MetroHealth Medical Center

MetroHealth Medical Center

The MetroHealth System is one of the largest, most comprehensive health care providers in Northeast Ohio, serving the medical needs of the Greater Cleveland community for 170 years. More than 500 primary care and specialty care physicians practice within The MetroHealth System. Affiliated since 1914 with Case Western Reserve University School of Medicine, MetroHealth is a center for medical research and education, with all active staff physicians holding Case faculty appointments.

The MetroHealth System is comprised of a major medical center, a rehabilitation hospital, two long-term care/skilled nursing centers, an outpatient surgery center, and a network of community-based health care centers.

MetroHealth Medical Center is a level one Trauma Center providing care to nearly 28,000 inpatients. More than 700,000 visits are recorded each year in the medical center’s outpatient centers.  Patient visits to the emergency department exceed 91,000.

Basic Core Design

MetroHealth Medical Center

Block I: Surgery/Internal Medicine

Christopher Brandt, MD – Surgery Discipline LeaderNicola Helm, MD – Internal Medicine Discipline LeaderJennifer Lastic – Surgery AdministratorMichelle Joseph – Internal Medicine Administrator

Weekly Schedule

Surgery Medicine

-Four weeks of Inpatient General Surgery rotation, which includes ½ to one full day of General Surgery ambulatory clinic per week.

-Four weeks of Inpatient General Medicine rotation.

-Two weeks on IM/Med Specialty ambulatory clinic rotation

-Two (2-week) electives in Surgery Specialties. Options include: Vascular/Thoracic, Burn/Pediatric Surgery, Plastics, ENT, Orthopedics, or Urology

-Two weeks of elective inpatient rotation – for most students, this will be on Cardiac Stepdown. Other possible rotations include Hem/Onc and Medical Intensive Care Stepdown.

Conferences15 weekly multidisciplinary didactic sessions – Wednesdays

8am-12pm All Block I students attend. Topics include:• Chest pain – CAD, EKG• Chest pain – CHF, PE/DVT• Abdominal Pain• Fluids/electrolytes/renal failure• Dyspnea/cough/hemoptysis/pulmonary nodules/lung cancer• Diabetes/Obesity• Hypertension, Thyroid/Parathyroid• Dysuria/hematuria• Perioperative Assessment, Airway Management/Hemodynamic

Monitoring• Hematemesis/dysphagia• Jaundice/GI-hepatobiliary• Joint pain/Back pain, Claudication/rest pain/hemiparesis• Breast pain/nipple discharge/women’s health• Rectal bleeding and pain• Infectious Disease

Conferences, cont.

Departmental Conferences: Surgery – Students attend weekly Morbidity &

Mortality conference, Surgical Grand Rounds, & service conferences (students prepare case presentations for Attendings and Residents on their service).

Medicine – Students attend daily noon teaching conferences, including weekly Morbidity & Mortality conference & weekly Medicine Grand Rounds; Monday Chairman’s Rounds; Tuesday through Thursday Ward Attending Teaching Rounds.

Design Features Orientation – First day of block – includes general hospital

orientation (Epic training, HIPAA, Infection Control) and discipline-specific orientation (team/preceptor assignments, education conference schedule, night call, OR orientation and overall expectations of each discipline

Learning relationships – • Each student meets with a block advisor every 4 weeks• Surgery – each student has a Surgery Attending Preceptor for the 8-

week rotation• Medicine – each student has a Teaching Attending in addition to the

Ward Attending – students meet with the Teaching Attending twice weekly for 6 weeks for bedside teaching and case discussions

Feedback – CAS assessments will be monitored by the Discipline Leaders and administrators a minimum of every 2 weeks and will be reviewed with the students every 4 weeks by Block Advisors

Direct observation- Surgery - OR, case conference presentations, GI Rounds, Oral Exams,

Outpatient clinic with preceptor, Inpatient Team Medicine – Ward Attending Rounds and review of write-ups; review of

physical exam concepts, presentations and bedside exams with Teaching Attendings.

Design Features, cont. Exposure to career options – Surgery – The surgery experience will include two (2-week) electives

chosen by the students from various surgical specialties Medicine – The Medicine experience includes a two-week rotation, for

most students, on Cardiac Stepdown. Other possible rotations include Hem/Onc and MICU Stepdown. The students also have exposure to IM/Med Specialty clinics during their 2-week ambulatory rotation.

On call schedules – Surgery – Call averages every 7th night where students take Acute

Care Surgery/Trauma call. Medicine – students take call following their assigned intern’s call

schedule, averaging every 5th night, staying until 10pm, with the goal of admitting at least 1 patient – overnight call is optional

Inpatient-outpatient balance - Surgery students are assigned to ½ - 1 full day of clinic per week. Medicine students are assigned to seven (½ -day) IM or Med Specialty clinics per week during their 2-week ambulatory rotation.

Integration of Advanced Core learning objectives – A perioperative didactic session will include Perioperative Management, Assessment/Airway Management/Hemodynamic Monitoring.

Unique features of this rotation

Block One at MetroHealth offers • A multi-disciplinary approach to learning• Increased inpatient rotation time• Opportunity to take Trauma call in a level

one Trauma center • Opportunities for one-on-one teaching

with teaching attendings and preceptors• Free parking for students