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Case Western Reserve University - 2023/2024 Program Update
Hello current and future applicants! With the application deadline past, it's time for interviews! Since Case usually has our interviews at the beginning of the cycle, we figured it's a great time to push out another program update. During the interview season, things move very fast, so use this post as a reference as you start thinking about your rank list.
We love our program! I hope you all have the chance to interview here and meet us in person so we can show you why. If you aren't fortunate enough to match, we also welcome you to join us for a non-categorical year.
Case Western Reserve University has the nation’s only 5-year MD integrated OMFS program. We match 3 residents per year, 1 international resident, 1 research fellow, plus a variable number of non-categoricals (usually ~3-5).
Our Website
Year 1 (7 months UH OMFS, 3 months VA OMFS, 2 months Anesthesia)
Before you begin the program, you will take the CBSE again in May or June. You are required by the Case Western medical school to score above a 70 before you can take USMLE Step 1. You will take Step 1 in June or July, prior to going on service. Most of our interns take Step 1 in June so they have the rest of June and July to relax before they start August 1st.
As an intern, you are the backbone of our busy clinic. We are extremely resident-run, which comes with a lot of benefits, but also requires a strong work ethic by everyone on the team. In clinic, you will do all the procedures under local - that means impacted wisdom teeth, full mouth extractions, bone grafting, biopsies, expose & bonds, consults, etc. If it's under local, it's for the interns. With that said, there are always upper level residents in clinic to help if you should find yourself in a situation where you need help. You will also be in charge of overseeing the dental students and rescuing them when they get stuck with their patients. As a VA resident, your dentoalveolar experience is unmatched. You will be performing similar procedures as your time at the Case Western clinic, but your focus will be placing implants. Most of our residents place 100-200 implants at the VA their first year, many of which are multi-unit cases. At the VA, we plan the cases on our CBCT and place them freehand. At the VA, you’ll have much more supervision, and residents appreciate the close relationship with the faculty who serve as our personal coaches. In the hospital, you will manage our inpatients and learn how they are managed pre- and post-operatively. Interns take the most primary call of all the residents (see details below), but of course, there's always an upper level who has your back if needed. On anesthesia, you’ll be rotating at University Hospitals main campus. By the end of your anesthesia rotation you will be comfortable inducing, intubating, managing, and emerging patients from general anesthesia. We work one on one with CRNA’s and anesthesia residents, under the supervision of an attending anesthesiologist. When off service on anesthesia, you are not expected to participate in any on-service duties such as taking call and attending lectures. Throughout first year, you will have various medical school seminars learning how to do full H&P’s and you’ll be tested with actors in simulation exams. This is generally once per week during the evening. Not bad for getting to skip MS1 and MS2. You pay a very small amount of tuition this year.
Year 2 (12 months medical school)
You are a third year medical student. Your rotations include Surgery, Emergency Medicine, Neurology, Psychiatry, Pediatrics, OBGYN, Internal Medicine, and Family Medicine. You have no on service responsibilities. Most rotations treat us like regular MS3’s, some (like surgery and EM) will give us more responsibility and treat us more like acting interns. This is generally a light year that makes way for the potential for lots of reading. Most residents take STEP 2 in May or June right after their final MS3 rotation. You pay for medical school this year. This is generally the year we complete our CODA research requirement.
Year 3 (6 months UH OMFS, 3 months Metro OMFS chief, 3 months Anesthesia including 1 month dedicated pediatric anesthesia)
You are a midlevel resident, spending nearly the entire year on OMFS service. In clinic, you are head honcho most days. You will be doing IV sedations in the clinic all day (we do IV sedations 5 days a week), while supervising the 1st-year residents doing all the local cases. You are also placing most of the implants for all the dental student patients. After you learn to freehand at the VA, we've been moving to fully guided for our dental school implants, so you'll learn both ways. We have an intraoral scanner, model scanner, CBCT, 3D printer, and guided kits. You'll be comfortable with Straumann, Zimmer, BioHorizons, and Nobel by the time you're done. When in the the OR, you are 2nd operator for most cases, and usually chiefs will let you be 1st operator for infections and trauma cases. While at Metro, YOU ARE THE CHIEF. You do all the OR cases, and you run the clinic with 2 Metro non-cats. You are taking a lot of backup call, but notably less primary call than intern year. This is technically your 4th year of medical school, but besides taking STEP 2, you have no medical school responsibilities (except tuition). In May, you graduate from the medical school and get your MD. On anesthesia, you’ll have an entire month dedicated to pediatric cases. Many residents finish their graduation anesthesia requirements (300 total cases, 150 of which must be ambulatory OMFS cases) by the end of 3rd year.
