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Yes, Mayo Clinic has an international reputation as a premier tertiary medical center, with patients traveling here for care from throughout the world. What you may not realize is that Mayo Clinic in Rochester is also a major regional health-care provider. The majority of its patients live within 150 miles and present with a full range of common and uncommon problems. The Mayo Clinic Emergency Department is a major Trauma Center treating more than 75,000 patients annually with every conceivable condition.
The following common questions have been answered by our residents and staff and will provide a more accurate picture of the Emergency Medicine Residency at Mayo:
Why should I choose to train at Mayo Clinic?
"Here's why:
- Because the faculty are diverse.
- Because the off service rotations are unparalleled.
- Because you can learn cardiology, ACLS, ATLS, and orthopedic hand from well renowned scholars who wrote the textbook.
- Because the ancillary staff is amazing.
- Because the acuity is high.
- Because the variety is amazing.
- Because the research opportunities are endless.
- Because the resources to pursue your individual interests in EM are vast.
- Because the residents play an integral role in designing the program."
- 3rd Year Resident
"Residency at Mayo is a unique, high-quality training experience like no place else. I am so grateful and beyond satisfied to have matched here. The combination of world-class, focused subspecialty training in each of the major clinical areas of emergency medicine with exposure to a breadth of common and uncommon clinical problems in a busy emergency department has given me a training experience like no other."
- 2nd Year Resident
"Residency at Mayo is a unique, high-quality training experience like no place else. I am so grateful and beyond satisfied to have matched here. The combination of world-class, focused subspecialty training in each of the major clinical areas of emergency medicine with exposure to a breadth of common and uncommon clinical problems in a busy emergency department has given me a training experience like no other."
- 2nd Year Resident
"Most of all, you should come to Mayo because of the people. The staff is enthusiastic, approachable, ethical, and truly committed to providing you the educational opportunities you need to be competent. The camaraderie among the residents is a daily reality and a source of encouragement when you are sleep deprived and at your wits' end. If I had to go through the match again, I would not hesitate to rank Mayo number one. I've got no regrets."
- 2nd Year Resident
How do you like having 20% of your curriculum taught through high-fidelity simulation?
"Although these are intense learning experiences, they are a lot of fun. The actors, scenario operators and the consultants have as much fun as the residents do, if not more. The encounters are designed to pack a lot of learning objectives into the scenario, and one does learn a lot when placed in these situations. The team approach is great, especially as in intern. The second and third year residents always seem to find teaching points during the event. After the encounter, we do a debriefing with the entire team (consultants, control, and the team that just observed the situation). These are always filled with laughter and comradery as you get to observe the video of what just transpired. There is discussion of the cases which reinforces the teaching points and opportunities to discuss what was done well, and what can be improved upon."
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1st Year Resident
"I find that the simulation sessions are the most effective learning experience we have. It is easy to listen to a lecture on Clotting Disorders (the presentation, diagnosis, pathophysiology, treatment, etc.) and then have very little of that information translate into practice. With simulation we have the benefit of managing a disease process, and then debriefing on our performance in a non-threatening, practical way. I have found that after seeing a simulated patient with Christmas Disease, or TTP, that I am much more prepared to learn about the topic in a meaningful way, than if I was just listening to a classroom lecture on coagulopathy. The learning is optimal. Dr. Goyal arranges the cases to help emphasize the subtle differences that differentiate a worrisome from a very stable patient. In short, the Mayo Simulation center is teaching at its finest."
- 2nd Year Resident
"Having 20% of our core curriculum taught at the simulation center is amazing. It allows you to really place how the science behind the art of medicine effects your care. Reading up on a case after getting a simulated patients really works. For example, if you just try to sit down and learn about TTP and HUS that is one thing. If you read about it after having a simulation patient where you might not have picked up the diagnosis as quickly as would would have thought, that is another. I really enjoy my time in the simulator, but it isn't easy. The simulations are kept realistic but somehow all of the patients there have "black clouds" hanging over their heads and anything that could go wrong will. Keep in mind, you are working with other residents there and the ED nurses come over with you too - not actors, so it "feels like home". By the time you are done, you almost forget it is a simulation and start referring to "the last patient I had with sepsis..." before realizing that was in the sim center. It really is incredible."
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3rd Year Resident
How can I get good emergency medicine training at a place that only sees zebras?
