefecography with proctography, pancolonic transit times, and small bowel transit evaluation. About 12-15 of these procedures are performed on a weekly basis and greatly aid in the understanding of the etiology behind these diseases as well as in the formulation of the appropriate therapeutic outline. The residents are encouraged to participate as much as possible in activities in the Anorectal Physiology Laboratory.

In addition, there is an intrarectal ultrasound unit located in the Department which permits a high volume experience. The residents are encouraged to become familiar with the performance and interpretation of rectal ultrasonography.

Teaching Conferences

• Core Curriculum Conference
• Ultrasound Conference
• Anorectal Physiology Conference
• Teleconference with Cleveland Clinic Foundation Colorectal Surgery
• Practice Talks
• Radiology Conference
• Pathology Conference
• Colorectal Surgery Tumor Board
• Journal Club
• Research Forum
• Surgical Grand Rounds
• Surgical M & M
• CARSEPS Conference
• Other Meetings

Cleveland Clinic Florida hosts and sponsors the Annual International Colorectal Disease Symposium each year in February in Fort Lauderdale. Having become one of the largest annual postgraduate colorectal courses in the world, approximately 1,000 registrants were in attendance during the 1998 symposium, approximately 60% of whom were from 61 foreign countries. This intensive three day symposium provides in-depth analytical review of colorectal diseases. Popular areas covered include, but are not limited to, laparoscopy, colorectal carcinoma, inflammatory bowel surgery, and pouch surgery. A comprehensive review of both basic and advanced principles of diagnosis and management of a broad spectrum of commonly seen colorectal diseases will occur along with emphasis on controversial topics including pouch surgery, surgical emergencies, physiologic tests and applications, recurrent disease, and new diagnostic and therapeutic modalities.

The department covers the cost for our residents and fellows to attend this symposium.

In addition, support is provided for colorectal residents to attend a meeting(s) as a registrant or participant with the approval and/or direction of the department chairman.

More Information

Marisol Quintana
Graduate Medical Education
Cleveland Clinic Florida
Phone: 954.659.5240
Toll-free: 800.359.5101 ext. 56211
Fax: 954.659.5184
Email: quintam@ccf.org

Cleveland Clinic Florida's General Surgery Residency Program welcomes your interest in training here. This is a five-year, non-pyramidal program with 3 categorical positions per year, including 3 preliminary for PGY 1 and 3 preliminary PGY 2. Our commitment is to train young surgeons in a high level of clinical competence, while at that same time teaching them the importance of an up-to-date knowledge of surgical science.

The Residency Review Committee of Surgery approved the establishment of a new General Surgery Residency Program at Cleveland Clinic Florida beginning July 1, 2012.

Training in General Surgery includes management methods, critical appraisal of the literature and the role of clinical and basic research in advanced surgical science. These elements are the basis of the program with a staff with diverse interests and expertise.

General Surgery continues to change and evolve with increased understating of pathophysiology, enhanced technologies, and multidisciplinary approaches to improving treatment outcomes. Our department is at the forefront of such advances, with commitment to educate our residents through this clinical experience in combination with a structured teaching program and conferences.

We believe our Residency Program offers outstanding training, which will equip you to practice the art and science of surgery.

• Raul Rosenthal, MD
  Chairman, Department of General Surgery
  Program Director
• Mark Grove, MD
  Associate Program Director
• Conrad Simpfendorfer, MD
  Associate Program Director

PGY 1 Applications will be accepted only through ERAS.

Curriculum

The Residency Program

PGY-1

• General/Vascualr/Breast Surgery
• Minimally Invasive and Bariatric Surgery
• Plastic Surgery
• Cardiothoracic Surgery - Memorial Regional Hospital
• Night Float Call Service
• Pediatric Surgery – Memorial Regional Hospital <

PGY-2

• General/Vascular/Breast Surgery
• Colorectal Surgery
• Gynecology
• Urology
• Cardiothoracic Surgery – Memorial Regional Hospital
• Pediatric Surgery – Memorial Regional Hospital
• Trauma – Memorial Regional Hospital

PGY-3

• General/Vascular/Breast Surgery
• Minimally Invasive and Bariatric Surgery
• Pediatric Surgery – Memorial Regional Hospital
• Night Float Call Service
• Trauma – Memorial Regional Hospital

PGY-4

• General/Vascular/Breast Surgery
• Trauma – Memorial Regional Hospital
• Cardiothoracic Surgery – Memorial Regional Hospital
• Liver Transplant – Cleveland Clinic, Ohio

PGY-5

• General/Vascular/Breast Surgery
• Minimally Invasive and Bariatric Surgery
• Colorectal Surgery

Teaching Conferences

Morbidity & Mortality (weekly)
Oncology Conference (weekly)
GI oncology Conference (weekly)
Colorectal Conference (weekly)
Bariatric Conference (weekly)
Chief Rounds (weekly)
Surgical Grand Rounds
Surgical Science Course
Surgery Journal Club (monthly)
Bariatric Journal Club (monthly)

Contact Information

If you have questions about the General Surgery Residency Program, please contact:

Diana Niño
Residency Coordinator, General Surgery
Cleveland Clinic Florida
Graduate Medical Education
2950 Cleveland Clinic Boulevard
Weston, Florida 33331
Phone: 954.659.5815
Fax: 954.659.5622
Email: flgsprg@ccf.org

The internal medicine residency program at Cleveland Clinic Florida is an intensive three-year training program offering 9 categorical positions per year and up to three preliminary first year positions, with a total possible number of thirty residents.

• Learn more about the Internal Medicine Residency Program

Neurological disorders seriously affect a large and varied patient population, from a child learning to cope with epilepsy, to young men and women facing the crippling effects of multiple sclerosis in the very prime of their lives, to the elderly slowly fading away from their families under the burden of Alzheimer’s Disease. For these patients and many more, help depends on the experience and training of a qualified neurologist and neurology staff in conjunction with a medical facility offering the latest in current technology and research.

Program Objectives

The goal of Cleveland Clinic Florida's Neurology Residency Training Program is to graduate first rate neurologists with the clinical skills, judgement and experience to diagnose and treat patients within the full range of neurological disorders, and to provide them an opportunity to pursue clinical research in a field of their choosing.

Program Description

We have designed our program to provide residents a thorough education in all aspects of adult and pediatric neurology with emphasis on training of a solid, competent clinical neurologist capable of pursuing any avenue of neurologic practice, be it academic or clinical practice.

Our three-year residency program accepts two residents a year at the PGY-II level, following the required prerequisites set forth by the ACGME. PGY I is offered. The resident is assured of receiving a thorough education in all aspects of neurology. Residents are involved in both inpatient and outpatient services at the Clinic in addition to adult neurology, pediatric neurology and neuropathology.

Exposure also involves neurosurgery, psychiatry, neuropathology, neuro-ophthalmology and other specialists on how to treat medical conditions that affect or are affected by neurological diseases, as well as those conditions that mimic neurological disorders. Elective rotations are available in neuro-ophthalmology, neuro-radiology, neurophysiology, sleep disorders, EEG, movement disorders, stroke and clinical research.

