Residency FAQ

Medical_Residents_-_Internal_Medicine_Residency_Program

How many residents are currently in the program?

140. We have 37 categorical PGY1, 8 Preliminary PGY1s, 38 PGY2s, and 40 PGY3 residents. Our Med-Peds program has 15 residents. In addition, we have two Medicine-Genetics residents. Besides seeing photos of our residents on every page of the Residency Program website, you can click here to see all of our current residents.

 

How many PGY1 positions are available?

We have 26 Categorical positions, 4 Med-Peds, 8 Prelim, 1 Internal Medicine-Genetics, 2 Harrington Physician-Scientist Pathway and 6 Center of Excellence-Internal Medicine.

What criteria are used to select house staff?

We look for applicants who demonstrate a strong commitment to learning and professionalism, value teamwork, and have academic potential. We hope to recruit residents who have an intrinsic desire to learn, value autonomy, and who will become excellent teachers and can help our program thrive.

How many clinical training sites are there?

We have two hospital sites. The first, University Hospital Cleveland Medical Center, is a large tertiary academic hospital located on the CWRU medical school campus on the east side of Cleveland, and serves as a teaching affiliate for Case Western Reserve University. The second is the Louis Stokes Cleveland VA Medical Center, a state-of-art VA hospital, which is located one mile across University Circle from UH Cleveland Medical Center. In the past five years University Hospitals Cleveland Medical Center has undergone extensive aesthetic and functional upgrades rendering it a lovely place to train, and the Louis Stokes Cleveland VA Medical Center is one of the most modern and well laid-out VA hospitals in the nation. Our residents also may opt to spend ambulatory time in a variety of sites in the greater Cleveland area.

How much time do house staff spend at the two sites?

House staff spend approximately 2/3 of their time at UH Cleveland Medical Center and 1/3 at the Louis Stokes Cleveland VA Medical Center.

How do you choose the best training program for you?

When our medical students ask us what to look for in a training program, we offer a few objective parameters, such as the NIH research rank of the department which tends to reflect the depth and breadth of the faculty research as well as the caliber of medical schools residents come from. In addition, the places residents go after completing their training, and the competitiveness of residents for fellowships, is a reflection of how the training program is regarded in the academic medicine community. We would invite applicants to compare our NRMP residency match lists and our fellowship match list to our peer Midwestern academic programs.

The most important factor, however, is the learning environment of the program, which is best determined by speaking with current residents. At the end of the day, what matters most is finding the perfect fit - identifying a training program that allows a trainee to thrive and pursue his or her long-term career goals.

There are no validated systems for ranking Internal Medicine Residency programs. In 2013 the U.S. News & World Report attempted to rank Internal Medicine Residency programs, but their methodology was heavily based upon the overall name recognition of the institution and most Internal Medicine Program Directors do no view this as a valid method to rank programs. Now Doximity (owned by U.S. News) is attempting a ranking system that is highly reliant on programs lobbying faculty to “vote” for their program. Like a number of academic programs we have opted not to participate in the Doximity rankings. A number of residency program director groups (IM ad EM among others) have come out with a policy of not participating in Doximity rankings.

 

Why should I strongly consider the program if I am looking to enroll as a Preliminary Internal Medicine intern?

At UH Cleveland Medical Center, our preliminary residents are exposed to a breadth of both general medicine and subspecialty faculty on our inpatient ward teams. For residents going into diverse fields such as ophthalmology, radiology, and dermatology, the prelim medicine year is designed to build a strong foundation of knowledge, skills and ability to practice general medicine, exposing ways internal medicine relates to the future specialty of a resident's choice. At UH, our preliminary medicine residents rotate on general medicine teams at both University Hospitals and the Louis Stokes Cleveland VA Medical Center as well as inpatient subspecialty teams. These inpatient subspecialty teams focus on infectious disease, cardiology, gastroenterology, nephrology, and hematology/oncology and are staffed by attendings that specialize in that field. Due to the high quality of our training our residents are both capable and comfortable managing complex medical issues by the end of the preliminary medicine year; this undoubtedly positions them as strong candidates and helps them in their future field of choice.

