How is your relationship with the trauma service?
We have a strong working relationship with the division of trauma surgery. This relationship has been a long tradition at Metrohealth extending from the chairmen of the departments on down.

MetroHealth Medical Center and the Cleveland Clinic Health System have entered into an agreement to form a regional trauma network that will provide for common protocols and practices in the managment of trauma patients across the region.  A MetroHealth trauma surgeon is the medicial director for this network.  We expect that this network with its protocols will help insure that appropriate critically injured patients are brought to MetroHealth.

What about the other departments?
Excellent. Emergency Medicine is a mature department at MetroHealth. Dr. Charles Emerman is the senior chair at MetroHealth. Since our residents have a generous fund of knowledge, excellent interpersonal skills, and efficient work skills, they are widely respected throughout the institution. They are our true ambassadors to other services. In addition, our chief residents work closely with other chiefs on such things as joint conferences. Several of our faculty members work with faculty in other departments on collaborative research projects, hospital committees, and educational programs. We are very proud of our relationship with other departments and our standing in the hospital. At the Cleveland Clinic, we are an established department recognized for our overall excellence and our contribution to the institution.

How are trauma patients managed?
Trauma patients are categorized prior to arrival as "Level 1" or  "Level 2" or "Level 3" with  the first being the most critical. All level 2 and 3 patients are run by the EM2. The team leader for level 1 patients alternates each week between the EM3 and the trauma chief. Procedures are divided among the residents by the team leader. With this collegial structure, in addition to the fact that an EM resident is on the trauma team 11 months out of the year, the vast majority of procedures are performed by EM residents. Airway management is always the domain of emergency medicine.

 What about ultrasound?
Ultrasound education has become an integral part of the training program. Dr. Robert Jones, ED faculty and director of MHMC emergency US, is a national lecturer on the use of ultrasound in the ED and has published several articles and books on the FAST exam. MetroHealth is currently in its sixth year of an ultrasound fellowship program. Ultrasound machines reside in both EDs at all times to be used by ED residents and faculty for the FAST exam. Other common examinations in appropriate patients include gallbladder, pelvic, lung, foreign body location, and vessel localization for central line placement. During the ultrasound rotation, EM residents perform multiple studies on ED patients with a full-time registered diagnostic medical sonographer. Weekly didactic sessions and quarterly "hands-on" labs are held throughout the year for the residency. 

Describe your pediatric training.
Pediatric patients are integrated into the ED population, accounting for over 25% of all ED visits at both MetroHealth and the Cleveland Clinic.The faculty includes Pediatric-EM fellowship trained physicians. Residents also rotate on the pediatric urgent access clinic as a PGY 1 and in the PICU as a PGY 2.

What about toxicology? 
As a PGY 3 the EM resident spends 4 weeks at the Cleveland Poison Control Center working with a board certified toxicologist. 

What is your relationship with the Case Western Reserve University School of Medicine (CASE)? 
MetroHealth Medical Center is a major teaching hospital for the Case medical students. In 2002 the Case School of Medicine established the academic department of emergency medicine here at MetroHealth with Dr. Charles Emerman as the departmental co-chairman. All EM faculty hold faculty appointments at Case and have teaching responsiblities throughout the medical school curriculum. Our emergency medicine residents work with medical students at all four medical school levels.

How is EMS and pre-hospital care integrated into the residency?
Dr. Thomas Collins is the medical director for Cleveland Emergency Medical Services and Dr. Brendan Hawthorn is tactical medical director for the Cleveland Police Department. This is a tremendous asset to the program. Interested and motivated residents can work with Tom to learn about the medical direction of an urban EMS system and disaster management.  MetroHealth is home to one of the EMS base stations, helping to maintain our excellent relationship. During orientation, our EM1 residents spend time at the Fire School and the Police Academy.

Tell me more about Metro Life Flight.
Metro Life Flight is the second busiest aero-medical critical care program in the country. It flies four Sikorsky S-76 aircraft based at three locations throughout Greater Cleveland. The S-76 is a dual engine, two-pilot helicopter -- features that significantly add to flight safety. Metro Life Flight has flown more than 58,000 accident-free flights in its 27-year existence. Approximately 40% of the flights are for trauma patients. The remainder are a mix of medical, pediatric, and obstetrical emergencies. About 20% of the trauma flights are "scene runs."

Dr. Craig Bates, one of our emergency medicine staff, is the medical director of Metro Life Flight. During the PGY 3 rotation on Metro Life Flight, the EM resident is the flight physician and gains experience in aero-medical patient care.  A flight nurse and physician manage the patient on each flight. Opportunities for moonlighting are available for eligible EM residents. 

Metro Life Flight

How do I apply to your emergency medicine residency program?
Applications are accepted only through ERAS, the Electronic Residency Application Service. Applications are accepted beginning September 1 through December 1 for a residency position that begins the following year.

What application requirements does your program have?
We require a minimum of three letters of recommendation (CORD SLOR preferred). We expect at least one of those letters to be from an emergency medicine physician. It is preferred to have two letters from an emergency physician. Only Step 1 of the USMLE is required; however, most applicants send us their Step 2 score, too. Applicants from osteopathic schools provide us with their COMLEX Step 1 score. Even though applicants from the osteropathic schools are not required to take Step 1 of USMLE, they often do, and scores from USMLE and COMLEX are part of the application.

A complete application includes: the ERAS application, CV, Personal statement, three (3) letters of recommendation, Dean's letter, transcripts, and USMLE or COMLEX Step 1 scores.

When does your program interview applicants?
We interview on Tuesdays and Wednesdays beginning the second week in November and ending the last week in January. Interviews are by invitation only. Invitations are sent out via e-mail.

What does the interview day include?
There is an open discussion and slide show with our Program Director, Jeff Pennington, MD, interviews with our Steering Committee and other faculty members, lunch with our residents and a tour of MetroHealth Medical Center, Cleveland Clinic and the general Cleveland area.

Who can I contact for further information?
Denise Catalano, Residency Coordinator
emresidency@metrohealth.org
(216) 778-5088

How can I contact a current EM resident regarding the program?
The residents are available through the MetroHealth email system. The email address is the first initial of the first name, followed by the full last name. For example to email John Smith - the address is jsmith@metrohealth.org

You can always contact the Chief Residents: Ryan Agema, Sarah Klemencic, Stephen Scull