Training

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

Curriculum

13 4-Week Block Rotations

PGY-1 Year

  • Akron Children’s ER: 1 block
  • Emergency Medicine (Fairview): 1 block
  • Essentials of Family Medicine: 1 block
  • Family Medicine Service (Fairview): 1 block
  • Family Medicine/Medicine (MetroHealth): 1 block
  • Hospital Medicine Service (Fairview): 3 blocks
  • Obstetrics (Fairview): 2 blocks
  • Pediatrics (MetroHealth): 1 block
  • Surgery Inpatient (Fairview): 1 block
  • Surgery Outpatient: 1 block

PGY-2 Year

  • Ambulatory Pediatrics: 1 block
  • Behavioral Science: 1 block
  • Coronary Care Unit: 1 block
  • Dermatology: 1 block
  • Elective: 1 block
  • Family Medicine Service: 1 block
  • Geriatrics: 1 block
  • Gynecology: 1 block
  • Health Promotion: 1 block
  • Pediatric Inpatient (Fairview): 1 block
  • Management of Health Care Systems: 1 block
  • Sports Medicine (CCF): 1 block

PGY-3 Year

  • Allergy/ENT: 1 block
  • Care Enhancement: 2 blocks
  • Community Medicine: 1 block
  • Elective: 4 blocks
  • Emergency Medicine: 1 block
  • Family Medicine Service: 2 blocks
  • EYE/GU: 1 block
  • Orthopedics: 1 block

Center for Family Medicine (Office Hours)

PGY-1 Year: 1 half day per week

PGY-2 Year: 3 half days per week

PGY-3 Year: 4 half days per week

Monthly Conferences

  • Balint
  • Behavioral Science
  • Case Conferences
  • Computer Skills
  • Core Content
  • Dermatology (Clinic)
  • EKG
  • Evidence-Based Medicine
  • Geriatrics
  • Gynecology
  • Office Procedure Skills
  • OMT
  • Orthopedics
  • Patient Education
  • Pediatrics
  • Perinatology
  • Pharmacology
  • Practice Management
  • Radiology
  • Research
  • Sports Medicine
Curriculum Highlights

Curriculum Highlights

Essentials of Family Medicine Rotation

This rotation consists of lectures and activities that lay the foundations of family medicine as well as team building activities. The intern class completes this rotation all together during their 4th block of residency.

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 Indians. 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 Dr. Kelly, who has himself completed the two-year faculty fellowship in Integrative Medicine through the Arizona Center.

Global Health

The Family Medicine Residency Program offers a Global Health Track. The educational goals of this track include achieving heightened awareness of the health needs in developing countries, and experiential training in the provision of that care.

In the PGY-2 year residents participate in a 2-day global health course through University Hospitals. During their PGY3 year, residents can participate in an approved global health experience. The resident will be required to present their global health experience in a one hour didactic lecture.

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. Dr. Katie Jones DO, a graduate of our program who routinely practices OMT, also teaches practical application of OMT to all residents.

Co-Counseling

Residents have the opportunity to schedule counseling sessions with our behavioral science director, the patient and their resident physician. These sessions allow residents to connect with their patients and experience a valuable part of mental healthcare.

GYN Clinic

Once a month, an OBGYN physician comes to our clinic to teach resident outpatient gynecological procedures. This clinic includes colposcopy, endometrial biopsies and other more complicated gynecologic cases.

Dermatology Clinic

Residents are encouraged to refer difficult or interesting dermatology cases to our Dermatology Clinic. Dr. Anthony comes to didactic sessions and sees these patients with the residents. This allows for differential diagnosis discussions as well as treatment plans and easy access to Dermatology for our patients.

Electives

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

  • Addiction Medicine
  • Adolescent Medicine
  • Adolescent Psychiatry
  • Advocacy/Health Policy
  • Anesthesia
  • Alternative Medicine
  • Clinical Informatics
  • Dermatology
  • Direct Primary Care
  • ER/Pediatric ER
  • Functional Medicine
  • Geriatrics
  • Geriatric Psychiatry
  • GYN
  • Hospital Administration
  • Integrative Medicine 
  • International Health (Workshops or conferences)
  • LGBTQ
  • Maternity/Paternity Electives (Usually a research project)
  • Medical Spanish
  • Musculoradiology
  • NICU
  • 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

Special Elective: An experience created by the resident, tailored to their specific interests. 

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 course is 200 hours online.

Population Health

Population Health

Population Health Curriculum

Population Health Overview

The Cleveland Clinic partnered with the Ohio University Heritage College of Osteopathic Medicine to develop an accelerated family medicine curriculum that allows learners to complete undergraduate and graduate medical education in six years. This was developed as part of the AMA’s “Accelerating Change in Medical Education Consortium” to change the focus of physician training to include more training in population health.

With this novel program, called the Transformative Care Continuum (TCC), our program will be expanding to 8-8-8 with 4 students from the TCC joining the program each year. With this educational shift, residents will be off some of their rotations for one half day per week for various population health activities as described below. This curriculum highlights community, racial equity and advocacy.

Experiences include:

  • Adolescent Psychiatry: Dr. Jason Lambrese is an integral part of the resident psychiatric training. He has weekly Friday morning clinics in our office where residents are able to perform a complete psychiatric evaluation on 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.
  • Controlled Substance Committee: Our clinic has a Controlled Substance Committee that monitors all patients that are on controlled substances. This committee is a resource for residents and faculty who have patients that have broken their Controlled Substance Agreement or are complicated cases. Residents have the opportunity to be on this committee as well.
  • Doctors on the Street (DOTS): Residents will work with residents from MetroHealth, our community hospital, to staff Doctors on the Street. This clinic provides free health care to the homeless population of Cleveland.
  • Harrison Elementary School Clinic: Residents will go to Harrison Elementary School monthly to provide mentorship to students. They will also visit their community garden to instill principles of healthy eating.
  • Lakewood School Clinic: We partner with the Lakewood School District to staff the in school medical clinics. Residents see patients once a month in these clinics which allows students to receive medical care while preventing missing too much school for appointments. These visits consist of sports physicals & injuries, general physicals, birth control discussions and psychiatric evaluations.
  • LGBTQ Health: Lakewood has a vibrant LGBTQ community and the Lakewood Family Health Center is home to the Cleveland Clinics Center for LBGTQ+ Care. Residents will help create a sexual health training program for our LGBTQ adolescent population at Lakewood Schools and Albert Einstein Academy.
  • Nursing Home: We are fortunate to do our nursing home training at O’Neill Bradley Bay, where Dr. Tyler is the Medical Director. Residents provide care to our nursing home patients in person on Tuesday mornings with Dr. Tyler and are assigned these patients in their panel.
  • Shared Medical Appointments (SMA): Our clinic hosts yearly SMAs for patients with chronic conditions. Residents have the opportunity to choose the focus of the SMA as well as help run these sessions. Our most recent SMA targeted patients with hypertension.
  • Ultrasound Curriculum: Dr. Hanicak is developing our primary care ultrasound curriculum. Residents will have didactic lectures, protected time to learn ultrasound and ultrasound training integrated into their rotations (examples: FAST US on Emergency rotation, OB ultrasound on OB rotation, etc.)
  • Upside of Downs: Residents will help create training for front line staff working with patients with Down Syndrome. Residents will continue to learn from Dr. Tyler, who specializes in care for patients with developmental disabilities.
  • Other Novel Opportunities: This curriculum also includes Lean Six Sigma Training, Advocacy Training, Racial Equity Training and appointments as OUHCOM Assistant Clinical Faculty as senior residents.