Cleveland Clinic Foundation info

In short, if your career goal is to be heavily involved in academic medicine or research then Cleveland Clinic would be a good place to go. Your other points are all valid. Yes, Cleveland would be a miserable place to live. Their trauma experience leaves a lot to be desired and I would argue you would get a much better operative experience at a different type of program.

When making your rank list, you want to look at what type of program will be the best fit for you - do you want to be a community surgeon and just operate, do you want to do academics/research and spend less time in the OR, or do you want a balance of both? I personally went with a program that offered a big name with many academic opportunities, yet also provided one of the best operative experiences out of any program in the country.

At the end of the day, the city/location/weather/etc will be less of an issue if you find a program you will enjoy being at. Deciding where you want to do your residency is a huge decision and it can be easy to get caught up in smaller details. Figure out what you want and what you are looking for, and try to go to a program that offers the best fit for you.

The residents do most of the didactics. The trauma rotation puts you as a second class citizen at someone elses residency. On the positive, the residents are nice, they have strong rotations in many other non trauma rotations, especially joints and sports, and they have all the money you could ever want for research.

So to be more accurate, the CCF people do 2 months at metro trauma as a pgy-2 and then again as a pgy-3. Several chiefs come back to metro as pgy-5 if they are going into trauma or if they want more trauma experience. They are by no means treated as second class citizens. The CCF and case residents work together and get the same experience. Case residents take orders from the CCF chiefs and vice versa. The only difference is that the case residents spend more time in total over 4 years at metro...14 months total as compared to 4-6 for CCF.

Yes, Cleveland is THAT miserable.

BTW, the operative experience at Cleveland Clinic is second to none. Residents receive excellent training and have a lot of autonomy.

thanks for the input everyone, there are pluses and minuses to each program, and the task is to manipulate these into a final ROL.. good luck to all

I rotated and spent a few months here, wanted to be here, and everyone knew that. So you will not get any negatives, but I will respond to some of the negatives I have seen so those applying this year get an honest idea of what it will be like.

1) Operative experience: Seriously, no joke, it cannot be better at an academic center. There are advantages to community programs, I have seen some great ones, and you might get to operate more (but not much) as a 1 and 2. But at the clinic you rarely double scrub, rotate at several different CCF sites, and get the best of academic and community OR experience because of it.

2) The didactics: I am not sure why people badmouth this? When I was rotating the academic days were incredible. There was a PE lecture by the team docs for the indians, and browns, and also had a sim lab in which all the sports guys assisted in teaching SLAP repairs ect. Each academic day had lectures by faculty, and they are all well-known and well published orthopods that are always available and willing to help. Some lectures were by the senior residents or residents on their research year, but they know their shit, and they can offer advice on dealing with certain issues as they relate to the Clinic, so your learning orthopaedics and how you will see and deal with them from personal experience at your program.

3) Fellows: yes there are many, but its the cleveland clinic, what do you expect? There are PLENTY of cases to go around. I have never heard one resident complain that he had to sit back double scrub with fellows all day.

4) research: opportunity is second to none

5) fellowship: I have heard some say you can get any fellowship from anywhere, and this may be true, but when every attending at your program knows someone, it makes it alot easier. - if you come here you can get any fellowship you want.

6) Most important the CITY: Cleveland is a great city, I love it, people who are not from here talk shit about it, but those who are from cleveland love it. The winters stink; but your a resident, your not gonna be catching rays on south beach anyways. The downtown has anything you could ask for; great bars, restraunts, and nightlife in general. The metroparks are actually really nice in the spring and summer if you take advantage of them, and the sports teams have the best fans in the world, who else can deal with the misery they put us through?

So in general, Im telling you this is biased, but its all 100% true. I know the program better than some east/west coast yuppy that came to cleveland for one day and decided it wasnt for them. They dont interview many so if you are interested do a rotation, and if you dont mind the weather, you will love the clinic.

