Adolescent Medicine Fellowship
Adolescent fellows serve as part of a team of providers caring for patients either through the provision of direct care in the outpatient and inpatient settings or consultative care in the inpatient setting. The team includes a supervisor and may include other licensed independent practitioners, other trainees and medical students. The clinical responsibilities for each fellow are based on PGY-level, patient safety, fellow education, severity and complexity of patient illness/condition and available support services. The specific role of each fellow varies with their clinical rotation, experience, duration of clinical training, the patient's illness and the clinical demands placed on the team. The following is a guide to the specific patient care responsibilities by year of clinical training. Fellows must comply with the supervision standards of the service on which they are rotating unless otherwise specified by their program director.
First Year Fellow
First year fellows are primarily responsible for the care of patients under guidance and supervision of an attending. Fellows evaluate patients, obtain the medical history and perform physical examinations. They are expected to develop a differential diagnosis and problem list.
Using this information, they arrive at a plan of care or a set of recommendations in conjunction with the attending. They document the provision of patient care as required by hospital/clinic policy. Fellows may write orders for diagnostic studies and therapeutic interventions as specified in the medical center bylaws and rules/regulations. They may interpret the results of laboratory and other diagnostic testing. They may request consultation for diagnostic studies, the evaluation by other physicians, physical/rehabilitation therapy, specialized nursing care, and social services. They may participate in procedures performed in the clinic, operating room or procedure suite under appropriate supervision. Fellows may initiate and coordinate hospital admission and discharge planning. Fellows discuss the patient's status and plan of care with the attending and the team regularly. Fellows help provide for the educational needs and supervision of any residents and medical students. In most settings there is direct supervision available; however, as fellows demonstrate independence in generating plans, ordering tests and consults and communicating with patients as determined by supervising attending in collaboration with the fellowship director, the fellows can receive indirect supervision in specific settings: the homeless clinic and juvenile detention.
Second and Third Year Fellows
Second and third year fellows may be directly or indirectly supervised. They provide direct patient care, supervisory care, and consultative services, with supervision of an attending physician; however, they are expected to be more independent than first year fellows in developing an appropriate differential diagnosis and organized plan to address the differential.
They are expected to be able to be independent in ordering tests, consults, and following up with patients. They are also expected to be independent in presenting the plan to patients and families and in communicating with consultants and other team members. Second and third year fellows are expected to serve in a supervisory role of residents in the outpatient adolescent medicine clinic; however, the attending physician is ultimately responsible for the care of the patient.
Pediatric Fellowship Contact Information
Rina Lazebnik, MD
Chief, Division of General Academic Pediatrics and Adolescent Medicine
Professor of Pediatrics
Case Western Reserve University
Director Adolescent Medicine Program
UH Rainbow Babies & Children's Hospital
11100 Euclid Avenue
Cleveland, OH 44106
Academic Fellowship Coordinator
The Center for Pediatric Education
UH Rainbow Babies & Children’s Hospital
11100 Euclid Avenue, RBC Rm 838, Mailstop: RBC 6002
Cleveland, OH 44106