Year 4 (3 months OMFS at UH or Metro, 3 months ENT, 3 months Plastics, 1 month Trauma Surgery, 1 month Pediatric Surgery, 1 month Trauma ICU)
At most programs, this is a full “GenSurg year” where you spend 12 months on the general surgery team. At Case, you will spend 3 months on OMFS continuing your responsibilities as a midlevel/chief. On ENT, you'll spend time with our nationally-ranked Head & Neck colleagues doing flaps and flaps and flaps. Plastic surgery done is at MetroHealth for 3 months where you’ll get more exposure to flaps, reconstruction, and cosmetic surgery. The final 3 months are a month each of TICU, Trauma Surgery, and Pediatric Surgery. Most of our residents take STEP 3 during 4th year. We receive 2 years of ACGME credit toward medical licensure. YES, 2 full years of ACGME credit!
Year 5 (12 months OMFS)
As chief, you will be chief of the UH team. You are ultimately responsible for all aspects of the service. You will be in the operating room multiple days every week as the primary operator. Our faculty puts a great deal of trust in us to be prepared for our cases, and in turn, we cut 100% of the cases. Our attendings are there to teach us and help us when we need it, not to do the procedure and have us assist. When you are not in the operating room you will be in clinic doing sedations, seeing your post-ops, and training the lower level residents. This is a busy year with a lot of responsibility, but when you finish chief year you will be ready to go out and practice independently and confidently.
Total 34 months of OMFS
Scope
We are a broad-scope program, including ample training in dentoalveolar surgery, implants, sedations/anesthesia, orthognathic, pediatric cases, TMJ, infections, benign pathology, reconstruction, trauma, and cosmetics.
Dentoalveolar: Being on the ground floor of a dental school with 80 students/year and speciality departments, we are flooded with dentoalveolar cases. You will be more than comfortable managing any dentoalveolar case and administering in office sedation.
TMJ: I think we do more custom TMJ replacements than 90% of programs. We get referrals from throughout Ohio and beyond. We offer a full spectrum of options ranging from conservative treatments like TMJ Botox and arthrocentesis, to aggressive treatment like total TMJ replacement.
Infections: These are a great opportunity to allow our junior residents a chance to be primary operators in the OR setting. We see enough of these that you will quickly become comfortable managing these patients surgically and medically.
Dental Implants: As I mentioned above, most residents place 100-200 at the VA their first year. Then do even more as a midlevel at the dental school. I think the numbers speak for themselves. We use Zimmer, Straumann, BioHorizons, and Nobel. We use CoDiagnostics for our planning software. We have an in house 3D printer and design and print our own surgical guides.
Orthognathic: We have a great orthodontic department that provides a steady stream of referrals. Case Western is home to a craniofacial orthodontics fellowship program which means we work hand in hand with the fellow on complex orthognathic cases. Our attendings are well known and respected in the community and also receive a high volume of referrals from private orthodontists. At MetroHealth we have a steady stream of OSA patients on whom we perform MMA. Our residents all graduate feeling very comfortable working up, planning, and performing orthognathic surgery.
Cosmetic Surgery: This is where we stand out. Dr. Quereshy brings us to rhinoplasties, face lifts, neck lifts, blepharoplasties, facial implants, and more. In clinic, we keep the Botox and Filler stocked and ready to use. I think I've done almost 150 filler cases myself. We've had residents match into cosmetic surgery fellowships in the past, and we seem to keep attracting more who want to pursue it.
Trauma: Most programs have good trauma, and we're no exception. We cover two Level I trauma centers (University Hospitals main campus and MetroHealth), so we are not lacking for trauma cases. There are parts of Cleveland with high crime rates in the Summer, and there are lots of MVCs in the Winter thanks to the ice. Lacerations are done in the ED by our interns, and you'll see plenty of dog bites, falls, assaults, and slips on ice. We get too many mandibles and orbital fractures. Once in a while we get those gnarly pan facials from a self-inflicted gunshot wound or MVC. We cover trauma call every 3rd week, with ENT and Plastics covering the remainder of the time.