Training in adult neurology and electives takes place in Fort Lauderdale and is enhanced by weekly video conferences with the Department of Neurology at Cleveland Clinic. The required pediatric and neuropathology rotation, three months each, are scheduled at Miami Children’s Hospital and at the Foundation in Cleveland, Ohio, respectively. Cleveland Clinic Florida assumes the cost of transportation to and from Cleveland and for housing during the training period.

Faculty

Cleveland Clinic Florida’s Department of Neurology is comprised of experienced, board certified specialists who represent the full spectrum of adult neurological sub-specialties: stroke, movement disorders, sleep disorders, epilepsy, electrophysiology, neuromuscular disorders, dementia and Parkinson’s Disease.

Each member of the neurology team is committed to the success of the individual resident creating an atmosphere that enables the resident to learn.

• Efrain D. Salgado, MD, Program Director, Residency Training Program
• Nestor Galvez-Jimenez, MD, Chairman, Department of Neurology
• Maurice R. Hanson, MD
• Adriana Rodriguez, MD
• Tara Khan, MD
• Virgilio D. Salanga, MD

More Information

Residency Coordinator, Neurology
Phone: 954.659.5359
Toll-free: 866.293.7866
Fax: 954.659.6216
Email: neuroprg@ccf.org

Cleveland Clinic Florida
2950 Cleveland Clinic Boulevard
Weston, Florida 33331
Phone: 954.659.5000

Program Director

Martin I. Newman, MD, FACS

Cleveland Clinic is one of the nation’s largest and most respected group practice organizations with hundreds of full-time physicians across the country. Cleveland Clinic Florida's campus in Weston offers several graduate medical education training programs including a fully accredited three-year, independent Plastic Surgery residency. The broad patient base and extensive expertise of the institution’s faculty provide an excellent training environment in a congenial atmosphere with a civilized approach to resident education.

This compilation of materials is intended to help the plastic surgery resident candidate to gain a general overview of the residency program. The text that follows is for informational purposes only and is superseded by changes often.

We are currently accepting applications through the San Francisco Match www.sfmatch.org. The application process begins two years prior to the anticipated start date and usually follows the timetable below:

• July: Application period opens
• December: Application period ends
• January – April: Interviews by invitation
• May: Match
• June: Orientation begins (last week of June)

The Program

The faculty of the Department of Plastic and Reconstructive Surgery at Cleveland Clinic Florida is deeply committed to our residents and their education. Our Program is a three-year, independent residency program accepting candidates who are board eligible in general surgery residency or are board eligible in subspecialties such as orthopedics, otolaryngology, oral surgery, and urology.

We offer two residency spots per year. There are no “Fellows” in plastic surgery. Neither are there residents or fellows in Otolaryngology, Dermatology, or may other specialties obviating the need to compete for cases. Therefore, our residents gain the broadest clinical experience possible. With guidance, residents-in-training are exposed to the many diverse areas within our specialty. Our particular strengths include: aesthetic surgery, breast surgery, body contouring following weight loss, hand surgery and craniomaxillofacial surgery.

Accreditation

Cleveland Clinic's Plastic Surgery Residency Program was initiated in 2004 after receiving accreditation by the ACGME Residency Review Committee to administer an independent training program.

Our most recent site visit found no citations and we continue to be fully accredited.

Clinical Experience and Goals of Training

The primary goal is to train competent plastic surgeons who will be well-prepared to pass their board examinations in plastic surgery, be safe enough to enter solo private practice or be sufficiently academically equipped for further training towards either sub specialization or a university career. The ethos of the program is founded on the principle that the patient’s interest is paramount in clinical teaching, medical practice and research.

Beginning in 2012 all independent plastic surgery residencies evolved from two year programs to three year programs. Part of this evolution introduced six new rotations into the curriculum: Anesthesia, Orthopaedics, Otolaryngology, Dermatology, Neurosurgery and Oral Maxillofacial Surgery. Like all plastic surgery residencies, we are currently integrating these rotations into our curriculum. This has proved to be a natural fit for our residents who already work closely with most of these services at our Institution who warmly welcome surgeons-in-training on their services.

Otherwise, residents will divide their time between Cleveland Clinic Florida's Weston campus, and the Hollywood regional Memorial campus (including the Hollywood Regional Memorial Hospital, Memorial West, and Joe DiMaggio Children’s Hospital). Additional locations include local surgery centers, physician offices and a Burn Rotation at Shands Hospital.

During their time with us the resident will gain experience in the breadth of plastic and reconstructive surgery He or she will learn by observation, participation and direct patient interaction the presentation of the majority of diseases, deformities and aesthetic discomfitures seen by plastic surgeons in the community and in the academic centers. The resident will also gain hands-on experience with the surgical management of these conditions, and assist in their preoperative workup, surgical treatments and follow-up care in the out-patient clinics. The resident will be expected to research the literature on a case-by-case basis and thoroughly understand the anatomy, the pathology and the surgical principles underlying the management of his or her patients.

He or she will be expected to master the basic techniques of wound closure, skin grafting, flap elevation, tendon suture, nerve repair, as well as fracture reduction-fixation in the hand and face. He or she will acquire the skills required to surgically expose the facial skeleton and approach any pathological process occurring in the hand.

The resident will learn by direct observation and participation the advantages and limitations of the grafting skin, bone, fat, cartilage, nerve, fascia and tendon. He or she will become familiar with the various synthetic implants used in plastic surgery including breast prostheses, injectable materials, facial implants, acellular matrixes and small joint replacements.

The resident will learn how to use the surgical instruments employed by plastic surgeons including the dermatome, the operating microscope and endoscopic equipment. They will gain familiarity with intraoperative laser imaging as it pertains to plastic surgery. The resident will be expected to have achieved a basic level of competence in microvascular surgery and be able to act as first assistant during microvascular or microneural anastomosis. The resident will become proficient at Shands Hospital in managing a serious burn injury and be vigilant to the dangers of inhalation injury and full-thickness circumferential burns. He or she will develop the skills at Shands necessary for early excision of burns and the handling of smaller full-thickness burns in critical areas. Last but not least, he or she will learn to apply aesthetic principles in all aspects of plastic surgery and make that vital transition from a General to a Plastic Surgeon.

As training matures resident training will focus more so on the acquisition of the skills and knowledge essential for the major subspecialties of plastic surgery, namely aesthetic surgery, breast surgery, pediatric plastic surgery, cleft surgery and craniofacial surgery. At the same time, the resident will be expected to refine his or her skills in the more general aspects of plastic surgery encountered during the early months of exposure: wound care, facial flap reconstruction and microvascular surgery.

The resident will develop the skills necessary to conduct a cosmetic consultation with some reasonable expectation that, should the surgery be indicated, the patient will have the confidence to book it. At the same time, the resident will come to realize that complications will always be with us and that the art of plastic surgery is not just in knowing how to correct them when they occur, but how to manage the patient during the process. The acquisition of this art is one of the goals for the mid-level resident.

Attending physicians will closely monitor the resident’s assessment of aesthetic deformities, his or her formulation of a treatment plan and the skills required for its execution. The goal here is for the resident to acquire a level of skill sufficient to equip him or her to deal comfortably with the common aesthetic problems seen in a plastic surgery practice.