Our Preliminary Internal Medicine interns have two separate 2 week blocks and "block zero" (week of June 23 - July 1) at the end of the academic year for a total of 5 weeks of vacation. In addition, each resident will have four days off on either Thanksgiving, Christmas, or New Years based on personal preference. We guarantee that preliminary residents will have at least 4 days off in each 4 week block. All Preliminary Internal Medicine interns at UH Cleveland Medical Center have 2.5 blocks (10 weeks) of protected elective time, as well as 2 weeks of ‘jeopardy call’ during which a resident is able to participate in any project/consulting service they wish but remain available to cover shifts in case of any unexpected call-offs.

What are the unique aspects of the Internal Medicine Residency program?

Our Internal Medicine Residency program provides trainees with a strong foundation in clinical and academic medicine balanced with a supportive and collegial atmosphere. The Department of Medicine is top ranked in NIH funding and clinical care in U.S. News & World Report rankings. Many of our faculty are academic leaders in their field with strong national reputation. UH ranks number nine in the U.S. for research funding. Research rankings reflect a strong academic mission and an outstanding cadre of faculty who are great teachers, so for residents who are not interested in research these rankings still reflect a strong learning environment.

When we ask our house staff about the unique aspects of the training program, they say the camaraderie among the house staff, relationship with faculty, program leadership and supportive atmosphere are unmatched.

Our residents receive outstanding clinical training working with approachable faculty who love to teach in two nationally recognized institutions, UH Cleveland Medical Center and the Louis Stokes Cleveland VA Medical Center. We also have innovative programs in Ambulatory Care (the VA–based Center of Excellence), and International Health.

Case Western Reserve University offers a balanced approach to clinical education, training and mentorship in an atmosphere that allows residents to achieve their best.

 

What do most of the residents do after residency?

A comprehensive list of our alumni with respect to future career plans is available on our website. A large portion of our residents successfully matriculate into subspecialty fellowships throughout the country, with the majority securing their first choice program. Our success in the fellowship match compares favorably with any academic internal medicine program in the Midwest. Our program also supports residents pursuing outpatient primary care or hospitalist positions. Finally, a large number of our residents end up in academic careers.

How do your residents do in obtaining fellowships?

Our residents have done extremely well in matching to competitive fellowships, with greater than 95% getting one of their top choices. Our website and application materials list the fellowship matches of our residents over the past decade. Our residents have done quite well in the most competitive areas such as cardiology, hematology/oncology, gastroenterology, and have successfully matched in all fellowships available. We had an extremely strong fellowship match for the classes of 2014, 2015 and 2016, with residents matching at John Hopkins, Beth Israel Deaconess, University of Pennsylvania, Mayo Clinic, Duke, Northwestern, University of Michigan, Washington University, UCLA, Stanford, among others. Our program has an excellent grasp on ways to prepare residents for the subspecialty match. Our subspecialty ward teams in cardiology, nephrology, geriatrics, gastroenterology, infectious diseases and hematology/oncology offers a unique opportunity for residents to work closely with subspecialty faculty and form close mentoring relationships, which is a tremendous asset in getting letters and advocacy for fellowships.

 

Are your rotations based on months or blocks?

We use a block schedule, which represents a four-week period, although some rotations may be 0.5 block long. The intern schedule is based upon 13 blocks. A block schedule makes the switch days standard and facilitates days off and weekend coverage.

What is the standard breakdown of rotations?

 

Categorical Intern

Wards 4.5 blocks
Elective 1
Professional Development 0.5
Ambulatory 1.5
CICU 0.5
Geriatrics 1
Vacation 1
UH MICU 1
VA MICU 0.5
Jeopardy 0.5
Nightfloat 1

 

 

 

 

 

 

 

 

 

 

Preliminary Intern

Wards 5.5 blocks
Elective 3
UCC 1
ICU (VA/UH) 1.5
Nightfloat 1
Vacation 1

 

 

Junior Resident

Vacation 1 block
Elective 2
Ambulatory 2.5-3 (split into 5-6 half-blocks spaced through the year)
Wards 2.5-3
UCC 0.5
ICU 2-2.5 (mandatory 1 block UH MICU and 1 block CICU)
VA Cardiology 1-1.5
Nightfloat 1-1.5

 

Senior Resident

Vacation 1 block
Elective 3
Patient Safety & Gen Med Consults 1
Ambulatory 2.5-3 (split into 5-6 half-blocks spaced through the year)
ICU 1.5
Wards 2.5
VA Cardiology 0.5

On the inpatient service, do you have subspecialty teams?

