Categorical Track: The traditional residency program structure. Carried out through the 4+1 model. The residents follow a comprehensive three year curriculum to cultivate a well-rounded internist and prepare residents for the subspecialty of their choice. Residents have inpatient, consult, elective, and longitudinal clinic experiences over the course of 3 years.
The Cleveland Clinic Internal Medicine program adopted a 4+1 structure for resident schedules. All inpatient, consult, and elective rotations are assigned within 4-week blocks called X weeks followed by one week of longitudinal continuity clinic (LCC) defined as Y week. The goal of 4+1 structure is to optimize and maximize our residents’ exposure to ambulatory medicine without interfering with training in the inpatient setting.
This creates two unique opportunities:
- The ability to deliver our curriculum in a dedicated manner without interference with clinical duties
- Empowerment of our residents to be the Primary Care Physician (PCP) for their outpatient clinic patients
All categorical residents have 1 week of longitudinal continuity clinic every 5 weeks.
Structure of Y week- LCC
During the LCC week, categorical residents have:
- 6 – ½ days of their longitudinal continuity clinic
- 2 – ½ days blocked for academic time (one on Monday morning and Tuesday afternoon) which is their protected learning time
- 1 – ½ day for sub-specialty clinic of choice or additional primary care experience
- 1 – ½ day for administrative responsibilities
Structure of X Weeks- Inpatient/Consults/Electives
Primary Inpatient Rotations:
- General Medicine
- Medical Intensive Care Unit (MICU)
- Cardiac Intensive Care Unit (CICU)
- Cardiology Clinic/Consult
- Vascular Medicine Clinic/Consult
- Gastroenterology Clinic/Consult
- Renal Clinic/Consult
- General Medicine Consult
- Pre operative Clinic
- Endocrinology Clinic/Consult
- Neurology Clinic/Consult
- Pulmonary Clinic/Consult
- Rheumatology Clinic/Consult
- Geriatrics Clinic
- Infectious Disease Clinic/Consult
- Allergy/Immunology Clinic
- Women’s Health Clinic
- LGBT Clinic
- Sports Medicine Clinic
- Dermatology Clinic
- Sleep Medicine Clinic
- Palliative Medicine Clinic/Consult
*These are just a few of the clinical opportunities available at Cleveland Clinic - many residents choose to pursue elective in more specialized areas to position themselves for success in pursuing a job or applying for fellowship.
All inpatient and consult rotations have an embedded curriculum with teaching sessions arranged a few times every week by dedicated faculty in that specialty.
Three Year Curriculum
Y week LCC
*All PGY3 residents attend 1 week intensive board review course in June
Clinician Educator Track (CET)
In July 2018, we proudly formed the Clinician Educator Track (CET) for the Cleveland Clinic Internal Medicine Residency Program! This track promotes the acquisition of skill needed to effectively teach, mentor and assess learners, develop new curricula, and disseminate scholarly work. This NRMP track is designed for residents interested in pursuing a career in academic medicine with a focus on medical education.
The program accepts three CET residents per year. Selection is competitive, and PGY1 residents will match into this track, separate from the categorical track.
During the CET:
- Residents have a longitudinal curriculum that spans three years.
- Residents will have one half-day of dedicated CET curriculum during their longitudinal clinic (Y) week.
- Residents have opportunities to teach built into the CET curriculum, including small group medical student teaching, inter-disciplinary teaching, teaching within GME, and also teaching at grand rounds.
- Residents have the opportunity for building curriculum and other educational projects, with time protected for this work.
- Residents will build an academic portfolio which will assist them in future endeavors.
- Residents enjoy a small team-based environment, with frequent interaction with all other CET residents and the CET directors.
Hospital Medicine Track (HMT)
Jazmine Sutton, MD
Director, Hospital Medicine Track
Associate Program Director
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Hospital Medicine is a growing and dynamic field of Internal Medicine. Expertise in inpatient medicine includes efficiency of care for hospitalized patients, broad-based knowledge in the management of acute medical conditions, and the ability to manage and succeed in a team environment to improve patient care.
In order to meet these goals, the Internal Medicine Residency Program offers an Inpatient or Hospital Medicine Track (HMT) to give this increased focus to your training. As an adjunct to the Categorical medicine training, you will have a dedicated 10 week experience (split over second and third years). You will be exposed to concepts of quality and patient safety, care transitions, risk management, perioperative medicine, and effective consultative practice. You will also be exposed to concepts of teaching and leadership training and be introduced to medical business practices.
This track is designed for residents who are interested in Hospital Medicine careers as well as those who plan fellowship training (particularly fellowships with a strong inpatient focus).