During the craniofacial/cleft/pediatric rotation, the resident will be part of the craniofacial team that assesses new patients with clefts and craniofacial deformities. He or she will learn to accept the input of differing health care professionals and synthesize a common treatment plan based on a multitude of interests and priorities. The resident will appreciate the vital importance of dental occlusion, orthodontics and speech therapy in craniofacial surgery and will be taught to take his or her own dental impressions. It is in this rotation that the resident will become comfortable reading complex CT scans of the skull and mandible and defining the extent of the craniofacial deformities encountered.

The resident will be expected to become competent in cleft lip and palate repair. He or she will gain a fundamental understanding of the principles of craniofacial surgery and assist in the more advanced applications of osteotomies, bone grafting and synthetic implant placement that he or she encountered in year one. He or she will be given wide exposure to pediatric patients (as well as their parents), made aware of the effect of various reconstructive modalities on growth and gain experience in many congenital and developmental disorders infrequently encountered in the adult population.

By the time the resident is ready for graduation, he or she will be qualified to successfully apply the principles learned and skills acquired to treat any plastic surgical deformity or disorder.

Didactic Curriculum

We are extremely proud of our didactic curriculum which is meticulously designed and supervised. The core curriculum cycles through all major topics in our specialty - and repeating them annually. We have chosen a one year cycle rather than spreading these topics over two or three years because of potential resident vacations, meetings, illnesses, and outside rotations. Rather than missing an entire week and, therefore, an entire subject, the residents gain exposure to the topic multiple times throughout their training which facilitates “learning in layers.”

During the week each respective topic is addressed at weekly conference. Preoperative diagnoses, clinical evaluations, relevant anatomy, pathology, embryology, intraoperative management and complications are discussed in detail. Any resident may be called upon to discuss different patient issues. A staff person heads Monday's 2 hour conference and classic articles on the weekly topic are presented and critiqued.

Core conferences will be augmented by a morning weekly conference held Tuesdays that deals with several issues. They include an “Indications and Evaluations” conference, a resident research conference, and special topics presented by the plastic surgery residents and staff.

One Monday evening per month is dedicated to Journal Club. Journal Club is an enjoyable gathering of the academic surgeons and residents, voluntary staff and the community plastic surgeons from Miami, Broward and Palm Beach counties. It is an exciting opportunity to share and to learn, Networking opportunities abound. Many of our residents have reported Journal Club to be one of the most enjoyable parts of their residency.

To comply with the Special Requirements in Plastic Surgery, staff persons outside plastic surgery will be recruited to cover a number of miscellaneous topics. These topics include but are not limited to medical-legal aspects of plastic surgery, medical ethics, practice management, radiation oncology, anesthesia and chemotherapy.

Mock Inservice Exams and Mock Oral Boards will be given several times annually.This is done to simulate, as closely as possible, actual American Board of Plastic Surgery exams. Residents report this to be an extremely positive learning experience that helps them prepare for the “real thing.”

The residents are required to take the annual ASPS in-service examination in each year in March.

Visiting professorships will be encouraged. Local experts will be used extensively and three times per year a professor will be brought from further afield.

Finally, basic service or clinical research, emphasizing in publication and/or presentation, is a mandatory requirement of the program.

Advisers

Each resident is encouraged to select a faculty adviser early in his or her first year. The adviser acts to both focus the resident’s clinical research and to shepherd the resident through his or her clinical training.

Practice Examinations

Each year, Mock Inservices and Mock Oral Exams are administered on. The ASPS PSEF written in-service examination each year is also a required exam and is used as a tool for promotion to the next year.

Teaching Experience

Residents have opportunities to teach junior residents and medical students in clinic, hospital and surgical settings. Opportunities also exist for presentations to staff at Cleveland Clinic.

ACLS

Basic and Advanced Cardiac Life Support certification is required for all Cleveland Clinic residents and fellows. Cleveland Clinic will assist in training and the certification examination.

Research Experience

The Plastic Surgery research program is directed by Dr. Eric Stelnicki. Plastic Surgery residents are expected to complete one clinical research project per year. There is ample opportunity to participate in ongoing research projects. In addition, residents are encouraged to initiate research of interest to them as primary investigators.

Evaluation

The progress of residents is monitored throughout the training program. Specifically evaluated are progresses in the six core competencies as defined by the ACGME. The PSOLs are periodically reviewed, and the residency director meets formally with the residents during the two years.

Resources

Between the facilities, residents will have access to advanced facilities for plastic surgery training including: lasers, microsurgery facility, minimally invasive surgery equipment, ultrasonic-assisted liposuction technology and computer imagingcapabilities.

Information Services

All Cleveland Clinic Florida reference materials are available to the resident in training on a 24/7/365 basis. Librarians are available to assist with retrieval of desired medical information. Residents have access to Windows-networked computers for their use in acquiring information on patient care, education and research. Word processing, database, statistics and presentation software also is available.

Appointments and Applications

To apply to the Plastic Surgery Residency Program, please check the San Francisco Match website (www.sfmatch.org) for the current application process.

More Information

Residency Coordinator
Cleveland Clinic Florida
2950 Cleveland Clinic Boulevard
Weston, Florida 33331
Phone: 954.659.5000
Fax: 954.659.6216
Email: gme@ccf.org

Residency Application (161KB)

Cleveland Clinic Florida's Plastic Surgery Residency currently participates in the Plastic Surgery Residency Match Program starting with the class of 2010. However, updates are posted on the San Francisco Match web page: www.sfmatch.org.

Revised 01/2013

Cleveland Clinic Florida in Weston offers a three-year fellowship in Cardiology for physician’s board eligible/certified in internal medicine. The program provides depth in major specialty fields including cardiovascular imaging, electrophysiology, invasive cardiology, congestive heart failure, clinical cardiology, intensive care, preventive cardiology and vascular medicine.

Distinguished faculty members of the Department of Cardiology are well published and feature speakers at local and national cardiac meetings. Joint research trials and educational efforts including elective and mandatory rotations are shared with Cleveland Clinic in Cleveland.

Cleveland Clinic Florida is a continuum of the long tradition of innovation in cardiac care and research in Cleveland, Ohio. The facility in Weston Florida provides state-of-the-art diagnostic and therapeutic capabilities including cardiac computed tomography and magnetic resonance imaging, a 24-hour Med-Alert acute myocardial infarction program, all contemporary electrophysiological procedures including atrial fibrillation ablation and biventricular pacing and surgical procedures including minimally invasive, cardiac robotic assisted surgery.

As a primary and tertiary referral hospital in South Florida, Cleveland Clinic Florida has a diverse mix of patients including many patients of international origin. This provides for a busy and interesting clinical practice and opportunities for research and education. The Department of Cardiology is interested in applicants of all background for consideration for fellowship training.

Craig R. Asher, MD, FACC Program Director

More Information

Program Coordinator
Cleveland Clinic Florida
2950 Cleveland Clinic Boulevard
Weston, Florida 33331
Phone: 954.659.5000
Fax: 954.659.6216
Email: gme@ccf.org

The Cleveland Clinic Florida offers a three-year program providing in-depth training in gastroenterology, hepatology, and nutrition as well as training in clinical research to qualified applicants who have successfully completed their training in internal medicine. At any given point there are 4 trainees in the program with 1-2 positions available each year.

