Center of Outpatient Education Pathway

Frequently Asked Questions

Can I apply to both the Categorical and COE Tracks?

Yes, many people choose to rank multiple tracks.

Do residents in the COE program receive adequate training in subspecialty and inpatient medicine?

Absolutely! Participants of the program receive ample time on the wards at their respective hospitals and are indistinguishable from categorical residents when not participating in the COE block.

How many residents are in COE track?

We typically accept 6 residents from University Hospitals (UH) and 6 residents from Cleveland Clinic (CCF) every year.

What is a typical weekly schedule during COE?

Residents rotate through COE for 3 months at a time. Below, is a sample schedule of a typical week on COE During the elective blocks, residents can choose to go to any subspecialty clinic at the VA, Cleveland Clinic, or University Hospital or work on research projects.

Sample Schedule

Day of Week	AM (8a - 12p)	PM (1p - 4p)
Monday	Panel Management	Primary Care
Tuesday	Elective	Urgent Clinic
Wednesday	Primary Care	Women's Health
Thursday	Primary Care	Electives
Friday	Didactics	Self-Directed Learning

What do COE graduates do when they finish?

The program is designed to prepare graduates for any career, whether it be Primary Care or a subspecialty. Many subspecialties have a significant outpatient component, and our graduates are comfortable in both inpatient and outpatient settings. Below is a sample of the variety of career paths and statistics from residents who responded to survey requests (both Cleveland Clinic and University Hospitals residents) over the past few years.

• Average number of invites for 2021 & 2022 fellowship match season: 17.6 interview invitations
• Average rates of invites per programs applied to for 2021 & 2022 match season: 37.1% of programs applied to the following:

Cardiology Fellowship

• Duke University
• University of Virginia
• Rush University

Gastroenterology Fellowship

• Baylor Medical Center
• Vanderbilt University
• Dartmouth University
• UCLA Medical Center

Pulmonary/Critical Care Fellowship

• Cleveland Clinic
• University Hospitals
• University of Virginia
• University of Texas, Houston

Hematology/Oncology Fellowship

• University of Texas MD Anderson
• Mayo Clinic Rochester
• University of Pittsburgh Medical Center
• Indiana University

Endocrinology Fellowship

• Mayo Clinic Rochester
• Emory University
• Baylor Medical Center

Allergy and Immunology

• Rush University

General Medicine Fellowship

• Harvard University

Chief Medical Resident

• COE Chief Resident of Quality and Safety at Cleveland VAMC
• Cleveland Clinic
• University Hospitals

Primary Care / Hospitalist

• Cleveland VA Medical Center
• Ohio State University
• Cleveland Clinic
• University Hospitals
• Orlando VA Medical Center

What makes the training within the VA COE track special?

We have several unique teaching strategies and training opportunities for residents in their COE blocks:

1. Unique community and learning environment
   • Medical residents serve as the leaders of their primary care team working with nurses, social workers, and schedulers assigned to each team to direct patient care with attending supervision
   • We have a diverse group of learners including medical residents, nurse practitioner residents, psychology fellows, pharmacy residents, and more who participate in our educational sessions
   • Our learners come from various backgrounds and hail from all over the country and the world
   • CCF and UH residents become very close colleagues and friends during their time in the VA
2. Specialty clinics (separate from electives) available to residents at the VA including
   • Women’s Health
   • Urgent Clinic
   • Geriatrics
   • Procedure clinic
   • Subspecialty clinics including GI/Hepatology, Rheumatology, Endocrinology and more
3. Lean QI curriculum
   • Residents will take formal Quality Improvement and Patient Safety lectures, conduct a QI project in a team, and obtain Lean Yellow Belt certification during their time in the VA
   • Residents have the opportunity to submit their abstract to IHI (Institute for Healthcare Improvement) for presentation at the IHI conference in Orlando, Florida
4. Social Determinants of Health curriculum
   • Residents will participate in didactics and sessions focused on the impact patients’ social circumstances have on their health
5. Patient video experiences
   • Residents record a video of themselves with a patient in clinic (after obtaining consent) for feedback on patient interaction and communication skills. Videos are recorded during PGY-1 and PGY-3 blocks so residents can compare how they have developed
6. Panel Management
   • Residents have a dedicated half-day for Panel Management on Mondays that allows them to take a “bird’s-eye view” approach to their panel of patients'
   • We have a Panel Management curriculum that focuses on common primary care issues such as diabetes, hypertension, cancer screening, and loss to follow up, and residents will develop strategies and treatment plans to improve the care of their patients in these areas
7. Special sessions including
   • Leadership sessions with local healthcare leaders and visiting guests like Dr. Melvin Smith (Emotional Intelligence Expert), Dr. Peter Provonost (Quality Improvement Expert), Jim Smith (The Executive Happiness Coach), and Caroline Carter (Leadership Coach)
   • Visit to the Cleveland Museum of Art for a session on professional satisfaction
   • Visit to the Cleveland Museum of Natural History to explore the impact of climate and weather on population health
   • Ice cream socials