Curriculum

Mayo Clinic emergency medicine staff in emergency department

First year (PGY-1)

Rotation Length
Emergency medicine 5 months
Pediatric emergency medicine 1 month
Emergency psychiatry (combined rotation with anesthesia) 1 month (Monday, Tuesday and Thursday afternoons)
Anesthesia (combined rotation with emergency psychiatry) 1 month (Monday through Friday mornings)
Intensive care unit (ICU) 1 month
Emergency Medical Services or EMS (combined rotation with ultrasound) 2 weeks
Ultrasound (combined rotation with EMS) 2 weeks
Surgical intensive care unit (SICU) 1 month
Orthopedic trauma surgery 1 month
Obstetrics and gynecology 1 month

Emergency medicine

  • Assess, resuscitate and treat patients in emergency department
  • Take primary responsibility for patient care with supervision by emergency medicine staff and senior residents
  • Manage the airway of all leveled trauma resuscitations
  • Have integrated adult and pediatric emergency medicine experience (20 percent of shifts a month in the pediatric emergency department)
  • Your average shift load — 19 to 21 shifts a month (nine-hour shifts)

Pediatric emergency medicine

  • Assess, resuscitate and treat pediatric emergency department patients
  • Assume primary responsibility for patient care with supervision by emergency medicine and pediatric emergency medicine staff and senior residents
  • Your average shift load — 19 to 21 shifts a month (nine-hour shifts)

Emergency psychiatry

  • Perform primary psychiatric evaluation on emergency department patients needing psychiatric assessment

Anesthesia

  • Acquire and perform airway management procedures — including endotracheal intubation, nasotracheal intubation, laryngeal mask airway and more
  • Learn the pharmacological adjuncts to rapid sequence intubation

Intensive care unit (ICU)

  • As a PGY-1 resident, care for unstable patients in a high-acuity medical and surgical ICU under the supervision of the ICU staff, senior residents and fellows
  • Take responsibility for resuscitating and performing necessary procedures in patients with critical illnesses

Emergency Medical Services (EMS)

  • Attend EMS administration meetings, as well as Gold Cross ambulance and Mayo One helicopter ride-alongs in order to gain a comprehensive overview of prehospital care and EMS direction
  • Observe during Mayo One flights, as a PGY-1 resident
  • Participate as a team member during Mayo One flights (EMS selective for PGY-3 residents)
  • Have opportunities to serve as an EMS co-director for a local rural EMS unit
  • Additional EMS experiences created for interested residents

Ultrasound

  • Attend scanning shifts with 1 of 3 faculty members who are fellowship trained in ultrasound
  • Perform bedside ultrasounds independently, which are reviewed by ultrasound-trained faculty for quality assurance

Surgical intensive care unit (SICU)

  • Care for unstable patients with major trauma and general surgical conditions (supervised by the ICU staff and senior residents)
  • Gain exposure to ultrasonography, central line placement, tube thoracostomy, resuscitations and airway management
  • Have opportunities to observe and participate in surgical tracheostomy, if desired

Orthopedic trauma surgery

  • Provide consultative support to the emergency department for cases requiring orthopedic evaluation (supervised by senior orthopedic residents and staff)
  • Respond to the emergency department for cases requiring orthopedic evaluation, perform reductions and hematoma blocks, and splint extremities
  • Participate in sports clinic weekly with sports medicine fellowship-trained staff
  • Review fracture radiographs obtained in the department on a weekly basis

Obstetrics and gynecology

  • Work in both the obstetric triage unit, as well as labor and delivery
  • Serve as the only junior resident for labor and delivery, triage, and antepartum and postpartum care (supervised by senior obstetrics and gynecology resident and staff member)
  • Evaluate patients with pregnancy-related emergencies and active labor
  • Receive opportunities to assist in vaginal laceration repair and participate in cesarean delivery

Second year (PGY-2)

Rotation Length
Emergency medicine and pediatric emergency medicine 6 months
Emergency medicine research 1 month
Hand surgery 1 month
Surgical intensive care unit (SICU) 1 month
Pediatric intensive care unit (PICU) 1 month
Intensive care unit (ICU) selective 1 month
Elective 1 month