The program’s goals are fourfold: to meet the training guidelines of the American Society of Gastrointestinal Endoscopy in all basic endoscopic procedures; to provide the inpatient and consultative gastroenterology skills necessary to understand, diagnose and treat a wide-range of gastrointestinal disorders; to develop teaching abilities; and to provide a meaningful and stimulating clinical research experience. There is sufficient flexibility to provide the necessary skills for trainees that wish to pursue an academic or clinical practice career.

The first year of the fellowship is mostly a clinical year with rotations in the inpatient/outpatient gastroenterology and hepatology service, endoscopic procedures and motility laboratory. The second and third year also includes rotations in the hepatology and liver transplant service in Cleveland Clinic, Ohio. Research is expected to be an evolving process during the full 3 years of training with dedicated rotations each year. Under the careful supervision of a mentor, fellows are expected to design, implement and publish a research study.

The facilities and equipment are state of the art providing for training in ERCP, endoscopic ultrasound, capsule endoscopy, enteroscopy and motility. We have an outstanding faculty of 8 full time gastroenterologists in our Weston facility with subspecialty interests in colon polyps and cancer, nutrition, hepatology, gastrointestinal motility, advanced endoscopy, pancreas and inflammatory bowel disease. In addition to our own faculty, we closely interact with the divisions of colorectal surgery, bariatrics, radiology and pathology to provide for a well-rounded educational experience.

An extensive monthly conference schedule allows for formal teaching and the opportunity to develop teaching skills.

• Journal Club
• Management Conference
• State of the Art
• Research
• Basic Science
• Pathology
• Radiology
• GI Board Review
• Hepatobiliary
• Inflammatory Bowel Disease
• GI Oncology
• Teleconference with Cleveland Clinic Foundation Gastroenterology

Fernando J. Castro-Pavia, MD
Program Director

Program Coordinator
Cleveland Clinic Florida
2950 Cleveland Clinic Boulevard
Weston, Florida 33331
Phone: 954.659.5000
Fax: 954.659.6216
Email: gme@ccf.org

The fellowship in Geriatric Medicine encompasses exposure to older persons who are well, frail, or at end of their life. The venues for training are at the outpatient, inpatient hospital, rehabilitation unit, hospice care and long term care skilled nursing home facility. The fellow will be expose to physiology of aging, normal changes of aging and interaction with diseases, pathophysiology of common geriatric syndromes e.g. urinary incontinence, falls, dementia, and decubiti ulcers and deal with various psychosocial issues. After the training, this should enable physicians to assume leadership in the academic medical centers and in the community through clinical, educational, research and administrative activities.

The fellowship training is for one year and all the activities are spent in clinical rotation at the outpatient, inpatient, rehabilitation hospital, nursing home and home care visits.

Jerry O. Ciocon, MD, FACP, FACA, AGSF
Program Director

Program Coordinator
Cleveland Clinic Florida
2950 Cleveland Clinic Boulevard
Weston, Florida 33331
Phone: 954.659.5000
Fax: 954.659.6216
Email: gme@ccf.org

The Department of Hypertension & Nephrology provides comprehensive diagnostic and therapeutic services for patients with renal disease and hypertension. The department participates in an active renal transplant program, all modalities of dialysis care, and clinical research studies. In addition to unique diagnostic capabilities, the department offers specialty clinics in renal stone disease, renal transplantation, chronic renal diseases and hypertension.

A two-year nephrology-hypertension fellowship is offered within the department, with one fellow at each level. The fellowship program is open to those who have completed a three-year internal medicine residency.

Mauro Braun, MD
Program Director

Program Coordinator
Cleveland Clinic Florida
2950 Cleveland Clinic Boulevard
Weston, Florida 33331
Phone: 954.659.5000
Fax: 954.659.6216
Email: gme@ccf.org

The Pulmonary Fellowship Program at Cleveland Clinic Florida is the newest ACGME accredited pulmonary program in the State of Florida. The program strives to provide an outstanding educational experience in an environment that assures a balance between academic, clinical activities as well as clinical research. It takes great pride in preparing fellows to become the next generation of expert practitioners.

The Department of Pulmonary disease has eight members that are all committed educators and bring years of experience and commitment to teaching to the program. The diversity of clinical material is enhanced through the collaboration with other departments at Cleveland Clinic Florida such Cardiothoracic Surgery, Radiology, ENT, Allergy & Immunology and Pathology.

During their two years of training, the fellows have exposure to various disciplines of pulmonary medicine with strong subspecialty training in pulmonary hypertension, interventional pulmonology, thoracic oncology, interstitial lung disease, bronchiectasis and sleep medicine.

In addition to education which centers around patient care interactions, the program has comprehensive didactic conferences. The fellows are required to attend two weekly core curriculum conferences, as well as a monthly Pulmonary Medicine Grand Rounds, Journal Club, Morbidity & Mortality Conference and an interdisciplinary Thoracic Oncology Conference.

Program Director

Laurence Smolley, MD

Associate Program Director

Anas Hadeh, MD

Program Coordinator
Cleveland Clinic Florida
2950 Cleveland Clinic Boulevard
Weston, Florida 33331
Phone: 954.659.5000
Fax: 954.659.6216
Email: gme@ccf.org

Program Director

Virgilio D. Salanga, MD, MS
Chairman, Department of Neurology

Electrodiagnostic medicine is the medical subspecialty that applies neurophysiologic techniques to diagnose, evaluate and treat patients with impairments of the neurologic, neuromuscular and/or muscular systems.

Qualified practitioners require knowledge in anatomy, physiology, kinesiology, histology and pathology of the brain, spinal cord, autonomic nerves, cranial nerves, peripheral nerves, neuromuscular junction and muscles. They must know clinical features and treatment of disorders of the central, peripheral and autonomic nervous systems as well as those of neuromuscular junction and muscle. Practitioners also require special knowledge about electric signal processing, including waveform analysis, electronics and instrumentation, stimulation and recording equipment and statistics.

In an ACGME approved adult neurology residency, residents obtain 1-3 months rotation in Electrodiagnostic medicine. This is insufficient time to meet the standards for knowledge, skills and experience required for certification by the American Board of Electrodiagnostic Medicine. This is also insufficient time for those who aspire to focus their future practice toward neuromuscular neurology.

Additional period of training/preceptorship in electrodiagnostic medicine under the direct supervision of an experienced electrodiagnostic medicine consultant who is ABEM Board Diplomate is the best way to offer such training and experience.

Applicants

Applicants must have satisfactorily completed a Neurology Residency Training Program accredited by the Accreditation Council for Graduate Medical Education (ACGME).

The Program

Month 1

Supervised performance of Nerve Conduction Tests, Electromyography, Evoked Potential Studies. Didactic lectures in neuromuscular anatomy, physiology and instrumentation. Didactic lectures in clinical and electrodiagnostic examination correlation.

Months 2-3

Graduated reduction of supervision in conducting electrodiagnostic examination/consultation. Clinical case presentation to the department staff and residents.

Months 4-12

Substantial autonomy in conducting electrodiagnostic examinations under limited staff supervision. Research projects planned and completed during this remaining period.

