Cleveland Clinic New PMR Program

[PMR4life2016]

The Cleveland Clinic is starting their own PMR program with their first class this July. As a medical student graduate of 2016, I would be in their second class. Without any current residents to get feedback from, I am wondering what other applicants thought during their interview day or from residents in other programs about what they think the program will become.

Here are some of my thoughts-
1) Their curriculum seemed very similar to Mayo's in structure. Their MSK US is run by a Mayo graduate as well.
2) Affliation with Case's program which has been around for a long time. Several inpatient rotations are at Metro in addition to the didactics being combined.
3) EMG is with the neurology department allowing for great exposure to rare pathologies.
4) Department has been around for a while with some well known names currently on faculty.

So despite being new they seem to have a lot going for them.


What are other some other thoughts?

Thank you!

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[j4pac]

I don't know anything about the program, but Cleveland Clinic is a great hospital, with a prestigious name, with lots of money and resources. Very similar to the Hopkins program in that regard.

It also traditionally been one of the most DO friendly major hospitals.

It has potential.

 

[DOctorJay]

I am only familiar with Schaefer and some of the PM&R spine docs and they are all fantastic. They certainly have the resources and staff to make it a great program.

 

[DMBandFan86]

2) Affliation with Case's program which has been around for a long time. Several inpatient rotations are at Metro in addition to the didactics being combined.

- I found this pretty odd. They want to become one of the top PM&R programs (and do it quickly), however they want to piggy-back on Case Western's didactics. I asked them and they stated they have no plans on creating their own separate didactics sessions in the future, but will be sending some of their own doc's to present some lectures.

- There are now 3 PM&R programs in Cleveland starting this year. It seems like they are really saturating the Cleveland market when compared to other Ohio cities. Not that this is a bad thing for the clinic program; I'm sure that there are tons of patients to take care of.

 

[DMBandFan86]

4) Department has been around for a while with some well known names currently on faculty.

Yes, they are already fully established and have well known staff to attend their clinics and rehab patients. Good potential to learn from expert staff.

I was actually told that the residents will never have call, ever. No pager at home and no coming in on the weekends. The PD told us that they will continue to have full staff with the addition of residents. For some people I'm sure this would be great and create a nice residency with no call and less responsibilities. To me it sort of makes it sound a little too easy, almost like medical school with a little more responsibilities. Only time will tell how this actually plays out.

 

[RangerBob]

Yes, they are already fully established and have well known staff to attend their clinics and rehab patients. Good potential to learn from expert staff.

I was actually told that the residents will never have call, ever. No pager at home and no coming in on the weekends. The PD told us that they will continue to have full staff with the addition of residents. For some people I'm sure this would be great and create a nice residency with no call and less responsibilities. To me it sort of makes it sound a little too easy, almost like medical school with a little more responsibilities. Only time will tell how this actually plays out.

No call would certainly be nice...

Though, I feel most PM&R programs already have really great call schedules (compered to just about every other specialty, we have a great QOL in residency). Having no call concerns me because while there are a lot of outpatient jobs that don't require call, there are tons of jobs that do require some coverage. There is a trend for the hospitalists to now do call for rehab units and manage the medical issues and the physiatrist just handles the rehab stuff, but there are still plenty of jobs where the hospital would be calling you.

I think it's ideal to have some experience with call, as handling issues on patients you don't personally know/round on is something that takes a little bit of time to get used to and build up confidence. For the most part, everything you'd need to know you'll learn intern year (as far as w/u of urgent/emergent stuff, when to transfer to the ICU, etc.), and there's very little rehab medicine-unique call stuff to learn beyond management of AD, ITB pump management, and neurostorming (though the latter tends to be an issue for the acute care teams, but we did have one guy who would still occasionally neurostorm). But sort of like the "use it or lose" it analogy, I think going three years without taking any call might really decrease one's confidence when they go out to the real world and possibly start taking call. And as DMBandFan mentions--I also think it would create less sense of responsibility while in residency.

Aside from that, I agree the program likely has a lot of potential. Only time will tell, but they'll likely start off on a better foot than many other new PM&R programs.

I wonder if Cleveland now has 3 programs, are perhaps looking forward to a day when the entire SF Bay area will have more than one program? (Davis doesn't count--Sacramento is not part of the Bay Area, and Sacramento Metro alone is larger than the Cleveland metro area as well). For that matter, the LA area is quite underrepresented in PM&R residencies based on it's population (18 million people...). Portland of course doesn't even have a residency program (nor do much of the Mountain West/Great Plains).

I hope this is expansion is partly a result of our country better understanding what we can offer patients, as I feel our specialty is far smaller than it should be based on what we can do. (Otherwise it just means more competition for jobs!)

 

[PMR4life2016]

Thank you to everyone who took the time to respond. All the comments are very informative and will help myself and any other applicant as we get ready to submit our rank lists.

I also remember hearing NO call during my interview day and that surprised me. Experiencing call while in residency would obviously make you much comfortable once you become our own attending. But like RangerBob stated, I think by the end of intern year we should feel confident in our abilities to handle most medical issues on a rehab floor.

As for piggy-backing off the Case lectures. Faculty from the Cleveland Clinic has been giving lectures to the Case residents for years. I think they are using the philosophy of why don't the experts in their respective fields lecture on that topic, instead of creating their own separate didactics for only 2 residents a year. In addition, Cleveland Clinic has great lectures in other subspecialties to offer their rehab residents.

 

[j4pac]

Thank you to everyone who took the time to respond. All the comments are very informative and will help myself and any other applicant as we get ready to submit our rank lists.

I also remember hearing NO call during my interview day and that surprised me. Experiencing call while in residency would obviously make you much comfortable once you become our own attending. But like RangerBob stated, I think by the end of intern year we should feel confident in our abilities to handle most medical issues on a rehab floor.

As for piggy-backing off the Case lectures. Faculty from the Cleveland Clinic has been giving lectures to the Case residents for years. I think they are using the philosophy of why don't the experts in their respective fields lecture on that topic, instead of creating their own separate didactics for only 2 residents a year. In addition, Cleveland Clinic has great lectures in other subspecialties to offer their rehab residents.

I'm strong believer of giving yourself options in life. Even if want to do outpatient, I would consider the lack of call a big negative. It would feel like a shadowing experience to me.

Read the threads about people wanting to quit the profession in residency because they weren't getting anything out of their inpatient rotations. Those are typically folks who went into PM&R as an avenue to outpatient MSK/Pain/SM. No call is on a whole other level of lack of stimulation. If the goal is to be an autonomous, competent physiatrist...I believe that doing call on the rehab ward is important. Your inpatient experience should supplement your desire to do outpatient.

 

[DMBandFan86]

As for piggy-backing off the Case lectures. Faculty from the Cleveland Clinic has been giving lectures to the Case residents for years. I think they are using the philosophy of why don't the experts in their respective fields lecture on that topic, instead of creating their own separate didactics for only 2 residents a year. In addition, Cleveland Clinic has great lectures in other subspecialties to offer their rehab residents.

That's sort of the point isn't it. I mean Case residents were already going to the Clinic for PM&R rotations. Clinic professor's were already giving some lectures to case residents. So why even start the residency. If Cleveland really needs 3 separate PM&R residencies, and the clinic wants to be one of the best programs in the country, then I feel they should be dedicated to creating their own separate program and proving that they are better with stronger education / opportunities / training / etc. As it stands now, I would think that it would have made better sense to just try to expand Case Western's already established program and further integrating it with the clinic.