Overview

Overview

Fellowship Overview

Cleveland Clinic's Center for Spine Health offers a unique opportunity to receive spine medicine graduate training through our fellowship program. At Cleveland Clinic, you will have the chance to work with some of the country's best Spine Medicine Physicians, Physiatrists, Rheumatologists, Neurologists, Neurosurgeons, and Orthopaedists.

Our Orthopaedic Surgery, Rheumatology and Neuroscience programs are consistently ranked among the top 10 in the nation and No. 1 in Ohio by U.S. News & World Report's Annual “America's Best Hospitals” survey. Cleveland Clinic itself is ranked one of America's top hospitals.

  • Learn more about the individual rankings
  • Our fellows are trained comprehensively - we focus not only on procedural techniques, but also on spine wellness, surgical evaluations, image interpretation, pharmacologic therapies and more. Fellows have opportunities to work with sports medicine, radiology, metabolic bone disease, chronic pain rehabilitation program, and integrative medicine.

    Objectives of the Fellowship

    The goal of the Cleveland Clinic Spine Medicine Fellowship is to train broadly competent, non-operative specialists in the evaluation and management of the full spectrum of spine disorders. The unique integration of non-operative and surgical specialists within the Center for Spine Health, provides fellows the opportunity to develop outstanding clinical skills grounded in an evidence based framework.

    Scholarly activity is encouraged and expected. Fellows are active participants in clinical research and writing.

    Fellows participate in weekly grand rounds and joint surgical/medical conferences as well as tumor board, Cleveland Spine Review, spine research meetings, and cadaver workshops. Fellows are also involved with resident and medical student education. Cleveland Clinic does have a PM&R Residency.

    Procedures Taught

    • Fluoroscopically-Guided Procedures Include:
    • Facet Joint Injections (Cervical, Thoracic, and Lumbar (C-T-L))
    • Medial Branch Blocks (C-T-L)
    • Radiofrequency Ablation of the Medical Branch Nerves
    • Epidural Steroid Injections (Caudal, C-T-L Interlaminar, and C-T-L Transforaminal)
    • Sacroiliac Joint Injections
    • Intra-Articular Hip Joint Injections
    • Piriformis Injections
    • There is exposure to Ultrasound-guided Interventions, EMG/NCS, Vertebral Augmentation
    • (Vertebroplasty/Kyphoplasty), and Spinal Cord Simulation as well.
    Program Details

    Program Details

    Rotations

    Spine Medicine fellows rotate through medical spine clinics, surgical spine clinics and an interventional pain management clinic, as well as a variety of electives and research experiences. The majority of fellow’s time is spent in medical clinics and interventional training and supplemented by surgical clinics, selective/elective experiences, and academic activities.

    Curriculum

    Our fellowship will offer you the opportunity to study all aspects of spine medicine care.

    Spine Medicine

    • Learn the clinical skills necessary for evaluation and management of a wide range of cervical, thoracic and lumbar spine disorders
    • Learn what role diagnostic imaging, electromyography, laboratory studies and diagnostic injection play in the evaluation of patients with spinal disorders
    • Gain experience in the interpretation of imaging studies, including MRI, CT, CT myelography and radiography
    • Gain experience in the use of therapeutic injections (e.g., trigger point and bursae injections and the use of fluoroscopy)
    • Learn the appropriate role of psychiatric pain management in the management of spinal pain
    • Gain experience in the use of the wide array of pharmacologic therapies employed in spine management, including analgesics, muscle relaxants, anticonvulsants, corticosteroids, and anti-inflammatory agents
    • Become familiar with the full range of active and passive physical therapy modalities available for spinal disorders
    • Be exposed to spinal manipulation techniques (manual medicine) and their role in the management of spinal disorders through clinic and twice monthly manipulation workshop/lecture
    • Be exposed to acupuncture or a useful modality in the management of spinal pain and associated symptoms
    • Gain experience in (remove basic) interventional pain management techniques including epidural steroid injections, trigger point injections, sacroiliac joint injections, piriformis injections, facet injections (intra-articular), medial branch and dorsal rami injections, radiofrequency ablation, intra-articular hip joint injections, and other peripheral joint injections.
    • Become familiar with the full range of procedural treatments for managing spinal pain, including indications, contraindications and potential complications of such treatments
    • Learn the indications for appropriate surgical intervention (surgical decision making)
    • Become familiar with the range of surgical options available for patients with a wide array of spinal disorders
    • Become familiar with the indications for referral to spine surgeons

    Research/Elective

    • Develop and complete a clinical research project, working with your faculty adviser
    • Author or co-author at least one paper during the fellowship, to be published in an indexed medical journal

    Conferences

    A weekly spine medicine conference includes case conferences, didactic lectures or a journal club. Interdisciplinary conferences (tumor conference, spine biomechanics course) also are available for interested fellows.