Research

The fellow is required to plan and complete a clinical research project of his/her choice in electrodiagnostic medicine with results submitted for presentation at a national meeting and subsequent publication in a peer-reviewed journal.

Fellow Teaching

The fellow is required to actively participate in the teaching of neurology residents as the residents rotate in this discipline and by giving lectures and presentations.

Teaching Staff

Virgilio D. Salanga, M.D., M.S., Program Director, Electrodiagnostic Medicine
Chairman, Department of Neurology
Cleveland Clinic Florida
Associate Professor of Clinical Neurology, The Cleveland Clinic Foundation Health Sciences Center of The Ohio State University

Nestor Galvez-Jimenez, M.D., FACP
Chief, Movement Disorders
A National Parkinson Foundation Center of Excellence
Director, Neurology Residency Training Program
Cleveland Clinic Florida

Adriana Rodriguez, M.D.
Staff, Department of Neurology
Cleveland Clinic Florida

Mary Ronnenberg
Chief Technologist, Department of Neurology
Cleveland Clinic Florida

Rotations

No off campus rotations are planned.

Goals and Objectives

At the end of this fellowship, the fellow will be very proficient in electrodiagnostic medical consultations and will satisfy the eligibility requirements of the American Board of Electrodiagnostic Medicine.

Evaluations

Evaluation of fellow with feedback to fellow at least twice per year.
Evaluation of staff and program at least twice per year.

Fellow Salary and Benefits

Salary is at the PGY5 level plus fringe benefits as listed in the House Staff Benefits and in the Graduate Physician Policy Manual.

More Information and Application

Graduate Medical / Medical Student Education
Cleveland Clinic Florida
2950 Cleveland Clinic Boulevard
Weston, Florida 33331
Phone: 954.659.6211
Toll-free: 866.293.7866
Fax: 954.659.6216
Email: gme@ccf.org

Program Director

Raul J. Rosenthal, MD
Head, Section of Minimally Invasive Surgery
Department of General and Vascular Surgery

Due to the rapid development of optoelectronic technology and new instrumentation minimal access surgery has become to play a significant role in all surgical specialties. Endoscopic surgical techniques for diseases of the gastrointestinal tract, urology, obstetrics/gynecology, diseases of the spine, abdominal wall hernias, morbid obesity, etc. are some examples that are approached endoscopically on a routine basis achieving the highest standards of medical care.

The establishment of a UMIS is aimed to improve service functions and management of surgical endoscopy by:

• Development and coordination of an educational and research program in endoscopic surgery together with other surgical subspecialties.
• Assist in the coordination of endoscopic activities to be performed by different surgical disciplines at CCF (obstetrics/gynecology, urology, orthopedics, vascular surgery, etc.).
• Provide appropriate instruction to attending staff, operating room nursing staff, fellows and residents with the endoscopic equipment.
• Ensure that equipment is appropriately handled, delivered, assembled, cleaned and maintained. This will allow to avoid, early recognize and report breakage as well as to ensure that regular servicing is performed of delicate endoscopic, electronic and video materials.
  • Enhancement of inventory control and improved equipment utilization avoiding specialty specific instrumentation and duplication of equipment.
  • More effective management and cost-effective purchase of equipment.
  • Maintain high standards of endoscopic services during 24 hours a day.

Laparoscopic surgery is one of the most desired postgraduate surgical specialties. Divisions of laparoscopic surgery are being established in most of the major institutions of our country.

The Program

This program is designed to give intensive clinical and research training in all phases of minimally invasive surgery. The fellowship consists of one year of clinical experience and an optional year of research. Applicants must have completed their basic training in general surgery and be able to obtain a Florida license in order to practice surgery. One applicant per year will be selected following the standard protocol of the Department of Surgery at CCF.

Fellowship Impact on Patient Care and Services

Surgery of the foregut
It will focus on benign and malignant disease of the foregut. Morbid obesity and gastroesophageal reflux disease as well as associated swallowing disorders will be specifically addressed. We will focus on minimally invasive techniques for gastric bypass, gastric banding, Nissen’s fundoplication, Heller’s myotomy, etc.

Surgery of the biliary tree, liver and solid organs
We will concentrate in the performance of laparoscopic cholecystectomies, common bile duct exploration as well as the routine use of cholangiogram and intraoperative ultrasound to detect abnormalities of the liver and biliary tract. Excision and cryoablation of liver lesions, splenectomy or palliative bypass procedures for malignant outlet obstructions of the biliary tree will also be performed.

Endoscopic endocrine surgery
New endoscopic approaches to endocrine diseases of the parathyroid and adrenal glands as well as diseases of the pancreas will be implemented.

Abdominal wall hernias
Incisional as well as inguinal hernias will be approached through the laparoscope. Fellows will be able to identify the indications when to use the open or laparoscopic approach as well as to be familiar with the different techniques that can be used in each area.

Endoscopic surgery of the spine
In conjunction with the divisions of neurosurgery and orthopedics we will develop a program for endoscopic approach to the thoracolumbar spine.

Morbid obesity
Overlapping with the above-mentioned diseases of the foregut and together with the departments of endocrinology, Nutrition and Medicine we will develop a unit of morbid obesity.

Emergency and diagnostic procedures
When appropriate the laparoscopic approach will be used to stage patients with malignancies or assess and/or treat patients with acute diseases of the gastrointestinal tract.

Daily Routine

The fellowship will focus on three main aspects.

Patient Care

Fellows will be supervised by attendings in all their activities. The presence of fellows will improve the quality of care and communications with patients and nursing staff. They will be involved in the pre-, peri- and postoperative care of our patients allowing us to clarify and recognize potential problems as well as early detect and manage complications. Their activities will be divided in daily morning rounds, conferences, operating room experience, outpatient clinic and data collection and analysis. The fellow will become familiar with handling of endoscopic instrumentation and equipment, indications and contraindications for endoscopic procedures as well as with the different surgical techniques. We may divide our outpatient work in subspecialized clinics that will concentrate on special disorders, e.g. heartburn clinic, hernia clinic, spine clinic, morbid obesity, etc. This may allow us to improve the quality of care and data collection.

Teaching

Fellows will be actively involved in case presentations, morbidity and mortality conferences, radiological conferences, etc. They will participate in the preparation and presentation of lectures for conferences to be given to CCF nursing and attending staff, non-staff nurses and physicians as well as sales and marketing industry personnel. This will give our fellows a comprehensive practical and teaching experience. At the same time this will facilitate the unit to offer on a regular basis courses that will update our nurses and physicians in state of the art endoscopic surgery. The Fellow will also participate in the education program of house staff, medical students and residents.

Research

We have implemented a research program in endoscopic surgery which will keep our unit in the forefront of basic science and technology. We welcome supporting grants from the industry in order to finance the below mentioned research program. We encourage our fellows to help develop and perform animal and human research projects. A wide variety of research protocols involving the participation of the departments of medicine, radiology, gastroenterology, pediatrics, etc. are being developed. We concentrate our efforts in two main research sites.