SO I rotated at CCF, and I am a westcoast yuppy. I have to agree with UTortho for the most part. If you're looking for one of the purest orthopaedic programs in the country you won't find anything better than CCF. There is a glaring hole in their curriculum in trauma though. I think there is a definite balance between becoming adept and trauma without doing so much of it that you dread it. I will say though from rotating at CCF and Case that if you're seriously considering trauma you should probably think about going to Case instead.

With regard to the city of Cleveland, I'm from the bay area and Cleveland has a lot to be desired. The bars are okay if you like the Browns or the Indians, if not you might be shit out of luck. I personally feel like the restaurants are terrible. I'll never forget a review about a restaurant I read in the local newspaper "It kills me how Clevelanders get so worked up over average food".

Now does this make a difference in the grand scheme of things? Probably not. But don't let anyone fool you. Cleveland is the rustiest part of the rust belt. Having said that I had a blast while I was there and it has a lot more culture and charm than cities 3-4 times its size. I could have lived there and been happy without a doubt.

and with regard to the "second class citizens" reference at Metro I'd have to agree. Most Case residents consider the majority of the CCF residents completely incompetent when it comes to trauma. When they see one that knows what they're doing they're truly surprised. You'll see 2 and 3 year residents "out-knowledge" CCF chiefs at Metro. and I'm not saying this from rumor. I spent a month at Metro and a month at CCF. Case may live in CCF's shadow but they do trauma like few in the country.

Anyone who disagrees probably hasn't seen both sides. I'm totally objective with this regard, I loved both programs but didn't match at either.

Rotated as well, have to agree with Oski. The trauma at CCF is basically nonexistent. I heard multiple residents complain about their trauma experience at metro, including one that said he had to assist an MS4 doing a tibial nail rather than getting to do it himself.

My thoughts on other issues:

1.Operative experience - overall I thought it was pretty good. It differs from service to service and from attending to attending. Some attendings let the residents go at it while supervising, others leave the room and just come back to check on things, while others don't let the residents do too much. Like any other academic center it is very attending dependent. The question with trauma is do they get enough "cold trauma" ie patients coming into foot and ankle clinic in a splint that needs ORIF and therefor even though there is no busy ER, you still get to do basic trauma cases on other rotations. I think the skills labs are good, but from what I could tell only the arthroscopy gets a lot of use. Heck I scoped a cadaver shoulder when I was there as a visiting student, so the opportunities are certainly there. I think overall this is good with the exception of trauma, although one PGY-2 on my rotation was complaining to a chief that he hadnt even done one approach to a total joint on his own (this was on like his 4th or 5th month of joints) so who knows. the chiefs i worked with seemed competent.

2. The didactics: UT and i obviously rotated at different times because I thought this was the most glaring weakness of the program. I did not see one didactic done by an attending outside of the scope lab and thought that other than the lab they were universally not very good and paled in comparison to other places I rotated. I thought this was surprising given the number of experts in their clinical field at CCF.

3. Fellows: I think the only service where fellows kind of run the show is sports, but from what i was told residents generally rotate with different attendings than the fellows on this service anyways. Fellows generally work with the big name sports guys though.

4. Research: I actually may be in the minority here but I would say the research at CCF is only average. It's more of a clinical powerhouse that rocks through cases like crazy than a research powerhouse (think New England Baptist)

5. Fellowship: Yea they got good fellowships just like everyone else seems to, seriously did anywhere not tell you they got their first 1 or 2 choices?

6. The city: didnt do it for me, what can I say

Another one : the staff - the attendings here are awesome, so easy to get along with and so down to earth, all the way up to the chair Iannotti per the residents.

Oh and one last one: Cush as he!! lifestyle if thats what you're looking for.

Its a solid program that like all others has strengths and weaknesses, just depends upon what your priorities are. I want a more well rounded program with a better trauma experience, so I didn't rank it highly.