The clinical Hospital Medicine experience will include one-to-one mentorship with a Hospitalist, following a Hospitalist work schedule. These rotations are done at Fairview Hospital, Hillcrest Hospital, or Medina Hospital, three excellent community hospitals in the Cleveland Clinic Health System. These experiences provide a unique opportunity to learn and practice Medicine in a community setting. Residents will learn clinical medicine, transitions of care, and compare the various hospital systems of care. In addition, patients in the community hospital setting often present with more “bread and butter” medical conditions, compared to many patients seen at the Main Campus tertiary care center who often have more complex situations.
The non-clinical portion of the track is comprised of a variety of educational programs and sessions. Problem Based Learning (PBL) cases are used to guide learning about several areas of systems-based practice. These sessions are supplemented with directed seminars about topics important to the practice of inpatient medicine. HMT residents spend time learning the basic concepts of Quality Improvement and Patient Safety; this experience includes the opportunity to interact with leaders in the Cleveland Clinic’s Quality and Patient Safety Institute as well as designing a QI/PS project. HMT residents also learn the fundamentals of perioperative medicine through a dedicated curriculum of case-based, didactic, and clinical experiences. A graduated experience is provided to residents in the second year of the track to build on knowledge and skills learned during the first year.
The Hospital Medicine track is designed to help physicians become effective agents of change in the complex hospital environment by training them to be leaders in coordinating and participating in the assessment, development, and implementation of system improvements. Residents will also become proficient in the care of complex hospitalized patients with exposure to:
- Increased experience in both consultative general medicine and perioperative assessment and care.
- Palliative medicine experience.
- Dedicated experience in hospital system-based competencies such as patient safety, quality improvement, and risk management.
- Dedicated experience in leadership skills including team approaches, multi-disciplinary care, management practices, and professionalism.
- Exclusive one-on-one time spent with experienced academic hospitalists. Hospital Medicine is a growing and dynamic field of Internal Medicine. Expertise in inpatient medicine includes efficiency of care for hospitalized patients, broad-based knowledge in the management of acute medical conditions, and the ability to manage and succeed in a team environment to improve patient care.
Primary Care Track (PCT)
Primary Care Track: Designed for residents who wish to prepare for a career in General Internal Medicine (GIM) within an academic or community setting. We seek to train superb GIM primary care physicians. Our health system allows for our residents to experience exceptional health care delivery models, hone their clinical skills, and practice their leadership skills.
Primary Care Track (PCT)
We have an outstanding three-year Primary Care Track (PCT) that is offered in a fully integrated collaborative way alongside our other Internal Medicine tracks. Our PCT has been around for over 20 years and is designed for residents who wish to prepare for a career in General Internal Medicine (GIM) within an academic or community setting. Interested students are encouraged to apply through ERAS to the Cleveland Clinic’s Primary Care Track Program (NRMP Code: 10751514).
PCT residents have a longitudinal continuity clinic (LCC) during their Y weeks. The Y week has dedicated teaching, LCC, and opportunity for an additional ambulatory clinic experience in another GIM practice location or subspecialty clinic with an ambulatory focus.
During specific months of the academic year, all PCT residents have Primary Care Block (PCB) along with their standard Y weeks. PCB allows for important GIM curriculum, topics relevant to outpatient medicine, and experience in appropriate subspecialty clinics to help prepare you for the practice of GIM in the ambulatory setting. For example, we offer office-based dermatology, ophthalmology, women’s health, psychiatry, and sports medicine among others.
Our PCT aspires to provide a balance of ambulatory and inpatient experiences in order to help you become a superb GIM physician. PCT program leadership and GIM clinical faculty exemplify the essence of GIM – clinical knowledge, empathy, and professionalism. We strive to develop in our trainees in the skills and tools necessary to go on to GIM careers within an academic or community setting. If you are interested please don’t hesitate to contact us at 216.444.2336 or via e-mail: [email protected] for more information.
Stacey Jolly, MD, MAS, FACP
Associate Professor of Medicine
Primary Care Track Program Director
Primary Care Core Faculty
I am the first in my family to become a doctor and have found a home in general internal medicine. I was drawn by the complexity of symptoms intertwined with disease, amazed at the resiliency of the human experience, and appreciated the focus on prevention and social justice. It is the time in my clinic that I enjoy the most and from those experiences get great ideas for clinical research, quality improvement projects, and medical education.
I feel fortunate to have chosen my career in general internal medicine as each day meets engaging and stimulating patient care with the benefits of a continuity relationship and opportunities to drive the positive impact of healthcare change for my patient population.