Laboratory of intraabdominal pressure

We are conducting basic science research in this area that will help us better understand the side effects of increased intraabdominal and intrathoracic pressures during the endoscopic procedures. We are analyzing the pathophysiological aspects of intracranial hypertension due to elevated intraabdominal pressure (IAP), the increased incidence of trocar site metastasis when operating for malignant disease, the effects of IAP on the splachnic and renal circulation and potential side effects in patients undergoing laparoscopic harvesting of kidneys for renal transplantation. Alternatives to pneumoperitoneum as abdominal wall lift will be also subject of research.

Endoscopic surgical techniques and skills laboratories

Together with the industry we are developing animal protocols that will allow us to improve and develop new techniques and instrumentation in endoscopic surgery. We promote participation of our fellows as trainees and later as preceptors in animal laboratory sessions. This will help fellows, residents and attending staff to acquire and refine their ability to perform specific endoscopic procedures. We envision that this skills laboratory will become a prestigious site that will grant continuing medical education.

Board Accreditation

In conjunction with all surgical divisions we will develop additional programs that will further promote our institution as a leader in endoscopic procedures. We have developed a fellowship program following the guidelines of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES).

Rotations

No off campus rotations are planned with the exception of animal laboratory work.

Goals and Objectives

• The development of highly competent clinical surgeons who will upon completion of training, deliver surgical care of the highest order.
• Identification and development of academic surgeons.
• Integration of scientific principles with daily care of surgical patients will be emphasized through conferences, teaching rounds, carefully planned rotations and well-balanced clinical and operative responsibility.

Evaluations

Evaluation of fellow with feedback to fellow at least twice per year.
Evaluation of staff and program at least twice per year.

Fellow Salary and Benefits
Salary is at the PGY6 level plus fringe benefits as listed in the Resident/Fellow Benefits.

More Information and Application

Graduate Medical Education / Medical Student Education
Cleveland Clinic Florida
2950 Cleveland Clinic Boulevard
Weston, Florida 33331
Phone: 954.659.5229
Toll-free: 866.293.7866 ext. 55229
Fax: 954.659.6216
Email: gme@ccf.org

Program Director
Nestor Galvez-Jimenez, MD, MSc, FACP, FAHA, FACA

A Movement Disorder Fellowship is offered at Cleveland Clinic Florida to qualified licensed physicians in the state of Florida.

Movement Disorders is a new specialty in the neurosciences dealing with the diagnosis, treatment and research of patients with disorders of the basal ganglia and associated structures, in addition to the spinal cord, peripheral nerves and muscle. Parkinson disease, Parkinsonism, Chorea, Ballism, Tremor, Tics, Ataxias, Myoclonus, Jerks, Stereotypies, and other motor disorders including gait abnormalities are some of the categories encompassed by this emerging field.

The trainee requires special knowledge of anatomy, physiology, kinesiology, histology and pathology of the brain and peripheral nerves/muscle when confronted with patients with disorder motor control. New treatment options are quickly emerging making this field one of the most rapidly expanding in neurology.

In an ACGME approved adult or pediatric neurology program no time is devoted to this field and most residents are ill equipped for the diagnosis and treatment of patients with these disorders.

Applicants

Must have satisfactorily completed a Neurology Residency Training Program accredited by the Accreditation Council For Graduate Medical Education (ACGME) or by the Royal College of Physicians of Canada. The applicant must be eligible to have a valid Florida License at the time of appointment.

Description of the Program

A mentoring one-on-one system exists where a fellow will assess and discuss patients with members of the Movement Disorders Program. Supervised assessment with gradual reduction of supervision during the year is expected.

The fellow discusses phenomenology with the staff during weekly videotape session (Monday afternoon), reviews the literature during the weekly journal club (Friday morning) and once a month prepares a didactic lecture to the neurology residents.

In addition, the fellow participates in a variety of neuropharmacology and epidemiological studies. Intensive training on the use of Botulinum toxin therapy is provided. The fellow also participates in the evaluation and treatment of patients with Deep Brain Stimulators.

Teaching Staff

Nestor Galvez-Jimenez, M.D., FACP
Chief, Movement Disorders
A National Parkinson Foundation Center of Excellence
Director, Neurology Residency Training Program
Cleveland Clinic Florida

Virgilio D. Salanga, M.D., M.S., Program Director, Electrodiagnostic Medicine
Chairman, Department of Neurology
Cleveland Clinic Florida
Associate Professor of Clinical Neurology, The Cleveland Clinic Foundation Health Sciences Center of The Ohio State University

Adriana Rodriquez, M.D.
Staff, Department of Neurology
Cleveland Clinic Florida

Efrain Salgado, M.D.
Staff Department of Neurology
Cleveland Clinic Florida

Mary Ronnenberg
Chief Technologist, Department of Neurology
Cleveland Clinic Florida

Rotations

No off campus rotations are planned.

Goals and Objectives

At the end of this fellowship, the fellow will be very proficient in the evaluation and treatment of patients with all types of Movement Disorders.

Evaluations

Evaluation of fellow with feedback to fellow at least twice per year.
Evaluation of staff and program at least twice per year.

Fellow Salary and Benefits
Salary is at the PGY5 level plus fringe benefits as listed in the House Staff Benefits and in the Graduate Physician Policy Manual.

More Information and Application

Graduate Medical / Medical Student Education
Cleveland Clinic Florida
2950 Cleveland Clinic Boulevard
Weston, Florida 33331
Phone: 954.659.6211
Toll-free 866.293.7866
Fax: 954.659.6216
Email: gme@ccf.org

Cleveland Clinic Florida's Department of Orthopaedic Surgery is pleased to offer a one-year Adult Reconstruction fellowship. Under the supervision of Gregory Gilot, MD, Preetesh Patel, MD, Brian Leo, MD, Jeffrey Wu, MD, David Westerdahl, MD, Daniel Grobman, DO, and Vinod Podichetty, MD, this fellowship offers an outstanding diversity of experience in all areas of sports medicine and adult joint reconstruction.

Fellows will be exposed to current arthroscopic and reconstructive hip, knee, ankle, shoulder and elbow procedures, as well as minimally invasive and minimal incision total hip, knee, and shoulder reconstruction, including reverse and resurfacing techniques. The group provides care for Division I collegiate athletes and local high school teams. Participation in academic activities of the department and completion of at least one publishable research project are expected. There are multiple research opportunities available.

The fellowship requirements include completion of an Orthopaedic residency training program and obtaining a Florida Medical License.

Interested candidates should send a current CV, a brief personal statement, and three letters of recommendation to:

Gregory Gilot, MD, Fellowship Director
Cleveland Clinic Florida
Department of Orthopaedics
2950 Cleveland Clinic Blvd.
Weston, Florida 33331
Phone: 954.659.5229
Fax: 954.659.5266
Email: gme@ccf.org

The Urogynecology / Reconstructive Pelvic Surgery Section of the Department of Gynecology offers a clinical fellowship of a minimum of two years. This position is open to physicians interested in the evaluation and treatment of women with urogynecologic and pelvic floor dysfunctions. The fellowship program is under the direction of G. Willy Davila, M.D.

The American College of Obstetrics and Gynecology has proposed the development of formal training programs in Urogynecology / Reconstructive Pelvic Surgery in preparation for sub-specialty certification. Until a predetermined number of programs have been certified, this sub-specialty will not be certified as such.

