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Spinal Cord Injury Medicine Fellowship
Comprehensive training in caring for patients with spinal cord injuries and disorders.
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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
- In 2023-2024 Fellows averaged 70 inpatient cases, 455 outpatient cases, 100 chemodenervation cases and 99 other procedures
- 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
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