Emergency medicine and pediatric emergency medicine

  • Acquire integrated adult and pediatric emergency medicine experience (20 percent of shifts a month in the pediatric emergency department)
  • Take increased responsibility for a larger patient load in PGY-2
  • Fill the role of team leader for medical and trauma resuscitations for all adult and pediatric patients
  • Supervise medical students
  • Your average shift load — 19 to 21 shifts a month

Emergency medicine research

  • Complete a scholarly project in the area of your choice with assistance from a research mentor
  • Have opportunities to apply for departmental funding for projects, work with a dedicated departmental statistician and receive financial support to present at conferences throughout the country

Hand surgery

  • Respond to the emergency department for cases requiring hand surgery evaluation
  • Acquire proficiency in the evaluation of the acutely injured hand and forearm

Surgical intensive care unit (SICU)

  • Fill the role of senior resident in the SICU
  • Assume responsibility for coordinating care for all trauma and general surgical patients in the SICU
  • Supervise PGY-1 emergency medicine and surgery residents

Pediatric intensive care unit (PICU)

  • Actively participate in the evaluation, resuscitation and treatment of pediatric patients with acute illnesses and injuries
  • Frequently serve as the only resident in the PICU working directly under a staff pediatric intensivist
  • Respond to rapid response team or code activations on the floor for pediatric patients

Intensive care unit (ICU) selective

  • As a PGY-2 resident, care for unstable patients in a high-acuity medical, surgical or neurologic ICU at Mayo Clinic's campuses in Minnesota or Arizona (supervised by the ICU staff, senior residents and fellows)

Elective

  • Pick from a wide variety of emergency medicine-related electives or design your own to allow for exploration of special interests within emergency medicine
  • Have opportunities to rotate elsewhere in the U.S. or internationally

Third year (PGY-3)

Rotation Length
Emergency medicine and pediatric emergency medicine 9 months
Electives 2 months
Selective 1 month

Emergency medicine and pediatric emergency medicine

  • Acquire integrated adult and pediatric emergency medicine experience (20 percent of shifts a month in the pediatric emergency department)
  • Assume responsibility for running medical and trauma resuscitations for all adult and pediatric patients, supervising medical students and off-service residents, and actively seeing a high volume of patients in the emergency department
  • Refine your emergency medicine skills to be able to run an emergency department in any practice setting
  • Your shift load — 19 to 21 shifts a month

Electives

  • Choose two electives, each one month in length
  • Have option to choose from a wide variety of electives or to design your own, allowing for exploration of special interests within emergency medicine
  • Have opportunities for rotations elsewhere in the U.S. or internationally

Selective

  • Experience the opportunity to have a "mini fellowship" in an area of administration, education, quality, ultrasound or EMS

Brief list of electives and selectives

  • Anesthesia (Mayo Clinic campuses in Arizona and Florida)
  • Radiology (Mayo Clinic)
  • Ophthalmology (Mayo Clinic)
  • Trauma (Health Shands Hospital at University of Florida)
  • Toxicology (Regions Hospital in St. Paul, Minnesota)
  • Electrocardiography laboratory (Mayo Clinic)
  • International emergency medicine (various places throughout the world)
  • Tropical medicine and global health certification courses (University of Minnesota; Centers for Disease Control and Prevention)
  • Ultrasound
  • Free open access medical education or FOAMed (Mayo Clinic)
  • Simulation (Mayo Clinic)
  • Education (Mayo Clinic)
  • Administration (Mayo Clinic)
  • Dental clinic (Salvation Army in Rochester, Minnesota)
  • Good Samaritan Clinic (Salvation Army in Rochester, Minnesota)
  • Intensive care unit (Mayo Clinic campuses in Minnesota or Arizona)
  • Emergency medicine (Mayo Clinic campuses in Arizona and Florida)
  • Community emergency medicine (Mayo Clinic Health System in Mankato, Minnesota, and other locations around Rochester)
  • Pediatric intensive care unit (Phoenix Children's Hospital)
  • Pediatric emergency medicine (Phoenix Children's Hospital)

Didactic training

The Emergency Medicine Residency didactics consist of four hours of weekly conference (mixture of various core lecture and board review topics) as well as four hours a month of simulation in Mayo Clinic's state-of-the-art training facility. This is in addition to the ongoing bedside teaching that occurs daily. While on off-service rotations, didactic teaching is frequent.