I love being challenged by the various presentations of acute and chronic conditions, and solving the puzzles of multiple signs and symptoms that make up the complicated stories of cases I see every day in the clinic. I find it extremely gratifying being able not only to diagnose and treat but also prevent diseases, making sure patients stay healthy so they can enjoy healthy and happy lives. I think knowing your patients, continuing to take care of each and every one of them throughout the years, knowing their stories and being part of their lives is a privilege that very few other professions can offer.
Primary care provides an amazing opportunity to take care of patients throughout their adult lives no matter the particular issue at hand. It is truly a privilege to be play such a significant role in the lives of my patients. I feel honored to have these unique relationships with my patients and it keeps me going.
Graduated Primary Care Track Residents - 2018
Chad Cozart, DO
Outpatient Primary Care Physician in a hospital-owned group practice setting alongside 5 other physicians and 1 NP.
Skyline Medical Group
Saad Munzar, MD
Associate Staff - Internal Medicine
Cleveland Clinic Lakewood Family Health Center
Graduated Primary Care Track Residents - 2019
Nabil Madhun, DO
Dhruvika Mukhija, MD
Graduated Primary Care Track Residents - 2020
Rachel Parker, MD
General Internal Medicine Physician
Infectious Disease/HIV Fellowship
Teera Crawford, MD
General Internal Medicine Physician
Virginia Mason Lynnwood Medical Center
Ceena Jacob, MD
General Internal Medicine Physician
Current Primary Care Track Resident Profiles
Parvathy Sankar, DO – PGY1
Growing up in Canada and finishing my medical school at Michigan State has allowed me to gain a wider perspective when it comes to health care and accessibility of it to people of varying socioeconomic backgrounds. The fundamental core of medicine is prevention of disease and worsening of complications. Primary care is at the core of it, and I wanted to be part of a curriculum which will allow me to understand and experience outpatient and inpatient medicine equally so that I can provide comprehensive care for my future patients. Apart from medicine, I enjoy spending time with my family and friends, and spending time outside.
Matthew Jeong, MD – PGY1
Prior to entering medical school I worked on many research projects, but the one that stood out to me the most was on health disparities in Asian American communities. I saw the impact healthcare workers can have on community health through relationship forming and education which made me interested in primary care and preventative medicine. Being in the primary care track at Cleveland Clinic is an amazing opportunity to learn the medicine while honing my ability to form bonds with patients. In my free time I enjoy playing video games (PC), going for runs, and watching sports.
Puneet Dhillon, DO – PGY1
I applied to the Primary Care Track because it aligned with my goal of being a well-rounded physician and honing my clinical skills. I am unsure of my exact future goals, but I enjoy outpatient medicine. I value forming meaningful, long-term partnerships with patients to better their health outcomes. I am from Jersey, but enjoy exploring Cleveland in my spare time. I also like to paint, hike, cook, read, and shop.
Kathryn Dere, MD – PGY1
I grew up calling many different places my home, and am very excited to be part of such a diverse resident community. I am interested in geriatric medicine, so it was important to me to find a program with strong outpatient training. In my free time, I enjoy cooking, music, and exploring different cities and art museums.
Dina Ali, MD—PGY2
My interest in medicine stemmed early in my undergraduate education as I learned about the social determinants of health and engaged in educational programs in the urban settings of Cleveland. This opened my eyes to the limitations of education, food, and resources that eventually lead to poor healthcare literacy, affecting community health as a whole. I am lucky to say that I am a part of a training program that focuses on Primary Care and offers me the best resources to learn how to practice preventative medicine while providing me the opportunity to form long term relationships with patients. Outside of medicine, I enjoy spending time with family and friends, eating delicious food and ice-cream, traveling and exploring new places and people.
Joseph Cataline, MD – PGY2
I chose PCT because I believe the best medicine is preventative medicine, and though sometimes being admitted can be an inevitability, I do my best to optimize the needs of my patients outside of the hospital. I feel that developing a rapport and positive clinic relationships help build trust between patient and physician, and a good provider-patient bond is invaluable. It is my hope that the relationships I foster with my patients combined with guideline based preventative care aid in their healthcare journeys, from medication compliance to preventing hospitalizations. The primary care track gives me the best of both worlds, where I have seen a healthy mix of inpatient medicine blended nicely with complex outpatient care.
Nayan Agarwal, MD – PGY2
I am originally from India, grew up in India, the Netherlands, Indonesia and China. I double majored in Biomedical Engineering and Psychology, and got a masters in translational medicine and worked for a startup. With a desire to solve medical problems, I pursued a career in medicine with special interests in primary care and preventive health. I am interested in reducing hospital readmissions and empowering patients to become healthier. I strongly feel that more patients need equal access to already engineered solutions to existing problems and that no one should be losing their foot to diabetes, for instance. I am passionate about advance care directives, medical ethics, sexual health and socioeconomic factors affecting access to healthcare. In my free time I enjoy eating out, watching TV/Disney/Bollywood movies, reading Jodi Picoult books, Zumba and am recently into hula hooping.