"The Mayo Clinic is a referral center for all of southeast Minnesota, southwest Wisconsin and northern Iowa, and, yes, many parts of the rest of the world. It is also the primary caregiver for all of southeast Minnesota. This is deep farm country - the breadbasket of the Midwest. The majority of what we see are bread and butter complaints from patients from local and surrounding rural communities. The zebras only drop in a minority of the time."
- 3rd Year Resident
"Instead of 1 percent zebras, Mayo might see 3 percent. Enough to be interesting, but still pretty rare."
- 2nd Year Resident
"Most of the emergency medicine patients come from Rochester or the surrounding communities. Mixed in with the normal patient population, are the individuals that are in Rochester to be worked up by the clinic but not as inpatients. They sometimes present to the Emergency Department with worsening symptoms of their conditions or new emergencies that must be treated in the context of their existing condition. It provides a well-rounded emergency medicine experience."
- 1st Year Resident
What types of patients will I see in a week working in the Emergency Department?
"First of all, there is no average shift. I'll describe some of the patients and pathology I saw on my last few shifts:
- 15 chest pain patients, two of which had ST-elevation MI's
- An overdose in a suicidal patient
- A ruptured thoracic aneurysm
- Four gastrointestinal bleeds
- An open tib/fib fracture in a scooter versus car accident
- A man we intubated for flash pulmonary edema who also had a history of pulmonary hypertension and pulmonary fibrosis
- Six patients with syncope
- A six-year-old s/p motor vehicle crash with bilateral proximal humerus fractures who required intubation
- Five stroke patients - two of whom were intubated in the Emergency Department
- A patient who had vital signs in the ED, on whom we performed a thoracotomy to relieve a pericardial tamponade after a motor vehicle crash
- An intra-articular phalanx fracture
- A drug-seeking patient
- A patient who stepped on a beer bottle leaving a piece of glass in her foot
- A patient stung by multiple wasps with throat swelling
- A patient who thought he had a worm in his testicle
- Three patients with hematuria
- Four patients with supra-ventricular tachycardia who converted with adenosine
- Five patients with atrial fibrillation with a rapid ventricular rate."
- 3rd Year Resident
"On a single shift I saw:
- A patient who was stabbed three times in the flank
- A patient who was found the morning after he fell 17 feet and had an orbital blowout fracture and an intraparenchymal cerebral hematoma
- A patient who rear-ended a dump truck and had an open tibial plateau fracture and a dissection of his innominate artery
- A young patient who was status-post cardiac arrest"
- 3rd Year Resident
"A very wide variety. Compared with more urban environments, Mayo sees relatively less intravenous drug use, sexually transmitted diseases and penetrating trauma, for example, but sees more cardiovascular emergencies and life-threatening blunt trauma."
- 2nd Year Resident
Do you see enough trauma and who is responsible for coordinating the resuscitations?
"We see a great amount of blunt trauma. Penetrating trauma is lower in numbers for Rochester, but resident electives at Mayo Clinic in Scottsdale, Ariz., Jacksonville, Fla., and North Memorial Hospital in Minneapolis allow exposure to penetrating trauma. The traumas in Rochester are run by teams of emergency medicine and surgery residents. The leader for the trauma alternates each day between the EM senior and the surgical senior."
- 3rd Year Resident
"I think the lack of trauma is a myth. We see plenty of trauma."
- 3rd Year Resident
How is the relationship between trauma surgery and the Emergency Department?
"Excellent. Our trauma teams are composed of one half EM residents and one half surgery residents. The trauma teams have excellent communication during the resuscitations and we work very well together. We also have a three-month block combining trauma surgery, EM and the Surgical ICU. During these three months, we work hand-in-hand with the surgical residents. This is a great bonding time to establish relationships that are needed for communication later in the Emergency Department."
- 3rd Year Resident
"Great, especially since we rotate with them on the floor and in the unit."
- 3rd Year Resident
How is your pediatric experience?
"Again, excellent. We spend about 25 percent of each month in the Pediatric Emergency Unit. Thus, we ensure that our residents see the seasonal variation inherent in pediatrics. The teaching is also excellent. In fact, two of our pediatric EM faculty were given teaching awards this past year."
- 3rd Year Resident
"Pediatric emergency medicine is strong here. In addition to a dedicated pediatric EM month in our first year, we have continuity of experience with several pediatric EM shifts each month. We're in the ED for the remainder of our residency."
- 2nd Year Resident
What are the off-service rotations like?
"Phenomenal. You are learning from the experts in the field. Can't think of another program with stronger off-service rotations."