Yes. A remarkable strength of our program is that we have subspecialty teams dedicated to each traditionally inpatient service. Staffed by subspecialists, these teams provide a rare opportunity to work closely with experts in each field. Moreover, residents who are interested in particular fields can have first-hand exposure from the beginning of training and gain additional mentorship. In addition, we have dedicated general medicine teams at UH Cleveland Medical Center and the Louis Stokes Cleveland VA Medical Center, which provide an opportunity to care for undifferentiated patients.

Can you tell me more about each rotation?

Sure. Below you can find a description of teams, types of patients admitted, and common diseases encountered.

Hellerstein

The Hellerstein team is composed of four interns, two senior residents, a dedicated cardiology fellow, and a staff cardiologist. This team takes care of patients with a variety of cardiology diagnoses including acute myocardial infractions, decompensated heart failure, and valvular disorders. Interns and residents are exposed to detailed interpretation of EKGs, cardiac catheterization films, echocardiograms, and stress tests.

Ratnoff/Weisman

There are two hematology/oncology house staff teams at University Hospitals Seidman Cancer Center. Each team is comprised of two interns and one senior resident with a hematology/oncology faculty attending or a hematology/oncology hospitalist attending. Residents and interns are exposed to patients with known solid tumor malignancy, blood dyscrasia, or complication from chemotherapy. A multi-disciplinary approach including social work, palliative care, nutrition, physical therapy, and pharmacy is utilized for these complex patients.

Carpenter

Carpenter is the infectious disease team composed of two interns and one senior resident with an infectious diseases faculty attending. All patients with HIV-related conditions are admitted to this inpatient service. Encephalitis, meningitis, infectious endocarditis, cellulitis, and pulmonary infections are just a few other disease processes encountered on this team. Our Program Director, Keith Armitage, MD, serves as one of the exceptional attendings on this service.

Dworken

Dworken in the inpatient gastroenterology service comprised of two interns, one senior resident, a gastroenterology fellow, and two staff gastroenterologists. The team rounds separately on general gastroenterology and hepatology patients. During this rotation, residents are exposed to patients with end-stage liver disease and its complications, inflammatory bowel disease, biliary tract disease, and pancreatic disease. House staff also have the opportunity to view colonoscopies, EGDs, and more complex studies on their patients.

Naff/Wearn

The two general medicine house staff teams at UH Cleveland Medical Center are each comprised of two interns, one resident, and a teaching hospitalist. Patients on these services are often undifferentiated with respect to diagnosis; thus, the work-up is comprehensive and broad (think "House"). Exposure to complex rheumatologic and endocrine diagnoses is common on these teams. The faculty who attend are exceptional diagnosticians and teachers.

UH MICU

The UH MICU team is comprised of four interns, five senior residents, two pulmonary/critical care fellows, and a staff intensivist. During this rotation, you will become familiar with hypovolemic and distributive shock, fulminant liver failure, blast crises, toxic ingestions, and ventilator management. The UH MICU is uniformly accepted as one of the best inpatient residency experiences, mostly as a result of high patient acuity, complex multidisciplinary issues, and an abundance of procedures available for every resident level.

UH CICU

The UH CICU team is composed of five senior residents, one day intern, one night intern, a cardiology fellow, and a staff cardiologist. Based upon house staff feedback, the structure of the team was completely reinvented in 2013 and the senior residents now alternate through a Q4 night call system. Residents actively participate in the care of patients with cardiogenic shock, ST-elevation myocardial infarction, ventricular arrhythmias, high-grade heart blocks, massive pulmonary emboli, and refractory heart failure requiring LV assistance devices or transplants. The staff cardiologists rotating through UH CICU are tremendous teachers, and most residents feel proficient at basic cardiac imaging following this rotation.