Hello all! First, let me start by saying that I am a current PGY-3 at CCF. Like all of you guys/girls, I definitely tried to use orthogate as a tool to gather information on programs back when I was in your shoes a few years ago. I must admit, I was selfish with regard to not joining and making contributions of my own experiences, and since becoming a resident, I maybe glance at the site once every few months just for curiosity's sake. Yesterday just so happened to be one of those curious days, and I was really shocked at some of the things that I read on the forums about CCF. So much so that I signed up this morning simply so I could try to clear up some of the comments recently made. Obviously match is already over for this year, but my goal is to get some helpful info out there for future applicants that might be interested. Undoubtedly you will think my comments are biased due to the fact that I am a resident at CCF, but I strongly believe we have a phenomenal program. Because some recent comments about CCF simply don't paint an accurate picture of our experience, I will go through several topics (and I promise to be honest!) in the hopes of providing some concrete facts students can base their decisions on. Warning, this is very long!

1) Faculty/Staff - Most of the comments I have read are dead-on with respect to our staff being extremely approachable and easy going. I rotated at CCF as an MS4 and this was one of the big reasons I liked CCF so much. We have a huge number of orthopaedic staff, and I have difficulty thinking of even one that I wouldn't feel comfortable going to with any question, problem, or request. Day to day interaction with them is very collegial and literally fun most of the time.

2) Operative experience - I read that some people were having a tough time getting a read on how much we actually get to operate. Let me assure you, it is early and frequent. With the exception of the night-float rotation or a day that you are on "day-call," there is not a single rotation in our entire residency in which you are not expected to be in the OR or clinic at the start of the first case. This includes interns all the way through chiefs. Everyone rounds on patients in the morning and going to the OR following. There is never any rotation in which interns or juniors are running around doing floor work while more senior level residents are operating. Simply does not exist. With regard to what you are doing in the OR, it is very appropriate for your level and in most cases, I whole-heartedly feel you will be doing more earlier at CCF than most other programs. I read a recent comment that one of our juniors was overheard saying that they had not even done an approach to a knee even after months on service. I was astounded by this statement. I'm not sure if something was taken out of context or something out of the ordinary was going on, but this is most assuredly not the norm. For example, I started out on the joints service first thing my PGY-2 year. On day one I was doing the approaches to primary hips and knees and by the end of my two months I was getting to do 90% of the whole case. (i.e. I was doing the operating and many times staff were the ones taking me through the case). My experience with all of my other rotations has been very similar and I couldn't be happier with the amount I get to operate. If it's concrete numbers you are looking for, I am very diligent with keeping up on my ACGME case log, and I just checked my total in order to give you guys an honest number. I currently have a total of 775 ortho cases logged and that is with 3 months still to go in my PGY-3 year. Since we do get to do more and more cases as senior residents (due to the fact that we have no more day calls, no more days being "post-call," etc, it leaves more days to be in the OR) I really expect to be at around 1800 or so by the time of graduation.

3) Didactics - There seems to be a lot of confusion regarding our didactics, specifically on how much is done by residents. The comments I'm reading really seem to be inappropriately skewed towards residents doing all the didactics. I think a lot of this has to do with the fact that we actually have a quite a bit of didactics going on that medstudents aren't exposed to. I'm not sure, maybe we also had some "weird" academic days that weren't the norm going on when students were with us last fall. In any case, I will simply list all of our didactics (that I can think of off the top of my head) and how we organize them so you can be the judge. This is not opinion, it is honestly how are didactics are set up...

- Our main academic day for all residents no matter what service they are on is tuesdays from 7-10:30am. These are almost always structured as 3 back to back lectures. About 60% percent of the time, the first hour lecture is done by a resident on a more basic topic (with a staff in attendance) and the second two lectures are given by staff themselves. The other 40% of our academic days, all 3 lectures are given by staff.
- Wednesday mornings from 7-8am are either fracture conference, M&M, or grand rounds. Yes, the fracture conference lectures are given by a senior resident, but staff are almost always in attendance.