Fellowship programs such as this clinical fellowship will eventually result in certification by the American College of Obstetrics and Gynecology as training centers for urogynecology sub-specialists. It is expected that this fellowship program will evolve into a certified Urogynecology / Female Pelvic Medicine / Reconstructive Pelvic Surgery fellowship program at the Clinic.

The Urogynecologic / Reconstructive Pelvic Surgery section serves as a referral center for women with urogynecologic problems including vaginal prolapse, urinary incontinence and dysfunctional voiding, and disorders of urogenital atrophy. Current ongoing research studies involve evaluation of new surgical techniques for the treatment of stress incontinence and genital prolapse, evaluation of systemic and local hormonal therapy in urogenital dysfunction and outcomes of non-surgical treatment of pelvic floor dysfunction.

Clinical activities in which the fellow will participate include urodynamic testing of women with bladder dysfunction, evaluation of anatomic defects related to urogenital prolapse, non-surgical physiotherapeutic treatment of pelvic floor dysfunction and surgical treatment of prolapse and incontinence. The fellow will be active in performing retrospective outcome studies and participating in ongoing prospective studies. It is expected that fellows will have completed a residency program in obstetrics and gynecology or urology.

The program’s academic activities include participation in local grand rounds, clinical conferences, regional and national continuing medical education courses and professional society meetings.

Dr. Davila was the previous fellowship program director at the Colorado Gynecology and Continence Center. Previous fellows trained through that program have met criteria determined by the American College of Obstetrics and Gynecology for sub-specialty training in Urogynecology / Reconstructive Pelvic Surgery.

Dr. Gamal Ghoniem serves as the urologic faculty member. He is a well-respected female urologist and also performs video urodynamics and complex urologic reconstructive procedures.

It is expected that multiple collaborative projects with other Cleveland Clinic in Florida departments such as colorectal surgery, urology and internal medicine will benefit the research fellow in obtaining a comprehensive educational experience about pelvic floor dysfunction. It is expected that the fellow will actively participate in research activities with the ultimate goal being formal presentation and/or publication of the research study.

As a clinical fellow, the collaboration with the other related departments will be encouraged including clinical rotations through other departments as determined by the interest of the fellow as well as availability of time periods. It is expected that the fellow will observe evaluation of women with colorectal dysfunction as well as pelvic floor rehabilitation therapy.

This is a funded position and a stipend will be paid to the fellow. The fellow must have successfully completed residency training in obstetrics and gynecology or urology, and is expected to obtain and maintain a Florida medical license in order to be able to participate in patient care activities under the supervision of one of the faculty members. The fellow will bill for clinical care performed.

Fellowship Activities

Clinical – 1st Year

• Urogynecologic reconstructive surgery – 2 days/week
• Urodynamic testing – 1 day/week
• Office patient care – 1½ days/week
• Research protected time – ½ day/week

Clinical – 2nd and 3rd Years

More flexible, but includes:

• Surgery time – 2 days/week or more
• Urodynamic testing – ½-1 day/week
• Office patient care – 1-2 days/week
• Research protected time – 1 day/week or more

Conferences – Teaching Activities

• Hospital rounds – daily
• Urodynamics review – weekly
• Journal club – monthly
• Multi-disciplinary pelvic floor conference – monthly
• Research meetings – twice monthly
• Didactic conferences – twice monthly
• CCF routine conferences – weekly Surgery and Medicine Grand Rounds
• Statistics course – 1 yearly cycle

National Conferences

• AUGS attendance expected
• Annual CCF Pelvic Floor Disorders Conference
• Potential attendance – IUGA, AUA, SGS

Expectations of Fellows

• Attend all rounds and conferences
• Prepare lectures for didactic and other conferences as required
• Attend statistics course
• Perform at least one research project per year – to be submitted for presentation at AUGS and/or another academic meeting, and submitted for publication in peer-reviewed journal

Fellowship Program Faculty

Urogynecology
Vivian Aguilar, M.D., Director
G. Willy Davila, M.D.

Urology
Gamal Ghoniem, M.D.
Lawrence Hakim, M.D.

Colorectal Surgery
Steven Wexner, M.D.
Juan Nogueras, M.D.
Eric Weiss, M.D.
Dana Sands, M.D.

Physiotherapy
Dawn Vickers, R.N.

Neurology
Virgilio Salanga, M.D.

Rationale
Training in this sub-specialty is best served through a fellowship program. There are a very limited number of programs available in the U.S. and abroad. Due to South Florida’s predominantly adult and elderly population, there is a clear geographic need for this program. This population allows the program to be held in this region.

There is a national need for this type of training program as there is a minimum number of training programs required for sub-specialty status to be granted. The department wishes to train people in this discipline due to the academic and teaching goals of this department. The fellowship director has an international reputation in the training of urogynecology fellows and is well-recognized as a leading urogynecologic academician.

Cleveland Clinic Florida has a national and international reputation as a state-of-the-art training center for sub-specialty clinicians. The job market for urogynecologists is expected to increase dramatically with the aging of the population. Thus, it is expected that there will be a significant need for a sub-specialty trained urogynecologists in the future. When sub-specialty status is granted to this sub-specialty, demand will increase even further as the number of actually certified clinicians is limited.

The pool of available applicants is large from both national and international sources. There is more than adequate clinical training material within Cleveland Clinic presently. With the enhanced exposure due to publications and regional presentations, this volume has increased on a yearly basis.

Evaluations

Evaluation of fellow with feedback to fellow at least twice per year.
Evaluation of staff and program at least twice per year.

Fellow Salary and Benefits

Salary is at the PGY5 level plus fringe benefits as listed in the Resident/Fellow Benefits and detailed in the Graduate Physician Policy Manual.

More Information and Application

Graduate Medical / Medical Student Education
Cleveland Clinic Florida
2950 Cleveland Clinic Boulevard
Weston, Florida 33331
Phone: 954.659.6211
Fax: 954.659.6216
Email: mailto:gme@ccf.org?Subject=Urogynecology

Program Directors
Efrain D. Salgado, M.D.
Cleveland Clinic Florida Weston Campus

Bhuvaneswari K. Dandapani, M.D.
Melbourne Campus

Vascular neurology is the area of medicine in which selected neurological disorders involving the central nervous system due to ischemia or hemorrhage are assessed, monitored, treated and prevented using a combination of clinical evaluation, imaging, interventional techniques, and medication.

Cerebrovascular diseases represent the most frequent cause of adult disability and the third leading cause of deaths in the United States. With the population growing older, it projects to be a pervasive problem for many years to come.

Great strides have been made in recent years in the evaluation and treatment of stroke patients. Research into the pathophysiology of ischemic neuronal damage, the evolution of new brain imaging modalities, the development of interventional neuroradiological techniques, and the currently ongoing search for effective neuroprotective agents to complement thrombolytic therapy are some important endeavors in this rapidly advancing field of medicine.

Given the rapidly advancing practical knowledge in this field, a 3 year neurological residency program alone is not sufficient to become adept in all the nuances of stroke care. Hence the need for additional training in this field.