- 3rd Year Resident
"Outstanding off-service rotations with many world-class experts in their respective fields."
- 2nd Year Resident
What is your research month like? Can you really or do you finish a project?
"The research month is what you make it. The bulk of the research can be finished in one month, but you will most likely use time outside of the month to wrap things up. And yes, you most definitely can finish a project. In fact, a majority of our residents have completed multiple projects. The resources for research at Mayo are many. If you can think of the project and are motivated to work on it, there are no roadblocks for supplies and resources."
- 3rd Year Resident
Can you do rotations at Mayo Clinic in Jacksonville and Arizona?
"Absolutely, and I highly recommend it. Anesthesia in Arizona especially during January when Rochester can be a bit chilly is a perfect option. Jacksonville and Arizona are also open to us rotating at the respective county hospitals to add a varied patient population in addition to collecting more trauma experience."
- 3rd Year Resident
"Yes, you can do rotations in Jacksonville and Arizona. Mayo has housing available for you and pays your flight. They also provide you with transportation and housing. There is space for family members to be with you while you are there."
- 1st Year Resident
Do you get enough teaching? If so, does it come mainly from other residents or do the faculty teach as well?
"Teaching is certainly a strong point of the residency. Faculty give almost all of our lectures, and at the bedside the faculty are almost always waiting there to give a pearl."
- 3rd Year Resident
"Absolutely. There is abundant one-on-one teaching from both highly qualified faculty with a sincere dedication to teaching, as well as other the residents."
- 2nd Year Resident
"We have five hours of conference a week. Most are run by faculty, sometimes faculty from outside the ED. Case presentations and morbidity and mortality conferences are usually done by residents."
- 1st Year Resident
Where do your residents go after graduating?
"Wherever they want to! And that is the truth. Some of them are now working as faculty andothers in busy community programs .
- 3rd Year Resident
Do you have a book fund?
"Not a book fund, but we are given textbooks. First-years get Harwood-Nuss, second-years get Rosens...I'm not sure about the other texts. We also get a notebook computer for use during residency."
- 1st Year Resident
"Currently, first-years receive Harwood-Nuss and second-years receive Rosen's and Roberts and Hedges (Procedures in Emergency Medicine). The exact texts that are used will vary based on which editions are new for the year."
- Assistant Program Director
What is there to do in Rochester?
"Rochester has a great trail system for running and biking, and hunting and fishing are abundant. We are only one hour from Minneapolis/St. Paul. The Rochester Civic Center hosts several well known artists for concerts."
- 3rd Year Resident
"Rochester is a beautiful city full of recreational activities. There are trails running all over the city for walking, jogging, biking and rollerblading. I'm told that there are a lot of cross-country skiing opportunities in the winter. There are several parks and public golf courses. There are movie theaters (for which Mayo has discounted tickets available), bowling allies and some descent shopping. There is a minor league baseball team (the Honkers) as well as other sporting events.
"It's Minnesota, so there are several lakes relatively close-by for fishing, camping and boating. There are several good restaurants in Rochester. The Twin Cities are about 90 minutes away with every major league sporting event, amusement parks, etc...(again, Mayo offers discounted tickets).
In June, I had the opportunity to go to some Rochester Fest events where they celebrate the city for a week with local bands and activities. The Olmsted County Fair is held in Rochester at the end of July (which, was quite an experience for this "city kid"), and there are Sunday night concerts in July and August that are free. They try to get up-and-coming bands for these concerts. Bottom line is, there is lots to do in Rochester. Sometimes it just means trying new things.
- 1st Year Resident
See the Rochester Campus section for more about living in Rochester.
Can a non-Minnesotan survive a Minnesota winter? If so, how?
"Dress warm...and learn to play outside."
- 3rd Year Resident
"Yes, you can. Minnesotans are famous for finding fun ways to enjoy winter and will gladly share their techniques. And no, it doesn't snow year-round! In fact, we have wonderfully warm summers and lots of outdoor activities. By mid-June, daytime highs are in the 80s, and during July and August, highs in the 90s are common. Occasionally, we'll have short period of 70-degree weather in the summer to cool things down.
"During the summer, we play all kinds of team sports (e.g., softball and volleyball), swim, hike, bike and skate and generally enjoy the outdoors. Golfers and tennis players have access to several public golf courses and tennis courts. Winter offers, ice skating, hockey, downhill and cross-country skiing and snowshoeing, so be prepared to work and play!"
- EM Faculty member
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