VA Cards

The VA Cardiology service is composed of five senior residents (including one night resident) with Q4 overnight call. There is also a cardiology fellow and staff cardiologist per team. This team exposes residents to patients with general cardiology diagnoses as well as those requiring CICU care.

VA Wards

There are four general medicine house staff teams at the VA. Each team is comprised of two interns and one senior resident with a teaching attending. Attendings at the VA can be general internists or specialists. Residents and interns often comment that the level of autonomy, complexity of comorbid illness and their patients, as well as the quality of teaching at the VA helps build their clinical confidence.

VA MICU

Three interns, one senior resident, a pulmonary/critical care fellow, and an intensivist make up the VA MICU service. The VA MICU is a closed unit with an abundance of available procedures. Typically not as busy as the UH MICU, this rotation gives interns and residents the opportunity to care for critically ill patients, while at the same time allowing for plenty of concurrent learning and education.

UH Nightfloat

The UH nightfloat team is composed of two second-year admitting residents working alongside a third-year night-time acting chief resident, who triages the admissions. There are also three interns on nightfloat who deal with cross-cover issues. Residents and interns are usually assigned between 2-4 weeks of nightfloat per year.

VA Nightfloat

The VA nightfloat team is composed of a second-year admitting resident and one intern who handle with cross-cover issues for the house staff teams.

Elective

Categorical interns have four weeks of elective time, usually distributed into two 2-week blocks. Second and third year residents progressively gain more elective time in their schedule (between 8-12 weeks). There is no set curriculum for electives; in fact, house staff can even choose to do electives outside of the Department of Medicine. One strength of our program is the flexibility of elective time, and house staff often choose to rotate on inpatient consults, outpatient specialty clinics, or participate in research. Furthermore, you can split your individual elective time between multiple adventures!

How many people are on a team?

Most of our inpatient teams are one resident and two interns. For the first four blocks of the academic year, we double the resident coverage at UH to help with additional support for new interns and acting interns. Two of our subspecialty teams (renal and cardiology) each have two residents and four interns throughout the year.

What is the conference curriculum?

We have a resident noon conference every day with lunch provided at both UH Cleveland Medical Center and the Louis Stokes Cleveland VA Medical Center. Perhaps the highlight of our week is the Department of Medicine Morbidity and Mortality (M&M) conference completed separately at both hospitals. The M&M conferences include discussions of challenging clinical issues, ethical considerations, patient safety, and system issues. We also sponsor weekly Grand Rounds, which is a live presentation at UH Cleveland Medical Center and is broadcasted to the Louis Stokes Cleveland VA Medical Center. The remaining three days are Resident Noon Conferences, which are a combination of staff lectures, case-based sessions, and interactive board preparation sessions. At the beginning of the year, we have special lectures called the Intern Boot Camp series that focus on knowledge and skills needed for beginning interns (this time is pager-free for interns). Finally, Morning Report takes place three days a week for residents and two days a week for interns (also pager-free time for interns) and is a case-based approach to clinical decision-making.

What is the Professional Development block?

All categorical interns spend two weeks on the Professional Development block, which focuses on establishing and developing procedural competency, resuscitation proficiency, communication skills, physician wellness, and physician exam skills. The block also includes modules on cultural competence, patient safety, meditation and reflection, humanism in medicine, and conflict resolution.

What are my options for elective time?

We are proud that despite changes in the program to meet duty hour rules, we have been able to preserve our culture of freedom and quantity of elective time. There are no strict regulations on what elective can be, nor is there an available list of electives that can be chosen. Residents are welcome to design their own electives. Some examples include inpatient consult services, outpatient subspecialty clinic rotations, research or any combination. If new interns are having difficulty identifying a possible elective, our Chief Residents are experts in guiding and creating worthwhile opportunities for them.

What is the Primary Care block?