Pathology/Reconstruction: We do not do malignant pathology - we have our excellent ENT colleagues for those cases. Most of us residents appreciate that we do not manage malignant pathology on our service and can refer these patients to ENT, and we see it as a blessing of the program. We do anything benign, no matter the size of the ameloblastoma or myxoma or ameloblastic fibroma. Dr. Baur is a big name in treatment of osteonecrosis, so he gets all the referrals from local surgeons for MRONJ and ORN. For reconstruction, we do lots and lots of iliac crest grafts, rib grafts, and mandibular autografts.
Craniofacial: Our craniofacial experience is limited to some secondary bone grafting and cleft orthognathics. We do not do primary cleft or craniofacial reconstruction. Just like for malignant path, most of us enjoy not managing complex craniofacial cases on our service.
Sedations/Anesthesia: I think this is where we excel. We run a very busy clinic, including IV sedations 5 days/week. When we are fully staffed with residents, we do 2 or 3 sedations per hour all day. Most of the residents here plan to go into private practice, so excellent clinic training is important to us all. Many of us are done with our CODA sedation requirements by the end of 3rd year.
Facilities
Our home is the first floor of the CWRU dental school building across the street from the Cleveland Clinic. The building is about 4 years old. Ask anyone who has externed with us - we have beautiful facilities! TV in every patient room, modern chairs and lights, clean and well lit interiors, wonderfully helpful staff, and plenty of space. We have a lab, pre-op/post-op areas, storage rooms, a resident room, a conference room, and much more. We have an entire army of dental students, ortho residents, and AEGD residents who are a constant stream of referrals to us. The new Samson Pavilion where we hold lectures and have medical school lectures is next door to our dental school.
Our clinic has 2 OR’s. Full-blown operating rooms. We are currently completing the process of credentialing and staffing these as ambulatory OR’s so we can start operating at our home base. We’re hoping to have these up and running by 2024. We’re really excited about opening these, because it means we can move all of our ambulatory cases out of the hospital OR’s and replace the block time with bigger cases.
Our OR home is University Hospitals Cleveland Medical Center, a Level 1 trauma center, about a 5 minute drive down Euclid Ave. We operate out of Mather OR (UH’s main OR) and Prentiss OR (UH’s pediatric OR). We also operate at some of UH’s satellite sites, including Ahuja Medical Center and Mentor Medical Center.
MetroHealth is a Level 1 trauma center on the west side of Cleveland. It's about 15-20 minutes from the dental school. Metro is the county hospital and a very busy trauma center.
The Louis Stokes VA Medical Center is a 3 minute drive from the dental school. This is where you rotate 1st year.
Call
Interns take the most primary call, generally ~q4-5. The non-cats also pick up some non-trauma days to help out. We split trauma call with ENT and plastics, with us taking every 3rd week. Metro and UH have two separate teams, so you will never be on call at both hospitals at the same time. It can be very busy on trauma nights. Any laceration, fracture, or god-knows-what to the head will be lighting up your pager. Thankfully, we have an AEGD team who takes tooth call. We do not splint teeth, this is handled by AEGD. Sometimes AEGD will call us in for an infection they don’t think they can handle, but they always go see the patient first to screen out a lot of the nonsense tooth calls other programs sometimes have to deal with. So non-trauma days are generally pretty quiet. We have a dedicated call room and we receive a food stipend. The VA has a pager but it rarely goes off.
Faculty
Dr. Dale A. Baur, DDS. Program Chair. Dr. Baur does just about everything. He is trained in Head & Neck. He's most known for benign path, osteonecrosis, orthognathics, and TMJ replacement. He is also very involved in the dental school, serving as vice dean among other roles.
Dr. Faisal A. Quereshy, MD, DDS, FACS. Program Director. @FaceSurgeon. Dr. Quereshy operates broadly, but is most famous for his cosmetic work. He runs a successful private practice in Ohio from which he sometimes refers patients.
