Brain Injury Medicine Fellowship

The Department of Physical Medicine & Rehabilitation (PM&R) at Case Western Reserve University (CWRU) offers a one-year ACGME-accredited fellowship in Brain Injury Medicine. The BIM Fellowship is a 12-month program that offers specialized training in the prevention, diagnosis, treatment and management of traumatic and non-traumatic brain injuries. The Brain Injury Medicine fellow will rotate through a variety of practice settings including The MetroHealth Medical Center, The Louis Stokes Veterans Administration Medical Center (Regional Polytrauma Network) and The Cleveland Clinic Foundation.

The Case Western Reserve University and MetroHealth Brain Injury fellowship is a robust clinical and research training program. Our collaboration with experts from institutions across the area provides diverse educational and experiential opportunities for trainees. Below are a few highlights detailing how the program goes far above and beyond the basic ACGME requirements including new efforts or plans still in progress.

Extensive redesign, remodeling and expansion of MetroHealth Rehabilitation Institute of Ohio
Strategic reorganization of clinical, education and research custom made spaces
Completed Summer 2021, includes conference room, common area, offices for fellows, offices for fellowship program coordinator

On the inpatient rotations, acute consultation and program leadership are emphasized in addition to acute rehabilitation management.
The outpatient clinics include exposure to persons with concussions and more severe brain injuries, sports and work-related injuries, and outpatient brain injury therapies in addition to rehabilitation and neuropsychology.
Procedures include steroid injections, neurotoxin injections and intrathecal baclofen pump management. The fellow is provided with two half day continuity clinics weekly throughout the fellowship duration, at MetroHealth and at the VA.
Monthly MetroHealth PM&R grand rounds and quarterly city-wide PM&R grand rounds where clinicians and researchers from four Cleveland PM&R departments collaborate and learn.
MetroHealth PM&R resident didactic series, and separate Brain Injury fellow didactics.
100% Brain Injury Medicine board first time board pass rate since ACGME accreditation.

Multiple Brain Injury Medicine board certified attending academic physicians.
Other Brain Injury Medicine and PM&R faculty credentials include membership in the National Academy of Medicine, past president of the AAP as well as committee memberships at numerous national societies.
Didactics and mentorship from nationally recognized BIM research scientists, speech therapists, psychologists and BIM-specialty nursing.
Fellows are typically presented for academic appointment as a Clinical Instructor of PM&R at Case Western Reserve University and are invited to monthly faculty meetings where they are treated as peers.

Annual research didactic curriculum delivered by MetroHealth PM&R scientists.
Access to MetroHealth Rehabilitation Institute research meetings with senior leadership and investigators where proposed and former studies are reviewed, invited researchers speak and relevant topics to the research community are discussed.
Research collaboration with physicians for research proposals and project development, including functional electrical stimulation investigators at MH, Cleveland VA, CCF.
Database availability within PM&R department. There is also access to de-identified databases including Slicer Dicer, Explorys, and Cosmos.
Weekly research time available or can be modified according to project needs. A research elective opportunity is also available.
Travel support available for conferences and especially any completed project during the fellowship time period.

Frequent bedside teaching residents and medical students.
Formal presentations at PM&R residency didactics and grand rounds.
Medical student didactic education experience.

The fellowship program leadership group meets annually and includes the Brain Injury Medicine fellow. This includes biannual Clinical Competency Committee meetings and an annual Program Evaluation Committee (PEC) meeting to consider potential concerns and improvements. As a result of recent PEC meetings, our action plans resulted in some innovative changes including the following:

A neurocritical care rotation was established as a regular feature, whereas in the past it was an elective.
Changes in timing of rotations throughout the year resulted in changes to the block diagram.
The fellow’s role as a team leader for the inpatient service was enhanced with stepwise independence through the fellowship year.