All categorical interns spend four weeks on Primary Care blocks in the PGY1 year. Interns are introduced to their clinic preceptors and patients and have protected time for small group learning sessions focused on ambulatory and primary care issues. Clinical activities include a variety of medical subspecialty clinics, urgent care, and continuity clinic. We are committed to having a balance between the inpatient and outpatient educational venues, and the Primary Care block for PGY1s reflects the commitment of the program and general medicine faculty to ambulatory education.

Can you tell me more about the ambulatory curriculum?

As of 2015, no residents have continuity clinic when they are on ward or ICU rotations. All PGY2 and PGY3 residents have five to six two-week ambulatory blocks evenly spaced through the year. All PGY2 and PGY3 continuity clinics occur during these blocks. PGY1 residents also have ambulatory blocks scattered throughout the year.

Continuity clinics occur either at the VA or at the Douglas Moore Clinic, which is a resident-run outpatient clinic at University Hospitals. There are no outpatient clinics for residents while on inpatient rotations. Spreading the blocks throughout the year is our version of the "6+2" Model and prevents residents from having long periods of time on inpatient services without seeing their clinic patients.

Ambulatory block activities include continuity clinic, medical subspecialty clinics, urgent care, primary care continuity clinic, and clinic-based quality improvement. Beginning in 2015 we will have a half day each week devoted to didactics and small group learning. Residents interested in primary care can do additional ambulatory blocks and tailor their experience based upon career goals. There are also built in free half days that allow residents to meet with potential mentors or explore other subspecialty clinics.

Is there a required neurology and geriatric service?

Interns spend four weeks on the geriatric service, which includes inpatient geriatrics, geriatric clinics, a home visit and nursing home care. There is no required time on neurology service, though elective time can be used if desired. Senior residents also have required structured geriatric experiences as part of the ambulatory rotations.

Are international experiences available?

Case Western Reserve University and Department of Medicine have a long tradition of involvement in International Health research, education and clinical training. Many of our residents pursue overseas experiences during training. Residents have spent time in Vientiane, Laos (where the Department of Medicine is engaged in an education project) and in Kampala, Uganda (where we have a long-standing, multifaceted research collaboration in Infectious Diseases, Cardiology and Hematology-Oncology). You can read about the international experiences our residents are involved in by visiting our Resident Travel Blog.

What is your approach to the work hour reform?

Our experience has taught us that only by decreasing the workload can we achieve duty hour compliance, and we have limited the number of admissions and number of patients an intern can follow. We continually monitor workload and duty hours, and have made changes in the program structure annually.

What changes have you made to support the duty hour reform?

We have limited the total number of patients on the teams and the number of admissions, and have continually expanded the number of non-teaching services. We have changed the structure of several of our teams, and have restricted the number of patients an intern can care for. We have added nightfloats at both UH Cleveland Medical Center and the Louis Stokes Cleveland VA Medical Center, and have created robust non-teaching services at both UH and the VA. As we know that things can get busy we have added a swing resident at the Louis Stokes Cleveland VA Medical Center responsible for managing the unforseen overflow of patients in the evening hours. The swing resident is focused on helping the nightfloat team as well as call team.

Are you participating in the iCompare trial?

Yes, for the academic year 2015-2016 we participated in the iCompare trial. We were randomized to the intervention arm, which means that we have some additional flexibility with duty hours but can decide to make changes based upon educational goals and resident well-being (we were not required to make changes). The only change we made was to have interns in the UH MICU take overnight call one-on-one with their resident, with a nightfloat system to facilitate mandatory napping while on call. There was a strong consensus among the residents that much of the procedure experience occurred at night and interns were missing this. We did not make changes to ward rotations. We will canvass our interns about continuing the system of overnight call for an additional year (under the iCompare rules).

How many admissions can I get when I am on call on ward rotations?

Interns are allowed to get three patients on call, including nightfloat admissions and ICU transfers. Interns are not allowed to follow more than ten patients at UH and do not get short call admissions if they have eight patients. For the first several blocks of the year, interns at UH are paired with AIs and do not follow more than six patients. The cap is eight patients for the hematology/oncology teams and eight at the VA. Interns do not take overnight call on the wards and take no new admissions after 7:00 p.m. on their call day. We have modified our nightfloat system to ensure that interns can sign-out as early as 6:00 p.m.

