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Frequently Asked Questions

Below are some frequently asked questions about the Mayo Clinic pathology residency program.

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Is the frozen section rotation a general surgical pathology rotation or a frozen section rotation?

The frozen section rotation, also known as the sink rotation, is probably best thought of as a combination of a frozen section rotation and a general surgical pathology rotation. The volume and variety of specimen material seen by residents while on the sink is comparable to what would be seen during a general surgical pathology rotation at a large medical center, yet the workflow is that of a frozen section laboratory.

Accordingly, the eight blocks spent on the sink rotation over the course of four years is slightly less time than would be spent on a general surgical pathology rotation at many programs. The elements that are missing from a traditional general surgical pathology rotation are provided through the XRSR biopsy rotation and other organ-specific rotations, such as gastrointestinal pathology and dermatopathology.

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Will the frozen section rotation prepare me for a more traditional practice following residency?

Yes. Former residents who have gone out into private practice or academia outside Mayo have not indicated any difficulty in adjusting to a more traditional practice. The majority of rotations during your residency will follow a more traditional method of examining formalin-fixed, H&E sections. Your experiences in the frozen section lab will enhance your diagnostic and communication skills. The frozen section model may be unique to Mayo, but the skills learned in the lab are universally applicable within any pathology work setting. The primary skills that residents develop in the lab are gross pathological examination skills, frozen section slide interpretation skills, and most importantly, communication skills. With multiple operating rooms waiting for a diagnosis at any single time, it is critical that residents learn how to precisely and clearly communicate relevant information. In addition, the large volume of material that is processed in the lab provides residents with superb training in gross examination through immediate and continuous gross-histopathological correlation.

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What is the toluidine blue stain and what does it look like?

In the Mayo frozen section labs, a single-color toluidine stain is used because it produces a fast and easily readable stain. The toluidine blue stain produces a slightly different staining pattern compared to H&E, but the morphologic features are inherent to the tissue. The most obvious difference is the lack of dual colors to distinguish between the nucleus and cytoplasm. However, toluidine blue stains nuclear chromatin and cytoplasm with differing intensities so with a little practice the toluidine blue stain becomes easy to read. Toluidine blue also provides superior nuclear detail compared to H&E which can be very helpful in some situations.

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Will looking at toluidine blue sections distort my ability to read H&E sections?

No. The vast majority of slides you will look at over the course of your residency will be stained with H&E. All specimens that are examined at the frozen section lab are reviewed the next day after the tissue has been processed in a traditional manner and stained with H&E. This allows a level a quality assurance by confirming the frozen section diagnosis and provides the resident and fellow with an opportunity to review their previous day’s work. Furthermore, toluidine blue is only used at the frozen section lab, in which you will spend only 8 blocks during your residency. During all of your other rotations H&E is the standard stain.

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What is it like working in the frozen section lab?

At times the frozen section laboratory can become very busy, especially in the late morning and mid-afternoon. Fortunately, you are never alone. The frozen section team consists of the consultant (faculty), surgical pathology fellow, resident, pathology assistants, multiple experienced histotechnicians, and numerous other technicians who retrieve specimens from the operating rooms, accession specimens, place tissue in cassettes, obtain tissue for research and type up reports.

If you ever find yourself swamped with specimens to gross, the pathology assistant, surgical pathology fellow and consultant help you. They are also available at all times to provide guidance on the best way to gross a specimen.

At various times of the day and depending on your level of training, you switch positions with the fellow so that you sit in the hot seat and communicate with the operating rooms while the fellow grosses.

As a senior resident, you rotate and work as a surgical pathology fellow. During lunchtime, the pathology assistant, resident and fellow take turns covering for each other.

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Does working with a surgical pathology fellow diminish the resident's educational experience?

No. On the contrary, the surgical pathology fellow is a great educational resource for residents, particularly new residents. The resident and fellow have overlapping roles and work together to arrive at a diagnosis in the frozen section laboratory. Historically, a significant number of pathology residents at Mayo have gone on to complete the surgical pathology fellowship so they are in an excellent position to provide mentorship.

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What is the clinical pathology training like at Mayo?

The clinical pathology portion of the curriculum consists of:

  • Hematopathology (4 blocks)
  • Lymph node pathology (1 block)
  • Cytogenetics (1 block)
  • Coagulation (1 block)
  • Transfusion medicine (4 blocks)
  • Molecular genetics (2 blocks)
  • Microbiology (2 blocks)
  • Clinical chemistry (3 blocks)

Mayo's clinical laboratories are staffed by experienced clinical pathologists who are eager to teach residents. Because Mayo also operates a rapidly growing national reference laboratory, residents have the opportunity to sign out cases with recognized authorities in the laboratory diagnosis of numerous rare diseases. Because fellowships are offered by many of these areas, established educational programs are already in place that the resident may take advantage of while rotating through various laboratories.

