Spinal Cord Injury Fellowship

The MetroHealth Rehabilitation Institute, with Case Western Reserve University, the Louis Stokes Cleveland VAMC and The Cleveland Clinic Foundation, offers a 1-year ACGME-accredited fellowship in SCI Medicine. This fellowship program offers a unique opportunity to work in three healthcare systems, including a center funded by NIDILRR as a SCI Model System in the setting of a Level I Trauma Center (MetroHealth Medical Center), a designated Spinal Cord Injury Center and Regional Polytrauma Network within the Veterans Health Administration, and a renowned referral and treatment center for multiple sclerosis and Spinal tumors (The Cleveland Clinic Foundation).

MetroHealth Spinal Cord Injury Medicine Fellowship

The Case Western Reserve University and MetroHealth SCIM fellowship is a robust clinical training program. Experts from across northeast Ohio collaborate to provides diverse educational and research 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.

High volume inpatient (recently averaging 86 traumatic SCI admissions, 77 nontraumatic SCI admissions and 78 acute SCI consultations) and outpatient (estimated at 900 adults/40peds at MHMC, 950 adults at the VAMC and at 500 adults at the CCF) traumatic and non-traumatic spinal cord injury and disorders
Protected continuity clinic twice weekly to follow patients from injury through chronic care
Level I adult and level II pediatric trauma center at MetroHealth and Polytrauma Network Site at VAMC
SCI didactic curriculum: More than 40 live or recorded SCIM board relevant lectures. One on one “flipped classroom” interactive teaching session with specialist
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
After-hours journal club for fellows and faculty led by the fellows to increase camaraderie, learning and discussion across institutions
MetroHealth PM&R resident SCI didactic series
100% SCIM board first time board pass rate since 2006
Annual attendance at ASCIP intensive review course

Dedicated 1 month of spasticity with ample additional opportunities at all 3 sites!
Bedside and clinic wound debridement, opportunity for wound flap surgery observation
Intrathecal baclofen trials, placement, refills, complex reprograming, and troubleshooting; including fluoroscopic and ultrasound instruction
Chemodenervation by botulinum toxin and phenol using anatomic landmarks, electrical stimulation, ultrasonographic and electromyographic guidance including secretion management
Peripheral nerve block, trigger point injection, diagnostic and procedural ultrasonography by SCI and MSK specialists
Pressure mapping
Diagnostic and therapeutic electrical stimulation
Observing, performing, and reading urodynamic studies and bladder botulinum toxin
Electromyography, spinal cord stimulator, intrathecal pain pump, fluoroscopy (as desired)

ASIA Learning Center certifications (InSTeP, WeeSTep, SkinSTeP, ASTeP, SpAsTeP)
Basic Life Support (BLS), Advanced Trauma Life Support (ATLS) certifications to facilitate on EMS experience with Metro Life Flight (Helicopters staffed with flight physicians, acute care nurse practitioners and flight nurses)
Annual attendance at the Cleveland Clinic Spasticity and Neuromotor Rehabilitation or Multiple Sclerosis Symposium
Advanced research and quality improvement didactic curriculum
Collaborative Institutional Training Initiative and Institute for Healthcare Improvement certifications

Inpatient mechanical ventilation management and weaning at 2 different clinical centers
Weekly urology conferences with neuro-urologists and fellows at VAMC
Weekly clinical conference with academic traumatologists at MetroHealth
Clinical rotations with dedicated time working with neurology, urology, neurosurgery, traumatology, and orthopedic surgery rotations
Nationally recognized telehealth expertise at VAMC
Multiple sclerosis and amyotrophic lateral sclerosis exposure via inpatient, outpatient, and telehealth clinic with neurologist at ALS Association Certified Center (VAMC) and Cleveland Clinic specialists
Elective experience with neurocritical care, reconstructive plastic surgery, sexuality and fertility, adult and pediatric spina bifida and pediatric SCI and emergency medical system highlighted by hyperacute SCI experience with Metro Life Flight - air and ground critical care transport service
Encouraged participation with seating/wheelchair clinic, driver training clinic, SCI osteoporosis clinic, wound clinic, ultrasound clinic, interdisciplinary tendon, and nerve transfer surgery clinic (MetroHealth and VAMC)

Seven ABPMR SCIM board certified attending academic physicians
Other faculty credentials include membership in the National Academy of Medicine, past president of the AAP, president of the North American SCI Consortium, ASIA and ASCIP board of directors as well as committee memberships at numerous national societies
Didactics and mentorship from nationally recognized SCI research scientists, physical therapists, occupational therapists, psychologists, and SCI-specialty nursing
Fellows are typically presented for academic appointment as a Clinical Instructor and invited to monthly faculty meetings where they are treated as peers

Leadership role in SCI Student Research Team focused on collaborative retrospective, literature review and quality improvement projects
Integral involvement with SCI model system team (one of only 18 in the USA) lead by Dr. Kimberly Anderson, PhD including attending weekly research meetings, statistical support, administrative support, and participation with ongoing studies
Weekly attendance at MetroHealth Center for Rehabilitation Research (MCRR) 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
Cleveland FES Center is internationally acclaimed for pioneering research in clinical applications of FES for individuals with SCI
Collaboration with Neuro-trauma registry for ongoing research including fellow-initiated projects
Two months (or equivalent) elective time which can be customized for research interests

Frequent bedside teaching with PM&R residents, Orthopedic residents, and medical students
Formal presentations at PM&R residency didactics and grand rounds
Formal presentations at United Spinal Association monthly meetings and MetroHealth SCI Community Annual Conference
Invitation to speak at regional and national conferences (e.g. biweekly SCAN-ECHO sessions, annual SCI provider conference at VAMC) and support for national or international conferences where fellows routinely present papers or posters
Hands on preclinical medical student teaching (e.g., MSK spine exam modules)

Active collaboration and support with the local Northeast Ohio United Spinal Association Chapter in monthly meetings, events, fundraising, research and community outreach and education
Adaptive Sports Ohio event coverage. Opportunities for involvement with national VA Wheelchair Games
Involvement in extracurricular volunteer opportunities including the annual Fresh Air summer sleep away camp for children with tracheostomies and/or mechanical ventilation where SCI fellows are encouraged to volunteer for 1 week as a medical buddy

Spinal Cord Injury Medicine Fellowship

Spinal Cord Injury Medicine Fellowship

Spinal Cord Injury Fellowship

Robust Core Spinal Cord Injury Medicine Education

Expert Procedural Training

Specialty Certifications and Trainings

Strong Related Subspecialty Education

Career Mentorship

Research Support and Education

Education Curriculum Development

Service Opportunities and Support