Is there an orientation program for incoming residents?
Starting around mid-June, we offer a 2-week orientation program essential for all new residents joining our team. During this period, we will cover several modules that must be completed before July 1st. These modules include Introduction to Hospital Medicine, ICU, clinic, Code Blue, Fundamental Central Venous Access (FCVA) course simulation, and Electronic Medical Record (EPIC) training. You'll also be able to shadow senior residents for a couple of days without any clinical duty. This will allow you to get a feel for the job before you start working on July 1st.
Is there a formal didactic curriculum, and what is its structure?
We have noon lectures from Tuesday to Friday every week, covering various topics in our curriculum. At the beginning of each year, we hold a boot camp for PGY-1s, where we teach about the most common diseases we encounter on inpatient rotations and how to interpret the most common diagnostic tests, such as ABGs, EKGs, PFTs, and CXRs. After Bootcamp, we move on to subspecialty didactics, clinical series, and evidence-based medicine lectures. Additionally, we have a dedicated didactic curriculum for cardiology that runs throughout the year. Over the three years, we will cover all MKSAP topics during our noon lectures.
On Fridays, we have resident lectures, which include Medical Management (PGY-1), Mortality and Morbidity (PGY-2), and Journal Club (PGY-3). These presentations are also attended by faculty at the hospital and guest subspecialty attendings.
What programs exist for resident education?
In addition to our educational programs, we offer several courses exclusively for Cleveland Clinic staff. These include the Distinguished Trainee Educator Program, an introduction to clinical research, and Biostatistics courses. Many of our residents take advantage of these courses free of charge, provided their schedule allows.
Does the general volume of clinical responsibility balance service and education?
Our program generally provides a balanced combination of patient exposure and protected time for education.
A typical day in hospital medicine involves starting with a half-hour morning report. Here, residents discuss interesting cases and learn from each other. After that, if you are a first-year, you will tend to an average of 6-7 patients, while seniors supervise 12-14 patients. You will improve your clinical knowledge during rounds by working at the bedside. Noon lectures are scheduled almost every day of the week. In the afternoon, you continue with patient care, complete notes and discharges, and coordinate care.
How does the resident's autonomy change as they progress through the program?
We aim to equip you with the skills and knowledge necessary to provide independent patient care during your training. As a first-year resident, you will work closely with your senior resident and attending physician to gain practical experience. As you progress through your training, your level of autonomy will increase as your clinical expertise and confidence grow. For instance, during your second year, you will rotate on a night float on the HM floors and ICU, where you will be responsible for making decisions independently. However, an on-call hospitalist or intensivist will always be available to provide additional support if you require assistance.
What do the regular working hours look like?
On Hospital Medicine rotation: regular working hours are from 7 am to 5 pm, six days a week.
On ICU: regular working hours are from 7 a.m. to 7 p.m., six days a week.
On Clinic: regular working hours are from 8 am to 5 pm, ~ 4 days a week on-site, depending on your clinic (3 different sites). You will have a fifth admin day at the hospital to follow up on your clinic patients (labs, follow-up calls, etc.).
Elective: regular working hours are 8 am to 5 pm, five days a week; Saturday is not usually a working day on elective, or if you have a weekend call (night shift, ICU Day/night call).
What does the call schedule look like?
On Hospital Medicine days, every resident will have a long call from 7 am to 7 pm (will carry the cross-coverage pager from 5 pm to 7 pm) ~ 5 days a month.
No calls on ICU as you are already working from 7 a.m. to 7 p.m.
How many night calls will I have in the first, second, and third year?
1st year: 4 weeks of HM floor night float (2 weeks block each) 7 pm to 7 am. You will have ~ 4-night shift calls on Saturdays a year.
2nd year: 2 weeks of HM floor night float (2 weeks block), and four weeks of ICU night float (2 weeks block each), plus ~ 6-night shift calls on Saturdays a year (combined ICU&HM).
3rd year: 2 weeks of HM floor night float (2 weeks block), plus ~ 2 night shift calls on Saturdays a year.
What provisions are made for backup call or sick-call coverage?
We have a Jeopardy system for coverage for each year's class. Each resident will be on elective/jeopardy module 4 weeks a year, i.e., you will be doing in-house elective, but you may be pulled to cover someone from your classmates in case of absence in core rotations (HM, ICU, Clinic, nights, etc.). In the case of Jeopardy activation, there is a payback system.
Are research opportunities provided to residents? Is this a required experience?