Do you have short call?

Our general medicine wards and some subspecialty wards have one short call per four-day admitting cycle, which is limited to nightfloats and ICU transfers (no new admissions) at UH but may include new admissions at the VA. There is no short call on weekends, and no short call if an intern has eight or more patients.

Is there a nightfloat system?

We have a nightfloat system at both UH Cleveland Medical Center and the Louis Stokes Cleveland VA Medical Center. Under the new duty hours, all interns now rotate as part of the nightfloat team, supervised by upper level residents. We emphasize teamwork and mentoring of nightfloat interns by upper level residents who are part of the nightfloat team. Interns on the nightfloat team cover the teams not on call, and may admit one or two patients. Most admissions are done by PGY2 or PGY3 residents, or by the non-teaching services. We also have third year medical students as part of the nightfloat team, and interns enjoy teaching these students.

How do days off work?

Typically, on inpatient rotations house staff get one Saturday, one Sunday and one Golden Weekend per four-week block. On some rotations including ICU rotations, residents get one day off per week which may fall on a Friday, Saturday, Sunday or Monday. Non-ward rotations have additional weekend days off. No matter the rotation, all house staff are ensured four days off per block. We have also put together a great selection of activities you can do any season here in case you want to explore the city more on your day off.

How do you handle vacation time?

Each resident has four weeks of vacation divided into two 2-week blocks. Vacation requests are taken before the start of each academic year and most requests are fulfilled, especially for significant life events (weddings, family vacations, etc.) Every intern starts their academic year during the last week of June, as such when the new intern class arrives the following year the graduating interns have an additional week off (that is five weeks total). During this last week of vacation many classes take a vacation together as a group to one of many tropical destinations (Florida, Dominican Republic, Cancun).

How do you educate house staff about patient safety and quality?

Both of our teaching hospitals have committed significant resources to patient safety and quality. UH Cleveland Medical Center ranks third in the 90-member university hospital consortium in quality measures, and has a large quality center that is involved in many initiatives, including educating our residents. In August 2012, UH Cleveland Medical Center received the American Hospital Association’s McKesson Quest for Quality Prize, making our institution the top hospital in the nation for its leadership and innovation in quality improvement and safety - and the first urban academic center to win this award. In 2011 the Ohio Patient Safety Institute awarded UH Cleveland Medical Center the Best Practice Award for our Resident EQUIPS (Externship in Quality and Patient Safety). The Resident EQUIPS program is a first of its kind rotation where the residents participate in our hospitals quality initiatives. The Louis Stokes Cleveland VA Medical Center is a center for patient safety and quality scholarship and education, and offers a fellowship in this area. We expect our residents to be leaders in patient safety and quality initiatives at the next step of their careers. We also include Patient Safety and Quality modules in the Professional Development block for interns, and involve PGY2 residents in quality committees.

What is the patient mix?

At UH Cleveland Medical Center we have about 1/3 tertiary or quaternary referral patients; 1/3 come from an undeserved urban population; and 1/3 community based internal medicine. UH Cleveland Medical Center is one of two major referral center in Northeast Ohio, and has a busy transfer center. The patient population at the Louis Stokes Cleveland VA Medical Center is both primary care and tertiary care, and comes from the greater Cleveland area and surrounding counties.

How are the ancillary services at the VA?

The ancillary services have improved significantly over the years. There are phlebotomy rounds eight times per day to ensure that patients can get their lab draws throughout the day; IV therapists are also available during the day to place IV lines. After midnight, the IV therapist is also available to do blood draws (blood cultures, etc.) Nurses in the ICU and telemetry floor do all admission ECGs, and all nurses will do ECGs for acute clinical changes in patients (i.e., chest pain). Nurses do labs on-demand for patients with a change in clinical status.

Do you have non-resident covered services?

