Training
To provide a comprehensive experience, we strive for balance: balance between training in the hospital and the office; balance between the treatment of acute and chronic medical problems and the application of preventive and health promotion strategies; balance between the traditional biomedical approach and the important psychosocial, spiritual and family aspects of patient care.
We also believe in a balance between patient care, education, and our own personal and family needs. We offer a positive working environment focused on education.
Inpatient Training
The care of hospital patients is taught from two perspectives. First, residents rotate through all the traditional clinical services and have the opportunity to learn directly from specialists in those fields. Fairview Hospital and the Cleveland Clinic have busy clinical services, designed and dedicated for education. Second, residents care for their own patients on the family medicine service at Fairview, under the guidance of our faculty. Residents learn the core principles of family medicine, including continuity, coordination, comprehensiveness and cost-effectiveness of care.
Outpatient Experience
The heart of Family Medicine is ambulatory care. Our model office, the Center for Family Medicine, provides an excellent environment for learning. We see more than 18,000 visits a year. From the beginning of the first year, each resident is an integral member of our healthcare team. The resident provides continuous care for a defined panel of families over the three years of training. Support is given by our behavioral scientist, patient education nurse, family medicine nurse practitioners and other specialty consultants. Our diverse practice population provides experience with patients of all ages and socioeconomic backgrounds.
Residents learn from and with their patients, precepted by an enthusiastic group of full-time faculty, community family physicians and sports medicine fellows. Our office is well-equipped and staffed with sincere, friendly people, who are there to help you. Our program uses the Cleveland Clinic's electronic medical records system, called EPIC. We have access to MyChart, which is a patient portal that allows us to communicate with patients by email. We have an active and constructive quality improvement process. We have an organized, comprehensive patient education program led by our patient education nurse. Residents gain extensive experience in managed care and practice management.
Curriculum Highlights
Essentials of Family Medicine Rotation
The depth and breadth of family medicine involves treating the whole person. In the fall of the intern year, there is a dedicated rotation focused on the Essentials of Family Medicine. This rotation is strategically offered a few months into residents' first year to allow focused (and fun) learning, skill building, and team development to enhance patient care and the self of the physician. Some experiential learning, including a tour of Lakewood to provide a better understanding of the community we serve, a procedure workshop (a resident favorite), ACLS/PALS training, Koru Mindfulness classes, a Myers-Briggs personality inventory with interpretation to better understand ourselves and our team, and training in Motivational Interviewing. The didactic component of the Essentials rotation includes classes on well-child visits, office billing and coding, improving office efficiency, video review and coaching, implicit bias modules, and an interprofessional lecture series. Additionally, residents continue to have clinics for patient care.
Health Promotion
Second year residents participate in this rotation to study all areas of health promotion including lifestyle behavior change, evidence-based screening, key health risks, and motivational interviewing. All faculty are involved in teaching this rotation which promotes faculty development and team-building.
Sports Medicine
The Family Medicine Residency Program, in collaboration with the Cleveland Clinic Sports Health Department, offers a well-rounded, exceptional education in the field of sports medicine. Residents rotate and work with the team physicians for the Cavaliers and Guardians. They can participate in the medical coverage of multiple sporting events during the year at Cleveland State University, Notre Dame College, John Carroll University, and Baldwin Wallace University as well as at local area high schools. Longitudinal experiences and fellowship didactic lectures are offered for residents interested in pursuing sports medicine. The Primary Care Sports Medicine Fellows also precept at our Family Medicine Clinics, providing the Family Medicine Residency Program with an outstanding educational experience and exposure to the field of sports medicine.
Care Enhancement Rotation
Care Enhancement (CE) is an exciting newer educational experience that we piloted successfully in the 2011-2012 academic year and are continuing to shape going forward. The CE resident communicates closely with the Inpatient Team and Center for Family Medicine (CFM) physicians and staff to identify opportunities to prevent hospital admissions and readmissions, enhance quality of life, improve patient and caregiver satisfaction, and prevent adverse outcomes. Contact with patients and families can occur in the home, at the CFM, in the hospital, or in the nursing home or other extended care facility. This rotation occurs following the block the resident was on the Family Medicine inpatient service so the resident is familiar with the patients and families.
Research
Our program promotes evidence-based medicine and provides training in the area of medical informatics. We also encourage scholarly inquiry and provide research support for interested residents. Our program has an experienced fellowship trained research director, Carl C. Tyler, MD, who leads a monthly evidence-based practice seminar. Residents design, conduct and report a short-cycle quality improvement research project as a class during their second year of training. Examples of past topics are: adolescent pregnancy, osteoporosis, acupuncture, asthma, pain management, Raynaud's phenomenon, tension headaches and strep testing. Modest funds are available to residents to foster resident research and scholarly activity without additional burden and time required to obtain external funding.
Integrative Medicine in Residency Track
Our program is the first residency in Ohio to offer the Integrative Medicine in Residency Track sponsored by the University of Arizona Center at Tucson Center for Integrative Medicine. The IMR track is a 180-hour online curriculum that is optional for second and third year residents. Participants devote one or more elective blocks to access the online IMR content, as well as setting up local experiences in Integrative and/or Functional Medicine. Some of their academic funds are used to defray a portion of the tuition expense. Residents who participate are mentored by Ann Rutt, CNP, who has herself completed the two-year faculty fellowship in Integrative Medicine through the Arizona Center.