Residents receive extensive exposure to laboratory management by attending numerous administrative meetings with lab directors. Residents also participate in the biannual internal College of American Pathologists (CAP) inspections and are often invited to serve on external CAP inspection teams. Second-year residents participate in the unique Leadership and Management Seminar Series.

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What call responsibilities do residents have?

Residents take weekend autopsy call, transfusion medicine call and chemistry call. Weekend autopsy rotations begin in the first year during your scheduled autopsy blocks. Transfusion medicine and clinical chemistry call consists of after-hours at-home pager call one week at a time, as well as day call during assigned rotations. There is no frozen section call.

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What kind of hours do residents work?

On average, residents work approximately 50 to 60 hours a week and rarely have to come in on weekends, except when rotating through transfusion medicine and Mayo Medical Laboratories. A typical day starts at 7:15 a.m. with a morning conference and ends sometime around 6 p.m., depending on the rotation.

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What is it like living in Rochester, Minnesota?

Rochester is a very livable city — in fact, it was ranked No. 1 on Livability's 2016 ranking of the best small to mid-sized cities in the U.S. Rochester and the surrounding community have a population of approximately 120,000.

Rochester has an excellent public school system, affordable housing, a variety of restaurants and local cultural institutions, including the Rochester Art Center and Rochester Civic Theatre. There are also numerous outdoor recreational activities available within Rochester, including multiple golf courses, an extensive bike path network, public tennis courts, a climbing wall gym and a volleyball center. The Twin Cities are located approximately 80 miles north of Rochester.

Find out more about campus life in Rochester.

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What is it like working at Mayo?

Mayo Clinic is a remarkable institution and is almost impossible to describe to someone who has not personally visited. Mayo is absolutely committed to providing the highest possible level of patient care and has not been afraid to invest significant financial and human resources towards achieving that goal. Just one example within the division of anatomic pathology is the very large number of support staff. Each of the forty anatomic pathology consultants has at least one personal secretary who can order special stains, request outside blocks, transcribe dictations and numerous other functions that might otherwise be relegated to the resident as scutwork. This high level of support allows the consultant to focus on patient care issues and the resident to focus on learning.

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What research opportunities are available to residents?

Residents may choose to engage in basic, translational or clinical research depending on the level of their interest, research background, and time availability. Research is encouraged but not required. Most residents end up working on at least one project which forms the basis for a “senior year talk”. Many residents also present at the USCAP meeting each year. Recent residents and fellows have won prestigious awards at the USCAP meeting including the Stowell-Orbison award, the Gastrointestinal Pathology Society award and the Society for Cardiovascular Pathology award. For those who wish to have extended time for research during residency, a fully funded one-year research track, a Clinician-Investigator Training Program and a Clinical Research Training Program are available.

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Does Mayo provide laptops for all of its pathology residents?

Yes, you will have a laptop with wireless connectivity for the duration of your residency. The residents' area, anatomic pathology floor, and all others areas where residents rotate are wireless-enabled.

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Does Mayo have a travel policy for residents presenting at meetings?

Yes. Residents are reimbursed for airfare, hotel, registration fees, meals and incidentals for meetings at which they are presenting work performed at Mayo. Each year several residents present at the USCAP meetings as well as various subspecialty meetings.

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What have previous residents gone on to do?

Follow this link for previous resident placement.

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What will my interview day be like?

Your interview day begins around 8 a.m. with a program overview by the program director. Then, you have a series of 30-minute interviews with members of the recruitment team, followed by a lunch with residents and a tour of the frozen section and autopsy labs. (Alternate tours will be available for CP-only applicants.)

In the afternoon, there are a few more interviews and a final wrap-up meeting with the program director.

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Can I spend more time with the residents during my interview day?

Yes. We traditionally offer a dinner with one or two of our current residents either the evening before or the evening of your interview day. The dinner is meant as an opportunity to meet some of our residents in an informal setting. You are under no obligation to accept. We always enjoy taking applicants out for dinner, but we also understand that travel itineraries do not always allow it. Furthermore, a group of residents will go to lunch with you and provide additional candid insights into the program.

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What if I have additional questions?

Feel free to contact program coordinator Kristina M. Smith or program director Brad S. Karon, M.D., Ph.D., by email at or by phone at 507-284-1196.

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  • Aug 23, 2016
  • ART388292