Additionally, a very robust set of longitudinal curriculum exists for emergency medicine administration, toxicology, quality improvement, health policy and residents as educators.

Simulation training

Photo of Mayo Clinic emergency medicine residents in simulation center

Mayo Clinic has a multidisciplinary, state-of-the-art simulation center that is a popular and substantive enhancement to the Emergency Medicine Residency curriculum. You benefit from being able to practice critical scenarios in this controlled environment. Mayo is unique in that it uses advanced simulation technology to teach 20 percent of its core curriculum. This allows you to push the boundaries of your expertise and solve problems in realistic situations.

Conferences

Tuesdays are dedicated core curriculum conference days with four hours of teaching beginning at 8 a.m. You attend and are excused from clinical duties during conference hours.

Conference days emphasize core content and deliver knowledge utilizing multiple models, including experiential learning, case-based learning, flipped classroom and basic lecture. Outside of core content other topics are addressed, including diagnostic imaging interpretation, ECG interpretation, administration and research topics, wellness, ethics, mock written and oral board examinations, and trauma rounds. One hour of lecture is dedicated to departmental Grand Rounds, which are given by experts in a variety of fields within Mayo as well as guest lecturers from throughout the world.

Journal club

Research faculty select articles that spark discussions regarding research methodology, critical appraisal of literature or interesting perspectives on clinical questions. Articles are selected for review and distributed to faculty, residents and departmental statisticians prior to journal club, which is oriented around a guided discussion regarding the pertinent features of the selected material.

Emergency medical services: Prehospital care

ambulance, plane, and helicoptor

During the PGY-1 year, you complete two weeks of prehospital care. This includes Gold Cross ambulance and optional Mayo One helicopter participatory ride-alongs. The setup and administration of a coordinated local and regional EMS system are reviewed. Fire, paramedic, law enforcement and 911 operations are explored. One-on-one time is spent with the EMS director to ensure a quality experience.

Gold Cross

Gold Cross is the primary paramedic and advanced cardiovascular life support service for southeastern Minnesota. Gold Cross provides the majority of patient transports within the greater Rochester area.

Gold Cross also provides intercept services for rural first responder and basic life support crews, as well as interhospital transport services between Mayo Clinic Hospital, Saint Marys Campus; Mayo Clinic Hospital, Methodist Campus; and Mayo-affiliated hospitals. In addition to daily interaction with members of Gold Cross in the emergency department, you ride with paramedics during the prehospital rotation.

Mayo One

Mayo One has four helicopters — one based in Rochester; one based in Mankato; one in Eau Claire, Wisconsin; and the fourth serving as a backup. Together, these helicopters complete approximately 2,400 flights annually. The PGY-1 rotation gives you observational exposure (one or two shifts). For those interested, a one-month selective in PGY-3 is available and serves as an in-depth EMS advanced rotation.

Southeastern Minnesota EMS

A large regional group of rural and first responder services, Southeastern Minnesota EMS, receives their medical direction for ongoing education through a consortium with a strong Mayo Clinic affiliation. Emergency medicine residents may serve as medical co-directors of these services, if they have a special interest in EMS administration. You may also provide educational lectures as invited presenters for these services.

Teaching opportunities

Opportunities are available for you to teach rotating residents and medical students.

Evaluation

To ensure that you acquire adequate knowledge and develop the appropriate technical skills to meet program expectations, your performance is monitored carefully during the Emergency Medicine Residency. You are formally evaluated by supervising faculty members on a regular basis and meet with the program director to review these evaluations. In addition, you regularly evaluate the faculty to confirm that your educational needs are being met.

Sept. 21, 2017