Osteopathic Recognition
Our residency program has received osteopathic recognition that was granted by the ACGME in 2015 and was dually accredited by AOA and ACGME prior to 2015. We have an osteopathic focused learning environment that spans the length of our educational program. Our program has been nationally recognized for our innovative osteopathic curriculum for both allopathic and osteopathic residents. We teach the osteopathic principles of practice through focused and longitudinal educational experiences. Our 2nd year osteopathic residents lead monthly lectures to teach their peers the foundations of osteopathy. We have multiple osteopathic faculty who routinely practice OMT that teach practical application of OMT to all residents. All interns (DO and MD) attend a two-day OMM Course for All in Columbus early in their PGY-1 year.
Co-Counseling
We provide specialized learning experiences through co-counseling. Residents can provide short-term counseling to their patients by partnering with our Director of Behavioral Science & Wellness Director, Terri Dalton. This provides learning opportunities for caring for patients while learning counseling skills including Cognitive Behavioral Therapy skills, motivational interviewing, and behavioral and supportive therapy strategies to help patients with mood disorders, grief, coping with a health diagnosis, family stress, and addictions. Most visits are integrated visits that include medication management and address comorbid or chronic health conditions.
Ultrasound Curriculum
Dr. John Hanicak directs our primary care ultrasound curriculum. Residents will have didactic lectures and protected time to learn ultrasound and have ultrasound training integrated into their rotations (examples: FAST US on Emergency rotation, fetal presentation, and fluid assessment on OB rotation, etc.). Dedicated faculty from the Emergency Services Institute also act as embedded mentors in point-of-care ultrasound.
Dermoscopy
As part of our family medicine, residents' training includes dermoscopy training; this involves using a dermatoscope to further evaluate skin lesions to increase sensitivity in the detection of skin cancer while also minimizing the need for unnecessary biopsies. Family medicine is uniquely positioned to train in dermoscopy principles, given the frequency and breadth of dermatologic presentations encountered in patient care. Our dermoscopy curriculum involves a lecture component and a dermoscopy/ultrasound club that meets monthly. Residents may also use their CME money to purchase a dermatoscope for their practice.
Subspecialty Clinics
Our program has four subspecialty clinics embedded into the Center for Family Medicine (CFM). Residents refer patients from their patient panels and work alongside teaching physicians.
- Child/Adolescent Psychiatry and Adult Psychiatry: We have two psychiatrists integral to our resident’s psychiatric training. They each have a weekly clinic in our office where residents can perform complete psychiatric evaluations with our patients. These clinics allow patients and families to stay within the Center for Family Medicine for their psychiatric care and teaches residents how to best manage common psychiatric conditions, including depression, anxiety, ADHD, and PTSD. After this assessment, patients are usually returned to their Resident PCP for ongoing management.
- Dermatology Clinic: We have a skilled dermatologist who provides teaching and staffs our Dermatology clinic. This clinic is provided monthly as a part of our didactic sessions, where we refer patients with complex dermatological symptoms.
- Integrative Medicine (IM) Clinic: Residents, including those who are in the Integrative Medicine track, can work with an Integrative Medicine Fellowship trained NP and physician in providing IM treatments to our patients.
- Gynecology Clinic: Our monthly GYN clinic provides the opportunity to provide evaluation and women’s health procedures to our patients. Procedures include colposcopy, D & C, and hysteroscopy. We work with a gynecologist who provides women’s health expertise. Additional opportunities for women’s health procedures are available with Drs. Eberlein and Sanyal who both have additional training in gynecology and obstetrics.
- Other Novel Opportunities: This curriculum includes Lean Six Sigma Training, Advocacy Training, and appointments as OU-HCOM Assistant Clinical Faculty as senior residents.
Electives
Cleveland Clinic's Family Medicine Residency Program offers a variety of electives for residents to take advantage of.
Any Medicine Subspecialty Elective
- Allergy
- Endocrinology
- ENT
- Dermatology
- Gastroenterology
- Infectious Diseases
- Nephrology
- Neurology
- Pulmonary
- Rheumatology
Special Electives by Past Residents: An experience created by the resident, tailored to their specific interests.
- Addiction Medicine
- Adolescent Medicine
- Adolescent Psychiatry
- Advocacy/Health Policy
- Allergy
- Anesthesia
- Alternative Medicine
- Clinical Informatics
- Dermatology
- Direct Primary Care
- ENT
- ER/Pediatric ER
- Functional Medicine
- Geriatrics
- Geriatric Psychiatry
- Global Health
- GYN
- Hospital Administration
- Integrative Medicine
- LGBTQ
- Medical Spanish
- Musculoradiology
- NICU
- Ophthalmology
- Pain Management
- Palliative Medicine
- Pediatrics (Ambulatory)
- Pediatric Cardiology
- Pediatric Dermatology
- Pediatric ER
- Pediatric Pulmonary
- Pharmacy
- Plastic Surgery
- Podiatry
- Population Health Management/SMAs
- Procedures
- Radiology
- Research
- Sleep Medicine
- Sports Medicine
- Stress Tests
- Urgent Care
- Urology
International Health Away Electives by Past Residents
Cleveland Clinic residents and fellows may participate in elective experiences outside of the United States provided appropriate approvals are obtained and the international rotation is felt to provide an experience which cannot be provided at Cleveland Clinic.
Previous approved rotations include trips to:
- Abu Dabi
- Brazil
- Malawi
- Peru
- Rwanda
- Tanzania
Integrative Medicine Track: Sponsored by the University of Arizona Center for Integrative Medicine, this is a 200-hour online course.