We have continually expanded our non-teaching services in order to decrease the house staff workload and keep the focus on education. At UH Cleveland Medical Center we have non-teaching services in cardiology, oncology and general medicine; in addition, we have expanded our general medicine non–teaching service at the Louis Stokes Cleveland VA Medical Center, allowing us to cap interns at eight patients.

Do you have hospitalist services?

At UH Cleveland Medical Center, our academic hospitalists attend on our general medicine teams, and we have separate non-teaching hospitalist services. In 2009, we established one of the first non-teaching hospitalist services in an academic VA Hospital, which has since expanded.

Is there a research pathway?

Yes, we participate in the ABIM research and have recently strengthened our program with the creation of the Harrington Physician Scientist Pathway. We also support residents who want to do an extra year of training, with two of the four residency years devoted to research. This option is not part of the formal pathway, but it is supported by the Department of Medicine and fits within the ABIM rules. There are a large number of well-funded, research-intensive faculty in the Department of Medicine. The Department of Medicine at Case Western Reserve University ranks 11th out of 126 in NIH funding among academic departments of medicine.

Is there a scholarly requirement?

All senior residents are required to give a scholarly seminar as part of Noon Conference series. The majority of our residents do research, many presenting at national meetings and our annual Department of Medicine Research Day. Resident research is not a requirement, but the overwhelming majority of our residents are involved in research projects. All PGY3 residents are required to do a quality improvement project.

Are there research electives?

Residents can use some or all of their elective time throughout their training to pursue research projects. As stated above, we also participate in the research pathway. We have a monthly evening seminar series called the Agre Society (named for a graduate of our program who received the Nobel Prize for discovering the aquaporin channel) on research careers and mentorship.

Is there a mentoring program?

All house staff are assigned to one of the Program Directors or Associate Program Directors. In addition, each intern is assigned to one of the Chief Residents based on their interests to begin the mentoring program. From there, they are assisted in obtaining mentors based upon their career choice. Recently, our PGY2 and PGY3 residents also instituted a mentorship program, which focuses on communicating with new interns immediately following the match and helping with the transition into internship. We conduct an anonymous survey of our residents every year and ask focused questions on issues such as mentorship to make sure we are meeting the residents’ needs and always improving the program. This year we are initiating a coaching program for all PGY1s.

How do I find a research mentor?

There are a large number of faculty supported by NIH grants and other external funding who provide mentorship. Interns meet with the Chair of the Department early in the intern year to discuss career counseling, and meet with one of the Programs Directors twice a year. We hold interactive sessions with the subspecialty divisions so residents can gain awareness of the faculty's research interests. Interactions during these meetings, as well as less formal interactions with Chief Residents and peers provide guidance for selecting research mentors. You can view our Research Abstract Directory to see the research projects taking place in the divisions and identify a faculty member to talk to based on your interests.

What is the salary?

The current PGY1 salary is $54,175. Cleveland has one of the lowest costs of living of any major metropolitan area, so the salary goes a long way at Case Western Reserve University.

Where will I live?

Most residents live within a mile or two of the hospital in Cleveland or one of the inner ring suburbs (Cleveland Heights, Shaker Heights). Housing in these areas is safe, very inexpensive compared to other large metropolitan areas, and convenient to the hospital. University Circle is a great place to live in as there are always exciting things to do. An increasing number of our residents also live in downtown Cleveland, which is about a 15-20 minute commute. You can read the interviews with our residents to get a glimpse of where they live and places they like to go to.

How will I eat?

Lunch is served at noon conferences. At UH Cleveland Medical Center residents have swipe cards for on call meals, and at the Louis Stokes Cleveland VA Medical Center food is provided for on call residents.

Do you have residency retreats?

We hold three major retreats for our residents. At the end of the year we meet off-site with all the categorical interns to talk about the skillset needed to be a successful resident and teacher in their PGY2 roles. We have an off-site retreat for the rising PGY3s, with the focus on system updates as well as the manager/leader responsibilities of PGY3s. Mid-year we have an evening retreat for current interns to discuss how the year is going and get their feedback on the training program.

Are there house staff social events?

