Curriculum

Residents participate in an 12-month didactic cycle consisting of at least three hours per week of core didactic material and two to three hours per week of interactive hands-on teaching sessions. Didactic seminars and clinical conferences are protected learning time for residents. Didactic time is protected for residents.

All resident didactic time is protected. The 12-month didactic cycle includes the following course topics:

Course Topics:

  • Brain Injury
  • Cancer Rehabilitation
  • Cardiopulmonary Rehabilitation
  • Career Planning
  • Disability
  • Durable Medical Equipment, Assistive Technology, Wheelchair
  • EMG NCS, Neuromuscular
  • Evidence Based Medicine, Research
  • Financial Planning
  • Gait Biomechanics
  • Medical Rehabilitation
  • Musculoskeletal / Sports
  • Pain and Spine
  • Pediatrics
  • Prosthetics and Orthotics, Amputee
  • Quality Improvement
  • Rehabilitation Billing and Coding
  • Rehabilitation Therapeutics
  • SAE, EMG SAE, Mock Oral Board Exam
  • Spasticity
  • Spinal Cord Injury
  • Stroke
  • Ultrasound

Workshops:

  • Cadaver lab
  • EMG NCS
  • Musculoskeletal procedures
  • Physical exam skills
  • Prosthetics
  • Spasticity (Chemodenervation, intrathecal baclofen pump)
  • Tracheostomy simulation
  • Ultrasound 
  • Wellness Wednesdays

Grand Rounds:

  • MetroHealth Rehabilitation Institute grand rounds are held monthly
  • Interdisciplinary Spine/Pain meeting (participants include PM&R, neurosurgery and ortho spine)
  • Quarterly City-Wide Grand Rounds with Cleveland Clinic, MetroHealth, University Hospitals, and VA

Interactive Resident lead sessions:

  • Anatomy
  • EMG NCS Case Review
  • Journal Club
  • Mock Oral boards
  • Morbidity and Mortality conference
  • Musculoskeletal Case Review
  • Psychology Professor Rounds
  • SAE board review

Detailed PM&R Schedule:

PGY-2

  • 2 months – MH Spinal Cord Injury Inpatient
  • 2 months – MH Stroke Inpatient
  • 2 months – MH Brain Injury Inpatient
  • 3 months – MH Outpatient Clinic (1 Pain, 1 MSK, 1 Neuro)
  • 1 month – VA Spinal Cord Injury Inpatient
  • 1 month – VA General Rehab Inpatient
  • 1 month – MH Consult/Evidence Based Medicine

PGY-3

  • 2 months – Elective
  • 2 months – MH EMG NCS
  • 2 months – MH Outpatient Clinic (1 Pain, 1 MSK Neuro Procedures)
  • 1 month – MH Consult/Evidence Based Medicine
  • 1 month – MH Spinal Cord Injury Inpatient
  • 1 month – MH Brain Injury Inpatient
  • 1 month – VA General Rehab Inpatient
  • 1 month – CCF Peds Rehab
  • 1 month – CCF MSK Outpatient

PGY-4

  • 1 month – Elective
  • 4 months – MH Outpatient Clinic (1 Neuro, 1 General, 2 MSK)
  • 1 month – MH Stroke Inpatient
  • 1 month – MH Brain Injury Inpatient
  • 1 month – MH EMG NCS
  • 2 months – VA MSK
  • 1 month – CCF Peds Rehab
  • 1 month – CCF Consult

Outpatient Experiences include:

Clinics

 Experience

Pain

Pain medicine clinic, epidural steroid injections; facet/medial branch injections; sacroiliac joint injections; peripheral nerve injections/blocks; ultrasound-guided procedures/injections, and fluoroscopic guided procedures. Limb loss and amputee rehab.

Neuro

Brain injury, concussion, stroke, spinal cord injury, botulinum toxin for migraine; neurotoxin procedures, spasticity, neuromuscular, wheelchair, urodynamics, intrathecal baclofen pump, and tetra-hand clinics.

MSK

Sports clinic, musculoskeletal clinic, large joint/bursa injections; tendon sheath/ligament injections; trigger point injections; diagnostic musculoskeletal ultrasound; ultrasound-guided procedures/injections

EMG/NCS

Complete electrodiagnostic studies (EMG/NCS), diagnostic musculoskeletal ultrasound

General

Cancer rehab, lymphedema, assistive technology, and limb loss clinics.

Limb Loss

Multidisciplinary prosthetics and orthotics clinic, gait.

PM&R Categorical PGY-1 Intern Year

Rotations (in weeks) Number of Weeks
General Medical Floor 10-12
Cardiac Telemetry 4-6
Medical Stepdown Unit 4-6
Night Float 4-6
Inpatient PM&R Stroke Rehabilitation 4
Elective 12-14
Vacation 4

 

PGY 3 and PGY 4 participate in continuity clinics weekly. Residents spend 1 year in neurological rehabilitation continuity clinic and 1 year in musculoskeletal rehabilitation continuity clinic.

  • Neuro rehab continuity clinic: inpatient rehab follow up, concussion, stroke, brain injury, spinal cord injury, general neuro rehab.
  • MSK based clinic: acute musculoskeletal conditions, sport injuries, peripheral joint injuries.