Robert Zimbroff, MD –PGY2
Having a strong interest in Geriatrics, I was first drawn to the primary care track for the foundation it provides in outpatient medicine. What I've come to find is that the track strikes a great balance between structured learning and flexibility to match my particular interests. I have been able to arrange electives in outpatient Geriatrics and Palliative Medicine, and use my sub-specialty clinic time to follow a panel of homebound patients with one-on-one precepting and mentorship with a staff Geriatrician. An added perk: the folks in the Primary Care Track are some of the kindest clinicians I've been fortunate enough to work alongside. Talk to me about the NBA (die hard Lakers fan), a great book you've read recently (The Swerve by Stephen Greenblatt), or a favorite running trail (Rocky River Bridle Path).
Sean Morris, DO, MPH - PGY3
I have been fortunate to train in the primary care track for the in-depth exposure to subspecialty clinical medicine, and robust didactic education during PCT block. My career in medicine will include both inpatient and outpatient care. I am most interested in seeking opportunities for behavior change, prevention, and sustained patient relationships. My background in public health has allowed me to work in global health, community health, and preventative medicine. These experiences have shown me the significance of one-on-one clinical interaction in establishing and maintaining wellness. In my free time I enjoy gardening, hiking with my wife, and visiting my hometown in Northern Michigan.
Nakul Bhardwaj, DO, MPH - PGY3
Born and raised in Ohio, I knew I held a strong connection with Cleveland Clinic and its push for promoting health beyond the confines of the hospital. The gratifying feeling of educating patients and teaching students is what drove me towards a career in medicine, and, more specifically, academic medicine. My clinical interests include obesity medicine, culinary medicine, and preventive care. Outside of the hospital, I love to play and watch soccer (go Arsenal!), cook, listen to live music, and find new foods in the great city of Cleveland.
Preliminary residents spend the majority of the year on core Internal Medicine rotations.
The 4+1 schedule structure extends to our preliminary track as well. Instead of IM longitudinal clinic, the Y-week will consist of a clinic or consult rotation.
Clinical experience may include
- General Internal Medicine (Kimball/Tucker)
- Subspecialty Consult Services (Nephrology, Gastroenterology, Cardiology, etc)
- Cardiology Inpatient
- Hepatology Inpatient
- Hematology/Oncology Inpatient
- Emergency Department
- Vacation: 3 weeks plus a float week
VA Northeast Ohio Healthcare System
Center of Outpatient Education
Megan McNamara, MD, MS
- Physician Director, Center of Outpatient Education, VA Northeast Ohio Healthcare System
- Professor of Medicine, Case Western Reserve University School of Medicine
- Physician Director, G.I.V.E. Clinic, VA Northeast Ohio Healthcare System
Khalid Jazieh, MD
- Chief Resident of Quality and Safety, Cleveland VA Medical Center
- Contact information (2021-2022): [email protected] (for further questions about the track)
About the track:
The VA Center of Outpatient Education (COE) track is a unique track offered by the Cleveland Clinic Internal Medicine Residency Program. We accept six physicians each year who have an interest in health care systems, quality improvement, patient safety, and interprofessional collaboration. If you are interested in this track, please make sure you select it when applying via ERAS and the NRMP Match websites (Cleveland Clinic VA Track code: 1968140C2).
Throughout your 3-year residency, your schedule will include four outpatient blocks of 12-weeks duration each. During the outpatient blocks, you will see patients in a primary care setting at the VA Northeast Ohio Healthcare System. You will be the primary provider responsible for a panel of about 200 patients. This unique opportunity provides a great deal of autonomy and unrivaled continuity. Skills and training obtained as a participant in this track will be applicable to all physicians, whether planning further specialty training or a career in primary care.
In addition to helping our residents excel in clinical knowledge, we provide an innovative curriculum to ensure our residents leave the program with the competencies in each of our six educational domains: shared-decision making, interprofessional collaboration, quality improvement, leadership, social determinants of health, and professional satisfaction.
