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. |
Aims
- Train well prepared Brain Injury Medicine physicians to practice in various settings, whether inpatient or outpatient, private or academic.
- Equip all fellows with a working knowledge of research methodology and statistics in order to complete a project for submission for publication or presentation at a national conference by the end of the fellowship.
- Provide fellows with required procedural experience for steroid injections, chemo-denervation with neurotoxins, and intrathecal baclofen pump maintenance.
- Prepare fellows with the appropriate mentoring and advising skills to assist with reaching career goals and developing leadership skills.
- Provide opportunities for fellows to cultivate teaching and presentation skills.
Benefits
Vacation and Leave
1. Vacation – 20 days per academic year plus major holidays
2. Maternity/Paternity Leave – Up to 12 weeks in accordance with the Family Medical Leave Act.
3. Sick Leave – 10 days per academic year
4. Academic Leave – with PD approval
5. Professional Leave – 5 days per academic year
Meals
Meals are available for purchase in the hospital cafeteria using cash or by signing up for the Cashless Card System (payroll deduction).
Medical Benefits
- You may choose from three medical plans: The MetroHealth Employee Plan, The MetroHealth Plus Plan. An employee contribution is required for each plan.
- Dental and Vision plans are provided at a minimal charge to the employee.
- Basic Life Insurance is provided to the employee. Additional coverage is available at minimal cost.
- Long Term Disability Insurance is optional and is available for purchase through pay-roll deduction.
- Workman’s Compensation provides medical expense coverage for on-the-job injuries.
Retirement Program
MetroHealth participates in the Ohio Public Employees Retirement System (OPERS) plan. Employee's OPERS contribution is 10% of the annual salary. The hospital will contribute 14% for each employee. OPERS takes the place of social security deductions. There are three choices available for you to manage your OPERS funds during your employment as well as when employment is terminated.
Malpractice/Liability Insurance
The hospital is self-insured, and each resident is covered under the program of self-insurance and indemnity. The program provides occurrence coverage for residents while acting within the scope of their duties and employment. The limit of the self-insurance program is $3 million per occurrence. MetroHealth Medical Center also purchases excess insurance that would respond should a claim exceed $3 million. This is also an occurrence form of coverage.
Safety and Security
- All employees are required to wear a MetroHealth Medical Center Identification Badge.
- The MetroHealth Police Department is a full-service police department that is open 24 hours a day, seven days a week. Escort service is available during late evening hours.
- Secure, lighted parking is available on the medical center campus. The current parking rate is $15.72 per bi-weekly pay.
Financial Resources
- Direct Deposit of your paycheck is mandatory. You may use any bank and/or credit union of your choice for either savings, checking or both deposits.
- The hospital has two ATM’s on premises.
- There is a credit union on campus. You may sign up for membership with The Steel Valley Employee’s Credit Union. A $50.00 minimum deposit is required for membership. Benefits and services including: savings accounts, holiday and vacation clubs, direct deposits, signature loans, bill consolidation loans, new and used auto loans and credit cards.
Resident/Fellow Amenities
- The House Staff Association is made up of the resident and fellows of MetroHealth Medical Center. Activities of the association include social hours, community service projects, hospital projects and many activities throughout the year. Residents are asked to consent to a $7.00 per bi-weekly pay deduction to cover house staff dues.
- Lab coats are provided for each resident and are laundered free of charge.
- Scrubs are provided for each resident and are laundered free of charge.
- On-call rooms are assigned to individual services to guarantee ample on-call sleeping facilities. In most cases these rooms are adjacent to patient areas for the convenience of the resident staff. Please note that we do not provide permanent or temporary housing.
- The hospital has a medical library that contains over 25,000 bound volumes and in excess of 486 current subscriptions. In addition to MedLine, MDConsult, UptoDate and other electronic references, an inter-library loan service is available.
- All residents are provided a hospital email account. Residents are required to use this email account for residency and hospital related business.
- All residents are provided with an alpha numeric pager.
- A resident lounge is located on the first floor of the Core/Towers building adjacent to the GME office. The lounge is available 24 hours a day and includes a bank of computers, TV room and quiet study/rest area.