Our residents organize house staff social events on an ad hoc basis during the year with financial support from the program. The Department of Medicine organizes a Holiday Party in December, and a Graduation Dinner in spring. Families and friends are invited to the Graduation Dinner, which also features awards and a skit spoofing the hospitals and faculty (primarily the Program Directors). In addition, the rising Chief Residents organize a Morale Week in February packed with fun events. In spring there is an annual event known as Bronson's Day which involves all the interns having the day off to attend a Cleveland Indians baseball game with their classmates and the Chief Residents. We also have a Summer Picnic (with coverage by attendings and fellows) in June as part of our Chief Resident and PGY2 sendoff. Program Directors and Chief Residents also organize ad hoc social events, including a series focused on arts, which includes book clubs and a night at the art museum series. You can see photos from our past social events at our Facebook page.

Can you tell me about your ABIM pass rate?

Our 2015 ABIM pass rate was 100 percent. Our three-year board pass rate (2014, 2015, 2016) is over 90 percent. We believe in a holistic admissions process, which means we do take some residents in our program who have exceptional abilities in some areas but are poor standardized test takers. The great majority of our residents do quite well, with several in the highest decile each year. We have focused mentorship for residents with low in-training exam scores. We also offer financial support for external board review courses for all residents.

 

What is the relationship between UH Cleveland Medical Center, the Louis Stokes Cleveland VA Medical Center, Case Western Reserve University, MetroHealth and the Cleveland Clinic?

UH Cleveland Medical Center is an academic affiliate of Case Western Reserve University and is part of a large, regional health care system that along with the Cleveland Clinic-affiliated system account for about 90 percent of health care in Northeast Ohio. UH Cleveland Medical Center and the Louis Stokes Cleveland VA Medical Center are academic partners of Case Western Reserve University School of Medicine, and all attendings are part of the full-time CWRU School of Medicine faculty. The Chair of the Department of Medicine at CWRU and UH Cleveland Medical Center is academic chair for Internal Medicine at the medical school. The hospital is physically connected to the medical school, facilitating research and teaching collaborations. MetroHealth is a CWRU-affiliated hospital located on the west side of Cleveland with a separate chair and residency. The Cleveland Clinic also has a separate chair and residency, and has a medical school track (the Cleveland Clinic Lerner College of Medicine) that is separate from the main medical school but is affiliated with Case Western Reserve University. The Department of Medicine at CWRU/UH Cleveland Medical Center/Louis Stokes Cleveland VA Medical Center has outstanding clinical programs, but what sets us apart from other medical centers in Cleveland and Ohio is the academic breadth and depth of the faculty (e.g., the NIH funding for the Department of Medicine at Case/UH Case Medical Center is over $55 million, vs. $17 million at the Cleveland Clinic and $6 million at Metro). University Hopitals ranks among the top 10 hospitals nationally for NIH funding. This is directly examplified by the recent talk by the President of UH Cleveland Medical Center, Daniel Simon, MD, highlighting the insitution's reserach enterprise and strong commitment to academic mission.

University Hospitals Cleveland Medical Center and the Louis Stokes Cleveland VA Medical Center are favored sites for CWRU students to do rotations, with the residents and faculty receiving outstanding evaluations from our students. Sixty-five percent of all CWRU students (not just those going into internal medicine), do Acting Internships in the Department of Medicine at UH Cleveland Medical Center and the Louis Stokes Cleveland Medical Center. The Department of Medicine at UH Cleveland Medical Center and the Louis Stokes Cleveland Medical Center also writes "Department of Medicine" Chair Recommendation Letter for 95 percent of CWRU students applying to internal medicine.

 

How should intern applicants interpret hospital ranking systems?

We live in a society where we like to rank universities, medical schools and hospitals. Lately U.S. News & World Report rankings have been receive a lot of press coverage, and hospitals ranked highly rightly celebrate the recognition. However, if you look under the cover at the rankings methodology, it is heavily influenced by name recognition and reputation and not a good reflection of quality of patient care. Importantly, there are ranking systems that are based more on quality outcome measures, such as Leapfrog. At UH Cleveland Medical Center we are proud to be the only large academic medical center in Cleveland with a Leapfrog “A” rating.

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