As for didactics that are rotation specific and I think many students may not even get any exposure to...
- Tumor service has a case conference every monday morning that is attended by onc ortho staff, pathology staff, and radiology staff.
- CCF Peds service has two morning conferences every week, one being an indications conference and one being a specific topic lecture, and all peds staff are in attendance.
- Sports service has a morning lecture every friday that is attended by about 30-40 people, including ALL sports staff.
- Joints service has a very informal conference every monday morning prior to starting the ORs that has multiple joints staff in attendance.
- Hand/Upper extremity service has a weekly morning journal club type conference that is attended by all fellows and one assigned staff.
- While doing trauma at Metro or Peds in Akron, you attend all of their morning conferences, grand rounds, indications conferences, which are attended by the Metro or Akron staff.
- Usually multiple evening journal clubs every month depending on service.

4) Our trauma/Metro experience: There are a few things I want to touch on - our time at metro, our relationship with Metro and the UH residents, and our overall trauma experience. As stated by others, we do two months as a PGY-2 and 2 months as a PGY-3. Yes, there were two CCF chiefs (who are both doing trauma fellowships) that returned to metro this year during their elective time, but this is not the norm. As of right now, it's really only an option for those planning on doing a trauma as a career. With regard to amount of time spent doing trauma, yes, we obviously don't spend near the time at Metro that the UH residents do, but on the other end of the spectrum, many of the UH guys are sick of Metro by the end of their training as they spend so so much time there.
With respect to this whole business about us going to Metro and being "second-class" citizens or whatever, is complete non-sense in my opinion simply because of one simple fact - The way that you are treated and respected has about 5% to do with what program you are from, and about 95% to do with you as an individual. This doesn't apply to just Metro, but honestly in every aspect of your professional life. I have already done my PGY-2 and 3 rotations at Metro and I LOVED my rotations there. I really do wish I could spend a little more time there. I got along great with the UH residents, the UH chiefs, and all of the Metro staff (two of which are CCF alums, by the way). We were all there to do the same job - take good care of patients, learn, and go home. I never felt that my knowledge level was any less than my peers from UH and I never ever, ever felt as though I wasn't getting the same resect or operative exposure as my UH counterparts. Several Metro staff openly asked me to keep in touch as I go further on in my training and to never hesitate in coming to them with questions or advice. I still keep in touch with previous UH chiefs that I worked with and am friends with current UH residents. Make no mistake, both CCF and UH graduate top-notch orthopaedic surgeons and I have nothing but respect for the UH guys as my peers.
With regard to our overall trauma experience, I will be the first to admit that we don't see as much acute trauma as other programs and this is a weakness for us. Now what does this really mean? (In my opinion, obviously). The things that we really only get to see while at Metro and not really anywhere else are: High energy pelvic fractures, high energy spine trauma, and the really bad acute injuries or open fractures that require immediate soft tissue or vascular attention. With regard to pelvis fractures and high-energy spine trauma, I assume there are very, very few people that would tackle these problems if they are not fellowship trained anyways. Now obviously, there is also a component of taking care of the acute trauma patient as a whole, not just simply fixing the broken bone, and I am very comfortable with my ability to do this. We get plenty more exposure to all other fractures through both our call at CCF locations and by way of "cold trauma" that gets sent in to our offices a week out from injury. Worried about ankle fractures and foot injuries? Not a problem, we see tons of ankle fractures, including bad trimals/fx dislocations/etc, in our ED. Calc fractures and Lis franc injuries? Yep, our foot/ankle staff are doing them all the time. Worried about tibia fractures that need plated or nailed? Yep, we get those too. Worried about femur fractures, broken hips, periprosthetic fractures? Don't worry, you'll be doing them until you're blue in the face by the end of our program. Worried about upper extremity fractures? Don't be, we see more than enough proximal humerus and shaft fractures and plenty of forearm/wrist fractures. I'm on the hand service right now and just this last 2 weeks I operated on an adult supracondylar fracture, a terrible triad elbow, two olecranon fractures, a 2 distal radius fractures, a metacarpal fracture, and next week I know we already have a dusted proximal 1/3 radius fracture from a GSW on the schedule. That's all on top of the elective scheduled cases. Getting my drift? I personally plan on having a general ortho practice and don't have any worry about my future abilities to care for trauma patients that don't have some horrible injury that obviously would be better done in the hands of a trauma trained surgeon.