    Requirements

    Applicants for the fellowship must have completed an accredited residency in physical medicine and rehabilitation, internal medicine, family medicine or subspecialty training in a medical specialty (e.g. rheumatology). All fellows must obtain an Ohio training medical license prior to beginning the fellowship.

    Credentialing Standards

    The fellowship’s credentialing standards cover medical assessment and management, including clinical skills, spinal anatomy, infections, pediatric spinal disorders and therapeutics, and interventional spine care, including facet joint injections, medial branch blocks, radiofrequency ablation, lumbar epidural steroid injections, sacroiliac joint blocks and clinical pharmacology.

    Faculty Application Process

    Application Process

    Interventional Spine and Musculoskeletal Medicine (ISMM) Fellowship is the world’s largest spine society representing surgical and non-surgical specialties. There has been a growing demand for well-trained interventional spine and non-surgical musculoskeletal specialists. To address this, NASS developed criteria to officially recognize ISMM fellowship programs that meet a standard of academic and educational rigor agreed upon by the NASS ISMM Fellowship Committee. A core curriculum has been developed to provide high quality, consistent clinical and procedural education for all matriculating trainees. All NASS-recognized ISMM Fellowships have agreed to participate in a Match program which is run by NASS.

    Our program is committed to abiding by this process. Applicant registration opens January 1, 2021 for July 2022 start.  Application is available on the NASS website: www.spine.org. Contacts at each program are listed in the directory.

    Please note that although registration is open up until the match deadline, applicants are encouraged to register as early as possible to allow time for application processing and interviews.

    The interview period is March 23 to July 24, 2021. The match will be made available July 28, 2021.

    If you have any questions regarding the fellowship or the application process, please contact: [email protected] or 216.636.2040.

    Russell DeMicco, DO
    Program Director
    Spine Medicine Fellowship
    9500 Euclid Avenue/S40
    Cleveland, Ohio 44195
    216.444.0229

    Adrian Zachary, DO, MPH
    Co-Director
    Spine Medicine Fellowship
    9500 Euclid Avenue/S40
    Cleveland, Ohio 44195
    216.445.5061

    Santhosh Thomas, DO, MBA
    Co-Director
    Spine Medicine Fellowship
    9500 Euclid Avenue/WL40
    Cleveland, Ohio 44195
    440.899.5516

    Current Fellows

    Current Fellows

    2020–2021 Spine Medicine Clinical Fellows

    Eduardo Bermudez, MD
    Eduardo Bermudez, MD

    Medical School: Morehouse School of Medicine, GA
    Residency: University of Rochester Medical Center - Internal Medicine & Physical Medicine & Rehabilitation

    Jean Betancourt Gonzalez, MD
    Jean P. Betancourt Gonzalez, MD

    Medical School: Univeristy of Puerto Rico School of Medicine - Internal Medicine.
    Residency: University of Puerto Rico
    Vanderbilt University - Physical Medicine & Rehabilitation

    Christopher Bill, MD
    Christopher Bill, MD

    Medical School: Wayne State School of Medicine
    Residency: Beaumont Hospital, Royal Oak - Physical Medicine & Rehabilitation

    Living in Cleveland

    Living in Cleveland

    Cleveland, an ethnically diverse, mid-sized city located on Lake Erie, features a host of cultural attractions, recreational activities, major sporting events and an exploding culinary scene. Cleveland is home to the second largest theater district in the U.S., a park system featuring 23,700 acres in 18 reservations, and is the birthplace of rock ’n’ roll, home to the Rock ‘n’ Roll Hall of Fame and Museum. Cleveland Clinic is located near the University Circle area, which is the cultural epicenter of Cleveland. This area features Severance Hall and the world-renowned Cleveland Orchestra, the Cleveland Museum of Art, several other museums, and Case Western Reserve University. Downtown Cleveland, home to all major sports venues and an exploding culinary scene, is approximately two miles from Cleveland Clinic’s main campus.