Dr. Keith Schneider, DMD, FACS. Dr. Schneider covers a lot of our trauma and is honestly one of the calmest, nicest people I've ever met. He also runs a very successful private practice in Ohio. He brings many patients from his private practice (as well as local prisons) to our service for surgeries.
Our VA attendings are…
Dr. Michael Horan, MD, DDS, PhD, FACS - Clinic Director
Dr. John Brokloff, DDS
Our MetroHealth attendings are…
Dr. Petra Olivieri, DMD, MD (Case grad from 2021) - Division Chief
Dr. Justin Clemow, DMD, MD, FACS
Dr. Alan Martinez, DDS
We also have various faculty who cover our clinic and act as mentors to us. They include…
Dr. Donald P. Lewis, DDS, CFE (Case grad)
Dr. James Perhavec, DMD (Case grad)
Dr. Maximillian G. Beushausen, DMD, MD (Case Grad from 2018)
Dr. Thomas J. Dietrich DDS, MD (Louisville grad from 2010)
We have dedicated staff, who are a blessing to have around. They assist in scheduling patients in the OR and clinic, seating patients, turning over rooms, taking patients to radiology, organizing cabinets, stocking supplies, and maintaining our medication room.
Finances
You are paid a stipend ~$65k-70k every year except 2nd year.
You pay tuition (~$55k) 2nd and 3rd year.
Financial aid is available from Case Western Reserve University.
Lectures/Didactics
We have set lecture series which occur most mornings. Our lecture series include…
- Case presentations (We review the upcoming 2 weeks of cases. What are we doing? How are we doing them? What concerns do we have?)
- OMFS Lecture Series (We split up the chapters in Petersons and Fonseca and we take turns giving lectures about the chapters)
- Orthognathic Conference with the Orthodontics Department
- AEGD Conference with the AEGD Department, usually focusing on implants
- Oral Pathology with our UH oral pathologist
- Emergency Lectures with Dr. Perhavec, covering anesthesia emergencies, clinic emergencies, etc.
- Pathology Lectures with Dr. Helman (Michigan Head & Neck trained).
- On Fridays, it’s usually a miscellaneous lecture, could be an extra OMFS Lecture, M&M Conference, etc.
We are expected to “participate in research activity” as mandated by accreditation. What you do is largely up to you. Some will complete it during medical school. We have been taking a research fellow each year, which has been awesome, because it allows us to focus on the surgery part, and the research fellow takes care of the research part, and we have been publishing a lot more thanks to them.
Externships
We try to always have an extern scheduled each week. It’s the best way to see our facilities and get a feel for our program culture. Externs tend to enjoy the week with us. When you’re here, we try to get you to every OR case we can. You are our guest and we do our best to treat you well. We always call you for any trauma which rolls in to get you involved.
Cleveland
It’s definitely not as bad as you’ve heard. Our university has a beautiful, private school campus feel and while there are bad parts of Cleveland, you will have zero reasons to go there. Looking to live close? Try University Circle or Little Italy. Looking to live somewhere young and hip? Try Ohio City or Tremont. Looking for a nice suburban neighborhood with families? Try University Heights or Beachwood.
In the Summer, downtown always has a pool party somewhere. For the outdoors people, Cayahoga National Park and the MetroParks is a common spot to hike or you can visit Edgewater Park and sit on the beach. For the cultured types, we have the Cleveland Orchestra and Cleveland Museum of Art, or you can take a stroll down to Little Italy for a fancy dinner and gelato. Sports fans will enjoy the Cleveland Browns, Cleveland Cavaliers, and Cleveland Guardians games. And if you really need to get away, Cleveland Hopkins International Airport is 15 minutes from downtown.
Residents
Our team of residents come from all over the country, of all different cultural and religious backgrounds. Many are engaged or married, with or without kids. In common, we are all hard working with easygoing personalities. We joke around a lot and spend time together, inside and outside of work.
In summary, we love this program. Every resident I know here ranked Case #1 on their match list which says all you need to know about our program. We are truly proud of our setup.
Highlights
- Resident culture which blends hard work ethic with easygoing personalities.
- Resident-driven program.
- Extensive clinic, dentoalveolar, and sedation experience.
- Attendings with private practice experience.
- Limited Med School and Gen Surg time.
- Strong associations with a dental school, a VA, and surrounding OS private practices.
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