We are proud of our research dedication! Almost all our residents actively participate in research. All our research is clinical research, with a broad spectrum, from case reports to database studies. Most of our residents have their IRBs and lead projects. Every categorical resident must complete a scholarly activity before graduation. Also, PGY-3s present their scholarly activity at our annual “Research Day” at the end of the year.
Is there a possibility of "protected" time for research?
We offer research electives for residents to focus on their research projects. This is limited to 4 weeks per year and six weeks in 3 years (for second and third-year residents).
Is attendance at regional and national conferences encouraged? Is it funded, and if so, to what degree?
Yes, attending conferences is highly encouraged by the program. Many of our residents present their scholarly activity at various national conferences. Residents from all years have three conference days, extra to yearly PTO. Residents can use their educational allowance to attend meetings.
Are there any required rotations that take place outside of the city?
Our continuity outpatient clinic rotations occur outside of the hospital (no on-site clinic), all located within a 15-minute distance from the hospital. All other required rotations occur at our hospital (except electives).
Is it possible to rotate at the Cleveland Clinic Main Campus?
Many of our senior residents got to rotate at Main Campus at multiple departments.
How often are the residents evaluated, and what is the evaluation structure (forms, face-to-face, etc.)?
We have an excellent evaluation system through the MedHub platform, supervised by the Cleveland Clinic GME, and built to evaluate a resident from all aspects. By the end of each rotation, you will have a face-to-face evaluation with your attending to have bi-directional feedback.
Also, your attending will receive an electronic evaluation request during each rotation to evaluate you. Points in the evaluation include the six core competencies: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Professionalism, Practice-Based Learning and Improvement, and Systems-Based Practice.
Each resident will have a semi-annual formal evaluation meeting with the Chairman of the Clinical Competency Committee (CCC) to determine the resident’s progress on achievement of the specialty-specific milestones based on cumulative evaluations from staff.
Additionally, you will receive an evaluation from your peers and nursing staff similarly. This is meant to give residents a 360-degree evaluation of their ongoing growth and improvement.
Is there a formal mentoring program for new residents, and do faculty serve as mentors?
All PGY-1 residents are assigned to an advisor from the core faculty who meets with the residents regularly. In addition, at the end of 1st year, residents select their mentor from our volunteer faculty depending on the resident’s future goals and interests.
We also have a buddy system where each PGY-1 resident is assigned to a senior (PGY2 or PGY3) resident before the academic year starts. Each buddy helps orient the incoming residents regarding the program and city and helps with their needs; this support continues throughout the year.
What are the expected medical students’ teaching responsibilities of residents?
Our hospital medicine and ICU teams have rotating medical students in almost all modules. Residents are expected to supervise the medical students with the team's attending physician. This is a great teaching experience for the residents as they get to learn while they are teaching at the same time.
What ancillary support is available: phlebotomy, respiratory therapy, social workers, etc.?)
Here at Fairview Hospital, we have a dedicated phlebotomy team 24/7, highly trained RTs 24/7, and very efficient and approachable case managers/care coordinators. Also, we have descent transportation personnel who will take patients to the CT scans / MRI or other procedures. You will not be responsible for pushing beds or bringing patients from the ED.
Is parking a concern for residents in your program?
Not at all. We have free, covered parking located attached to the hospital. It takes less than a minute to reach the hospital.
How are fellowships handled?
We have many residents who apply to a wide variety of fellowship specialties. Residents are supported by the program, whichever pathway they pursue in their career for their future, either primary care, hospitalist, or fellowship training.
Do you have any in-house fellowships?
No, currently, our hospital does not have any in-house fellowships.
Where do your graduates go (e.g., fellowship, academics, private practice)?
Our program equips residents with the skills and knowledge to excel in any healthcare setting, whether as a primary care physician, hospitalist, training fellow, or academic professional. Over the past several years, our graduates have pursued careers at many prestigious institutions for jobs or further training. Furthermore, many have established their practices.
Are meals paid for when on call?
No, unfortunately, we don’t have a meal stipend.
What is your family leave policy?
Compliant with the FMLA act, residents have eight weeks of maternity leave and/or four weeks of paternal leave. In addition, three days of bereavement also allowed for family emergencies. For further details, please refer to GME policy. The program adheres to The American Board of Internal Medicine (ABIM) policies for time away from training.
Are moonlighting opportunities available?
Yes, PGY-3s are allowed the moonlight, except holders of J1 visas. Interested residents initially apply for permission for moonlighting; once approved, they start moonlighting. At least a few residents every year do moonlighting.
Is there a House Officers Association?
Yes. It is called HSA (House Staff Association), an association throughout the Northeast Ohio Cleveland Clinic Hospitals. We have residents representing our hospital at this association every year.
