Curriculum

Curriculum Overview
During the Family Medicine Residency Program, your clinical training will emphasize the most common problems seen by and procedures performed by family physicians. You will gain extensive experience in both inpatient and outpatient settings. Home visits to patients will also be part of your training.

Outpatient - Mayo Family Clinic Kasson
Throughout the program you will provide continuing care for families at the Mayo Family Clinic Kasson, which is located in the town of Kasson, 14 miles west of Rochester. This clinic serves Kasson, with a population of approximately 4,400, and the surrounding rural area, which has a population of more than 25,000.

You will spend a minimum of one half-day per week at the Kasson Clinic during your first year; two half-days per week during your second year; and three to five half-days per week during your third year. This will allow you to develop a continuity practice of your own. You also are encouraged to become an active member of the Kasson community. A shuttle provides transportation between Mayo Clinic in Rochester and Kasson three times per day.

At the Mayo Family Clinic Kasson, families will be assigned to you with the expectation that you will provide most of their care during your residency. Patients' records are maintained in an electronic medical record, and computer access is provided from each exam room. You will be assigned to a resident group that includes first-, second-, and third-year residents and a consultant. Your group will share responsibility for families. You will be covered by the other group members when you are not available.

Outpatient Specialties - Mayo Clinic in Rochester and surrounding communities
One strength of our program is outpatient specialty training.  During outpatient rotations, you will have the opportunity for one-on-one training with many of the nation's leading experts in subspecialty fields. You will take required rotations in specialties such as dermatology, otorhinolaryngology, orthopedics and urology. In many cases, these rotations are at Mayo Health System sites in the surrounding communities.  While at these sites, you will work one-on-one with the specialist and will receive individualized training in their fields. As you will be the only resident present, you will have the opportunity to see all the patients and perform or assist with all the procedures, making for an outstanding training opportunity.  Our residents perform a significant number of upper and lower endoscopies and will have the chance to assist on a number of vasectomies.  Since you will be training in smaller communities, you will also get an excellent feel for the workings of small town and rural medicine.

Inpatient - Mayo Clinic Hospitals
The inpatient component of the Family Medicine Residency Program is spent primarily on the Family Medicine adult inpatient service at Saint Marys Hospital and the Family Medicine obstetrics and newborn nursery service at Rochester Methodist Hospital.  The Family Medicine adult inpatient service admits and cares for patients needing hospital care from any of the Family Medicine clinics.  The service is run by a senior Family Medicine resident under the supervision of a Family Medicine staff physician.  As the admitting resident, you will be in charge of the patient’s care during the hospital stay.  Specialty consulting services are available 24 hours a day, and often contribute excellent teaching when they are consulted.  The Family Medicine obstetrics and newborn nursery cares for laboring mothers and their newborns from all of the Family Medicine clinics.  As the resident on call, you will be responsible for the management of labor and delivery, as well as the care of newborns.  Other inpatient training includes rotations to the Critical Care Service/Code team at Rochester Methodist Hospital, general Cardiology, inpatient Pediatrics, and newborn resuscitation/special care nursery.  While these rotations are supervised by other departments, you will be treated as an equal and will have duties and responsibilities identical to the other residents on the service.  

Rotations
The following is a typical training schedule in the Family Medicine Residency Program.

Rotation Descriptions

PGY-1:

Family Medicine Inpatient:

• 3 months
• Assess and admit all hospitalized Family Medicine patients
• Primary responsibility for patient care, supervised by senior resident and staff
• Opportunity to perform bedside procedures on admitted patients

Family Medicine Obstetrics:

• 1.5 months
• Responsible for triage and management of Family Medicine Obstetric patients, supervised by staff
• Responsible for initial assessment and management of all Family Medicine newborns, including circumcisions

Obstetrics:

• 1 month
• Work with a senior obstetrical resident on the OB service
• Primary responsibility for triage, assessment, and management of actively laboring patients and postpartum issues
• Scrub in to assist with C-sections and other procedures

Pediatric Inpatient Service:

• 1 month
• Admit and care for pediatric inpatients on a busy and diverse service
• Care for a variety of pediatric issues, from asthma exacerbations to oncologic emergencies

Emergency Medicine:

• 2 months
• Assess, resuscitate and treat a wide variety of ED patients, including peds
• Primary responsibility for patient care, under the supervision of EM staff
• Average shift load is 19-23 shifts per month (average nine-hour shifts)

Critical Care:

• 1 month
• Work with a second-year medicine resident and critical care fellow to care for medical/surgical critical care patients
• Primary responsibility for the patients assigned to the resident, and opportunity to perform variety of bedside procedures

Radiology:

• 1 week
• Work one-on-one with radiology staff, learning how to interpret chest radiographs, CT scans, and ultrasound
• Assist with interventional and other procedures

Community Health:

• 3 weeks
• Work at a variety of sites, including Indian Health Services clinic, occupational medicine, underserved free clinics and public health department

Cardiology:

• 1 month
• Admit and care for patients with a variety of cardiology problems on a monitored floor
• Excellent didactics by many cardiology experts

PGY-2:

Family Medicine Inpatient:

• 2 months
• Assess and admit all hospitalized Family Medicine patients
• Primary responsibility for patient care, supervised by senior resident and staff
• Opportunity to perform bedside procedures on admitted patients

Family Medicine Obstetrics:

• 1.5 months
• Responsible for triage and management of Family Medicine Obstetric patients, supervised by staff
• Responsible for initial assessment and management of all Family Medicine newborns, including circumcisions

Emergency Medicine:

• 1 month
• Assess, resuscitate and treat wide variety of ED patients, including peds
• Primary responsibility for patient care, under the supervision of EM staff
• Average shift load is 19-23 shifts per month (average nine-hour shifts)

Level II Nursery:

• 1.5 months
• Primary responsibility for resuscitating newborns, including premature babies
• Responsible for all procedures during neonatal resuscitation
• Care for infants in a step-down care unit

Outpatient Surgery:

• 2 months
• Work at two different community hospitals with general surgeons
• First-assist on all cases
• Large volume of colonoscopies and upper endoscopies

Pediatric Outpatient:

• 2 weeks
• Work side by side with a community pediatrician for several days
• Work with community health nurses and dietitians to create healthy communities

Orthopedics:

• 1 month
• Work one-on-one with a community orthopedic surgeon in clinic
• High volume of joint injections, casting and other orthopedic procedures
• Evaluate and treat emergency room orthopedic patients

ENT:

• 2 weeks
• Work one-on-one with ENT consultants in an outpatient clinic
• Learn management of medical ENT issues

Elective:

• 1 month
• Your choice of a wide variety of electives, including but not limited to diabetes clinic, wound clinic, travel medicine, cardiac rehab clinic, obstetric ultrasound, overseas electives, and electives at Mayo Clinic campuses in Scottsdale, Ariz.,  and Jacksonville, Fla.

PGY-3:

Family Medicine Inpatient:

• 6 weeks (2-week blocks)
• Senior resident on the hospital service, responsible for supervising the team of junior residents and teaching on a daily basis

Family Medicine Obstetrics:

• 1.5 months
• Responsible for triage and management of Family Medicine Obstetric patients, supervised by staff
• Responsible for initial assessment and management of all Family Medicine newborns, including circumcisions

Endocrine:

• 2 weeks
• See patients in a diabetic outpatient referral clinic, supervised by diabetic consultants
• Additional experiences in the bone and thyroid clinic, as well as lipid and nutrition clinics

Geriatrics:

• 1 month
• Evaluate geriatric consults on hospital services and facilitate transition to outpatient care
• Do home visits for homebound patients and supervise junior residents doing home visits

Ophthalmology:

• 2 weeks
• Outpatient community ophthalmology clinic in a nearby small town
• Perform direct ophthalmologic evaluation and assist in minor surgery

Psychiatry:

• 1 month
• Perform emergency room psychiatric consultations
• See patients in an outpatient psychiatry clinic

Dermatology:

• 1 month
• See patients in an outpatient community dermatology center, diagnosing and treating a wide variety of dermatologic pathology
• Perform minor skin surgeries and biopsies

Kasson Clinic:

• 1 month
• Work in your continuity clinic regularly for one month
• Special emphasis on practice management and efficiency

Urology:

• 2 weeks
• Gain useful experience in pediatric urology, male/female urology, incontinence clinics, and performance of prostate biopsies and cystoscopies

Sports Medicine:

• 3 weeks
• Work alongside a primary care sports medicine fellowship-trained physician evaluating and treating musculoskeletal injuries in high school, college, and recreational athletes

 

Electives
Your elective options are unlimited. Each rotation lasts from one to four weeks, depending on the elective. Your choices include:

• Cardiovascular Health Clinic
• Travel Medicine/International Health Clinic
• ECG Laboratory
• Vascular Medicine/Wound Care Clinic
• Geriatrics
• High-risk obstetrics
• Hospice
• Lipid Clinic
• Medical genetics
• Occupational medicine
• Pediatric allergy
• Pediatric cardiology
• Diabetes/Endocrine Specialty Clinics
• Physical medicine and rehabilitation
• Pulmonary function laboratory
• Research
• Rheumatology
• Sports medicine
• Third World medicine

Didactic Training
Clinical conferences, seminars, small discussion groups, journal clubs and one-on-one instruction are an integral part of Mayo Clinic's Family Medicine Residency Program. Behavioral medicine will be integrated throughout all three years of your training.

Weekly conferences and monthly half-day seminars will cover primary care topics, including discussion of ethical dilemmas faced by physicians in training. Second- and third-year residents participate in a group quality improvement project and practice management seminars. 

Research Training
Your research opportunities at Mayo Clinic are outstanding.  You are encouraged but not required to participate in research activities.  Opportunities for both clinical studies and laboratory-based projects exist. Many faculty members are actively involved in research projects and can serve as research mentors.

Teaching Opportunities
You will have the opportunity to teach Mayo Medical School students, residents from other subspecialties and visiting students from other medical schools through bedside instruction and formal didactic lectures.

Practice Board Examinations
To prepare for board examinations, you are expected to take the in-training assessment examinations provided by the American Board of Family Practice once per year.

Call Frequency
During call months, you will be on call an average of every fourth night. Rounds are made seven days per week with a consultant and other residents on the service. You will have at least one 24-hour period per week with no clinical responsibilities. This residency complies with the ACGME duty hours requirement. Consultants rotate on a one- or two-week schedule, allowing you to work with several of them during your assignments. Consultants are available for advice 24 hours per day, seven days per week.

Rotations at Other Mayo Clinic Sites
You may choose to take an elective rotation at either Mayo Clinic in Jacksonville or Mayo Clinic in Scottsdale. Mayo Clinic funds the authorized additional costs of your travel, housing, auto rental and licensure fees. Our residents consistently rate these rotations very highly.

Moonlighting
Moonlighting is permitted for licensed residents beyond the PGY-1 level. Moonlighting activities may be scheduled during those times when you are assigned to consultative or outpatient rotations with the prior approval of the program director.

Moonlighting should not interfere with required learning and must not violate the ACGME work-hour rules.

Evaluation
To ensure that you acquire adequate knowledge and develop your technical skills, your performance will be monitored carefully during the course of your family medicine residency. You will be evaluated formally by your supervising faculty member after each clinical rotation. You will meet with your assigned faculty adviser and program director at least twice each year. In addition, you will regularly evaluate the faculty and program to ensure that your educational needs are being met.

Career Development
You will meet periodically with various faculty members, administrators and the training program director to discuss your goals. Mayo Clinic often recruits staff physicians from its own training programs. Thus, when you successfully complete the Family Medicine Residency Program, job opportunities may be available at one of Mayo Clinic's group practices.

Additional Training
At the conclusion of the Family Medicine Residency Program, you may wish to continue your graduate medical education at Mayo School of Graduate Medical Education. Fellowships are available in Preventive Medicine and Geriatrics. The program director can provide more information about these opportunities.