Curriculum Overview (more details below):
- Clinical training in both general medicine and subspecialties
- Didactic sessions and morning reports that address key medical topics
- Creation and implementation of Quality Improvement and Patient Safety Projects
- Interdisciplinary team-based care
- Proactive and reflective care
- Bioethics and health care humanities
1st Year: One Block (12 weeks of primary care clinic during the second half of the year)
2nd Year: First Block (12 weeks), Second Block (12 weeks)
3rd Year: One Block (12 weeks during the first half of the year)
The remainder of your schedule will be at the Cleveland Clinic where you will do inpatient services, consults, and subspecialty clinics similar to the Cleveland Clinic residents in other tracks. You will not have any inpatient services at the VA.
During the COE blocks you will have a balanced schedule that emphasizes clinical training in primary care as well as subspecialty care, quality improvement, dedicated didactic learning time, and self-directed time to study on your own or work on research projects. A typical resident schedule for a block would be as follows:
- 3 half-days of Primary Care clinic (combination of in-person and virtual appointments)
- 1 half-day of either Women’s Health or Geriatrics clinic (will have the opportunity to do both during your time)
- 0-1 half-day of either Procedure clinic, Rheumatology, Gastroenterology, or Endocrinology clinic
- 1-2 half-days of Elective time (can join subspecialty clinic at either the VA or Cleveland Clinic)
- 1 half-day of Urgent Care clinic
- 1 half-day of Panel Management
- 1 half-day of Friday Didactics
- 1 half-day of Administrative time
During elective half-day(s), residents will have the opportunity to develop close relationships with subspecialists of their choice at the VA or Cleveland Clinic. The 12-week block model allows for unprecedented continuity and opportunity to develop subspecialty skills or research.
Residents undergo robust clinical training in both general medicine and subspecialties in our innovative COE curriculum. You will experience autonomy as a joint primary care physician (alternating with one other COE resident) for a panel of VA patients during a two-year period. Additionally, residents will be trained in different areas of general medicine including women’s health, geriatrics, outpatient procedures, and urgent care. Our lectures and morning reports emphasize knowledge regarding essential medical topics. We have updated our curriculum this year to emphasize training in virtual medicine in light of the COVID-19 pandemic.
Below are some examples of how we achieve our curricular objectives:
- Residents receive formal training in the Lean process improvement model and work in interprofessional groups to complete a QI project. At the completion of their project, learners obtain a Lean Yellow-belt certification.
- There are weekly panel management sessions to get a bird’s-eye view of your patients, and initiate panel improvement projects to address issues such as uncontrolled hypertension or poorly managed diabetes within your panel.
Shared Decision Making:
- Learners receive formal training in patient counseling, motivational interviewing, and communication skills.
- During their training at the VA residents have the opportunity to video-record clinic visits with their patients for analysis and direct feedback on a real patient encounter.
- Residents present challenging management cases from their panel to their colleagues to discuss various treatment approaches with other learners and providers.
- Residents partner with NP residents, NP students, Pharmacy Residents, and Psychology Residents, and Social Work Residents in various projects throughout their COE training.
- As members of a primary care team, residents work collaboratively with RNs, LPNs, social workers, pharm-Ds, health psychologists, and administrative staff to manage their panel of patients.
- Our clinical administrators and healthcare leaders at the VA provide educational sessions to our learners on their experiences in their leadership positions.
- Residents get to supervise NP students in their clinic in a dyad model that provides a great teaching experience.
- Residents are expected to direct patient management within their primary care teams. They also lead numerous sessions during our didactics including Journal Club and educational lectures.
Social Determinants of Health:
- Our learners do Reflective Journeys during which they interact with one of their patients for part of a day within the hospital or outside in the community to better understand their healthcare and psychosocial challenges.
- During our didactics we discuss how health policy, legal precedent, societal challenges, and environmental factors affect clinical decision making.
- The Program Leadership are always open to feedback and suggestions from our learners to implement timely and continuous improvement to the curriculum.
- Our Friday didactics occasionally include taking trips to our local Cleveland museums for unique educational opportunities.
- We emphasize residence wellness with dedicated sessions by experts, coffee breaks during several of our Friday didactics for learners to mingle freely, and ice cream parties at the end of our blocks!
We look forward to seeing you at the Cleveland VA Medical Center!
Clinical Scholar Track (ClinScoP)
The Clinical Scholar Program (CLINSCHOP) is our specialized research track that categorical residents can apply for usually in winter of their 1st year and occasionally their 2nd year. Residents participate together in an approximately four month experience during the fall that includes clinical research course work in biostatistics and epidemiology, a small group journal club, research works in progress, and medical writing. It is for residents interested in a career in academic medicine and extra dedicated time for research. Residents apply for this in winter for the following academic year. Applicants submit a personal essay, research proposal and letters of recommendation from both their research mentor and advisor. A blinded review takes place by content and residency program reviewers and up to 8 residents are selected for the track.