5) Fellows - Most of the comments I have read seem pretty accurate. We do have a lot of fellows, but more than enough case to go around. As stated by others, they seem to have a stronger presence on the sports service, but when you rotate on sports as a PGY-4 and 5 you are just as likely to be getting one-on-one time with Parker, Miniaci, Schickendatnz, etc as the fellows. In all honestly I have found it very rare across the board that fellows get in the way of your resident operative experience.

6) Research - as others have said, tons and tons of opportunity, but not pushed on you at all. Yes, the research year after PGY-3 is completely optional. CCF in my opinion is a great place to train for both those thinking of going into academics as well as those that aren't. We consistently have a mix of both within the residency.

7) Hours - As said by others, we have no problem staying below the 80 hour rule. (And also shouldn't have any problems with whatever ridiculously crazy limits next year's intern class has. I'll be sure to get you guys some cookies and milk to go along with your mandatory evening nap time).

7) And lastly, the city of Cleveland itself. Now, I am from the midwest, but go to visit friends in NYC and Cali with some frequency and consider myself a "city" person for life. Undoubtedly, the worst thing about Cleveland and the midwest in general are the winters. Very gray and cold from November through March. But the remainder of the year is not bad at all and the summers are awesome. Cleveland is obviously not NYC, LA, or Chicago, but I always kind of laugh to myself when people talk about how there is nothing to do in Cleveland in comparison to most major cities. In part this is a little true, but people make it sound as though there are all these wonderful and glamorous activities going on in the lives of residents living in these other cities. I'm willing to bet that many of them spend 4-5 out of 7 evenings at home in their house or apartment watching TV or reading. Well gosh, I have a very comfortable and nice condo with a plasma screen TV and surround sound in my living room. Want to go to a movie and dinner one night? I'm not sure, but I think we have movie theaters here. And we do have a plethora of great restaurants (but I must admit I was cracking up about the one comment I read about "Clevelanders get way too worked up over mediocre food" haha) We must have some good food, or else why is everyone so fat
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Honestly, I'm obviously being a bit of a smart-ass here, there is quite a bit to do in Cleveland. Just off the top of my head, I can think off...The Browns/Cavs/Indians, the lake during the summer, Case Western's campus activities, the awesome art museum, the Cleveland Orchestra (which is one of the top 5 in the US), the botanical gardens, multiple great metro-parks, currently the annual international film festival is going on, there are multiple festivals and events every weekend across the city (especially during warmer months), west side market, Playhouse square always has broadway plays showing, there's always concerts at the Q or CSU's arena, you have your cookie cutter late night bar/club scene downtown, a super easy and accessible airport, etc. I think it is very important to remember that residency is difficult and time consuming no matter where you are. You will be kicking yourself if you don't take into consideration the added difficulties of the location where you will be living for the next 5 years. Cleveland may not have quite as much to do as some of these more glamorous cities, but the tradeoff is that while you still get quite a bit to do, day to day living is VERY easy, affordable, and laid-back.

Well, anyways, I hope this helps answer some questions that future applicants may have. Frankly, I am simply exhausted from typing (is this seriously what medicine residents do all day!?!?!) and you are surely tired from reading.
I don't mean to sound like a public service announcement, but how you come out as an orthopaedic surgeon after residency has more to do with you as an individual than it does with the specific place you train. Your goal is to find a place that will give you the most opportunity to learn everything you could possible want to learn in 5 years and be happy with life at the same time. I think you will be hard pressed to find many programs out there that give you more opportunity to see and do the cases you will get exposed to while at CCF, all while being in a very relaxed work environment and living in a city that provides plenty to do and still be affordable and super-easy to live in.

Please feel free to message me or whatever about questions regarding CCF and I wish everyone luck in their careers!

PM'ed you Knucklehead