Curriculum

Mayo Clinic has a long-standing tradition of teaching both the art and science of medicine. As the country's oldest, largest and best-known academic group practice, Mayo Clinic was founded on the belief that the mutual interdependence of clinical medicine, clinical research, and medical education — the three Mayo shields — fosters the highest standard of medical care.

Physicians, scientists, residents, students, pharmacists, nurses, social workers and allied health staff collaborate to work as a team. Our physician faculty members are referred to as "consultants" in recognition of their role as teachers and mentors of residents and students.

Internal medicine residency training at Mayo offers:

• A comprehensive three-year curriculum that prepares residents for a clinical or academic career in general or subspecialty internal medicine
• A rotation schedule that emphasizes block ambulatory care experiences in primary care and specialty clinics
• Full resident responsibility and autonomy for patient care
• An intensive didactic core curriculum that covers inpatient and outpatient practice
• A formal three-year curriculum in evidence-based medicine
• A comprehensive research curriculum that fosters scholarly inquiry leading to presentations at scientific meetings and peer-reviewed publications
• Extensive hands-on experience with all internal medicine procedures
• A formal curriculum in quality improvement and change management in health care systems
• A formal curriculum in health care systems and the costs of healthcare
• A variety of elective opportunities including rotations at Mayo Clinic Florida in Jacksonville and Mayo Clinic Arizona in Scottsdale, as well as an HIV/AIDS rotation at Maricopa Medical Center, Arizona

Residency education at Mayo is based on a foundation of general internal medicine. The program includes rotations in all internal medicine subspecialties, geriatrics, neurology, ambulatory care blocks, emergency medicine, intensive care units, and various electives in addition to general medicine experiences. Some rotations allocate separate blocks of time in the inpatient, outpatient and consultative settings. Each resident receives several comprehensive review texts as well as electronic access via iPad (provided by the program for each resident) or computer systems to UpToDate, MD Consult, Medline, and an extensive collection of electronic resources. Scheduling is flexible, and preferred rotations can be scheduled to facilitate planning a subspecialty career.

Excellence in medical education is a requirement of our faculty, who are selected for hospital service and outpatient education clinics based on the effectiveness of their teaching. Faculty have dedicated, protected time to provide teaching to the residents with whom they work.

Rotations

Didactic training

Over the three years of categorical residency, more than 800 didactic lectures are presented to internal medicine residents. The didactic portion of Mayo Clinic's Internal Medicine Residency Program includes:

• Core Curriculum Conferences
• Morbidity and Mortality Conferences
• Primary Care Conferences
• Grand Rounds
• Clinical Decision Making Journal Club
• Board Review
• Systems-based Practice and Quality Improvement Conferences
• Morning Report (Inpatient and Outpatient)
• Evidence-Based Medicine Didactic Conferences

A comprehensive, three-year didactic core curriculum addresses both inpatient and outpatient medicine. During PGY-1, the weekly core curriculum covers basic topics in internal medicine. These general core lectures are supplemented by a lecture series in each subspecialty service. Food is provided for residents, and conferences are telecast to multiple locations throughout the medical center so that residents can attend regardless of rotation or assignment.

In addition, more than 150 institutional clinical and research conferences are held each week.

Faculty will teach basic interviewing and physical examination skills to residents during the first year of residency using standardized patients and teaching videos. Residents will also learn in-depth clinical skills as part of each specialty curriculum. Workshops in procedural skills are provided during orientation and on specialty and ICU rotations.

During the second or third year, residents have the option to complete one general medicine rotation at Mayo Clinic Arizona in the role of a senior resident. This site provides an experience in a metropolitan-based practice that complements the rotations in Rochester. During this assignment, Mayo subsidizes the costs of travel, housing, car rental and licensure. Residents consistently rate this rotation very highly.

Selective and elective time

Selective and elective rotations vary among residents and are largely determined by career interests and individual requests.

• Additional consultative or clinic experience in internal medicine
• Subspecialty outpatient education clinics
• A choice from more than 100 electives inside and outside of internal medicine, including other Mayo practice sites
• Participation in research projects
• A third-world experience caring for the medically underserved at one of many global locations, supported by up to a $2,500 "Mayo International Health Program" scholarship for travel
• HIV/AIDS experience at Maricopa Medical Center, Arizona (travel and housing reimbursement provided)

Evidence-based medicine

Mayo Clinic Rochester has taken an enthusiastic leadership role in teaching residents, fellows, and staff physicians the principles of evidence-based medicine: literature searching, critical appraisal, and evidence-based clinical decision-making. Through a three-year, multidisciplinary curriculum, residents learn these skills, enjoy many opportunities to apply them in clinical practice, and apply these skills in educational settings. The ability to find, appraise, and apply evidence in clinical practice is one of the central themes in our philosophy of medical education.

Systems-based practice and quality improvement

The internal medicine residency program offers unique opportunities for learning systems-based practice, quality improvement, and patient safety. Residents participate in a longitudinal curriculum through which they design and implement their own quality improvement projects. Our goal is to give every resident the opportunity to innovate and improve patient care at Mayo.

Faculty development in clinical teaching

One of the visions of the internal medicine residency program is to set a national standard of excellence for faculty development in clinical teaching, in line with the mission to provide the best clinical training for our residents in the Mayo Model of Care. Third year residents are mentored in developing skills in clinical teaching during a Senior Medical Resident Teaching (SMR-T) rotation. The goals of this faculty development curriculum are to: 1) enhance versatility in clinical teaching, 2) provide education frameworks to analyze clinical teaching in the context of adult learning theory and 3) provide a forum for collegial exchange. During the rotation, senior residents will have the opportunity to apply newly acquired teaching skills while supervising continuity clinic interns. With the completion of this curriculum, senior residents receive a Certificate in Clinical Teaching.

• July 6, 2012
• ART444027