Cleveland Clinic Florida offers two 1-year Vascular Neurology fellowships designed to provide advanced training in the diagnosis, management, and research of patients with a wide spectrum of cerebrovascular disorders. This unique program will be based at 2 centers which complement each other by providing experience in the entire gamut of healthcare delivery to patients with stroke – a self-contained campus of a large private multispecialty group practice dedicated to outpatient and inpatient care as well as resident education and research, in addition to the resources of a large community hospital providing state-of-the-art stroke care.

Basic and advanced stroke services including diagnostic ultrasound (carotids and TCD), CT, CTA, MRI, MRA, MRV, SPECT, PET, cerebral angiography, interventional neuroradiology, neuro intensive care, and neurorehabilitation are offered. The fellows will have the opportunity to participate in ongoing clinical research and to develop their own research interests.

Applicants

Applicants must have completed a residency program in neurology accredited by the ACGME or the Royal College of Physicians and Surgeons (Canada).

The Program

Month 1

Supervised performance in the evaluation and treatment of patients with cerebrovascular disease (outpatient, inpatient) and in the performance of transcranial Doppler and carotid duplex ultrasonography; didactic lectures in cerebrovascular anatomy, physiology, transcranial Doppler, NIHSS certification training; introduction to clinical research trials and identification of personal research projects.

Months 2-3

Graduated reduction in supervision in the clinical evaluation and treatment of patients with cerebrovascular disease; performing and interpreting transcranial Doppler examinations and carotid duplex ultrasonography; active involvement in the recruitment of patients for stroke trials and the development of research projects; teaching the neurology residents, nursing, and public on issues regarding cerebrovascular disease.

Months 4-12

Substantial autonomy in all of the above.

Research

The fellow will be required to plan and complete a research clinical project of his/her choice in cerebrovascular disease. Presentation at a national meeting and publication in a peer-reviewed journal will be financially supported.

Teaching Staff

Weston facility

• Efrain D. Salgado, M.D.
• Virgilio D. Salanga, M.D., M.S.
• Nestor Galvez, M.D., F.A.C.P.
• Vivian Rodriguez, M.D.
• Mary Ronnenberg, Chief Technologist, Department of Neurology

Melbourne facility

• Bhuvaneswari K. Dandapani, M.D.
• William R. Sunter, Jr., M.D.
• Douglas J. Mogle, M.D.
• Timothy D. Carter, M.D.

Rotations

The fellow will rotate 6 months off campus in Holmes Regional Medical Center in Melbourne, Florida, under the supervision of Dr. Dandapani to complement their training in a large community hospital.

Call Schedule

Twice per week and every third weekend.

Goals and Objectives

At the end of the fellowship, the fellow will be very proficient in the evaluation and treatment of any patient with cerebrovascular disease. The fellow will be proficient in doing and interpreting ultrasound of the carotids and intracranial circulation and will also have a working knowledge regarding the conduction of clinical trials on stroke.

The fellow will satisfy the requirements for residency education in Vascular Neurology as published by the Accreditation Council for Graduate Medical Education. The fellow will be ready to embark in a lifelong career in providing the best care for patients with stroke or at risk of being stroke victims.

Evaluations

Evaluation of fellows with feedback to fellows once per month.
Evaluation of staff and program at least twice per year.

Fellow Salary and Benefits

Salary is at the PGY5 level plus fringe benefits as listed in the House Staff Benefits and in the Graduate Physician Policy Manual.

More Information and Application

Wanda Diaz-Rapalo
Vascular Neurology Fellowship Coordinator
Cleveland Clinic Florida
2950 Cleveland Clinic Blvd
Weston, Florida 33331
Phone: 954.659.5229
Fax: 954.659.6216
Email: quintam@ccf.org

Goals and Objectives

• Provide advanced training in the specialty of female pelvic reconstruction and voiding dysfunction and GU bowel reconstruction.
• Attract and recruit qualified applicants
• Improve patient care and surgery using cost-effective and minimally invasive approaches
• Increase the basic science knowledge of pelvic anatomy, pathophysiology, and neurophysiology and monitor outcomes for different treatments provided
• Provide geographical outreach of services

Duration

2 years

The Program

The educational program is based on Society of Urodynamics and Female Urology (SUFU) guidelines. It covers the following modules:

• Urodynamic Testing. Extensive urodynamic testing in the state-of-the-art laboratory using fluorourodynamics provides a thorough understanding of different disease processes.
• LUTS and Urinary Incontinence (male and female)
• Pelvic Organ Prolapse
• Voiding Dysfunction (neurogenic and non-neurogenic)
• Genitourinary Reconstruction. GU reconstruction includes use of bowel, urethroplasty and ureteral reconstruction.

These modules cover diagnostic evaluation and treatment of neurogenic bladder, pelvic floor dysfunction and prolapse, rectovaginal fistula, vesicovaginal and urethrovaginal fistula, and urinary incontinence and its different management modalities including behavior treatment, pharmacological treatment, biofeedback electrical stimulation, and surgical. The evaluation and treatment of anal incontinence is in collaboration with colorectal surgery. The educational activities cover the anatomy and pathophysiology of the bladder and the rectum. Urological reconstructive bowel surgery, male incontinence, urethral reconstructive surgery, neurogenic bladder dysfunction, and bladder outlet obstruction are examples of the domain of this specialty. Monitoring outcomes of different treatments is an integral part of the curriculum. Practice management and coding is discussed on one-to-one basis, and included in the core curriculum. Clinical trial design and statistics are included in the educational activities.

In addition to the structured curriculum, other unique activities are integrated:

• Annual Female Pelvic Floor seminar and workshops enhance educational opportunity and exposure
• Monthly Journal Club meetings in combination with Urogynecology
• Monthly Pelvic Floor Disorders meetings in combination with Urogynecology and Colorectal
• Periodical research meetings
• One trip to related national meeting or seminar (requires approval of program director)
• Visiting surgeons (national and international) provide a healthy environment and a broader perspective for interaction
• The Research Fellows Program provides a stimulating and cooperative complimentary aspect of the fellowship
• Participation in house training programs
• Participation in the different clinical research projects on new medications and devices offers an up-to-date on the newest applications in the field.

On-call and Consult Responsibilities

On-call responsibilities are approximately 2-3 nights per week. The call is not in-house and typically one week every three weeks. The different staff members cover their own patients during the weekdays. The fellow covers consultations during the on-call days.

Research Commitment

Research is integrated with clinical work during the fellowship training. A reasonable schedule that allows a balance between clinical work, study, self-development, and research is emphasized. The fellow is expected to have at least one major project to complete and expected to present his/her work at the annual SUFU meeting.

Evaluations

Evaluation of fellow at least twice per year.
Evaluation of staff and program at least once per year.

Fellow Salary and Benefits
Salary is at the PGY7 level plus fringe benefits as detailed in the Graduate Physician Policy Manual and listed in the Resident/Fellow Benefits.

More Information and Application

Graduate Medical Education / Medical Student Education
Cleveland Clinic Florida
2950 Cleveland Clinic Boulevard
Weston, Florida 33331
Phone: 954.659.6211
Toll-free: 866.293.7866 ext. 56211
Fax: 954.659.6216
Email: mailto:gme@ccf.org?Subject=Voiding