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Curriculum

The General Surgery Residency Program at Mayo Clinic Arizona is designed much like a series of postgraduate courses in various surgical disease entities with prominent "laboratory" (clinical patient care and operations) experience.

Within each rotation a core of medical knowledge, patient care, professionalism, and practice improvement is assured to be taught through our electronic curriculum. The electronic curriculum is organized by the week for all rotations during your training and defines very specific objectives with links to online resources to help achieve these objectives. Typical resources electronically linked for immediate access are landmark journal articles, key review articles, practice guidelines, evidence-based reviews, and treatment algorithms.

Clinical Training

Within the "mentoring and mastery" model of surgical education at Mayo Clinic Arizona you will be the most senior resident on nearly all services even as a first and second year resident. You will operate with the faculty surgeon whenever he or she is operating and you will see outpatients whenever he or she is in clinic. This model provides you with an educational continuity from preoperative evaluation through operative techniques to postoperative techniques to postoperative care from day one of training.

You will begin your experience in the first two years with common diseases and simple to moderately complex operations such as:

  • Lumpectomy
  • Mastectomy
  • Sentinel lymph node biopsy
  • Cholecystectomy
  • Laparoscopic ventral hernia repair

In the third and fourth years you will treat a broad scope of surgical disease and perform more complex operative procedures, such as:

  • Gastrectomy
  • Aortic aneurysm repair
  • Hepatic and pancreatic resections
  • Laparoscopic colectomy
  • Pneumonectomy

Mayo Clinic Arizona provides extensive training in minimally invasive techniques on all services and through our Center for Minimally Invasive Surgery.

As a chief resident (PGY-5), you will function like a junior faculty member under the supervision of senior faculty. You are assigned your own surgical service with operating time, secretarial support, an office, and a consulting calendar of patients scheduled with you. This experience is extraordinarily valuable in transitioning to an even higher level of autonomy prior to fellowship training or clinical practice.

Rotation Schedule
The following is a typical rotation schedule:

Year One

Rotation Length
Emergency/Consultative Surgery 3 months
Surgical Oncology 4 months
Vascular Surgery 1 month
Colon and Rectal Surgery 1 month
Trauma and Critical Care Surgery 2 months
Burn Surgery 1 month

Year Two

Rotation Length
Surgical Oncology 3 months
Critical Care 1 month
Plastic/Reconstructive Surgery 1 month
Endoscopy 1 month
Minimally Invasive and Bariatric Surgery 4 months
Colon and Rectal Surgery 2 months

Year Three

Rotation Length
Pediatric Surgery 3 months
Endocrine Surgery 3 months
Trauma and Critical Care Surgery 2 months
Cardiothoracic Surgery 2 months
General Surgery 2 months

Year Four

Rotation Length
Vascular Surgery 3 months
Hepatobiliary and Transplant Surgery 3 months
Colon and Rectal Surgery 2 months
Minimally Invasive Surgery 4 months

Year One

Rotation Length
Emergency and Consultation Chief 4 months
General Surgery 8 months

Required Off-site Rotations
All general surgery residency training takes place at Mayo Clinic, Scottsdale, and Mayo Clinic Hospital, Phoenix, except for the following rotations:

PGY-1 Level
Burn Surgery (1 month)
Arizona Burn Center at Maricopa Medical Center in Phoenix, Arizona, which is an American Burn Association and American College of Surgeons nationally verified Burn Center

Trauma and Critical Care Surgery (2 months)
St. Joseph's Hospital and Medical Center in Phoenix, Arizona, the only Level-1 Trauma Center in Phoenix designated by the State of Arizona and verified by the American College of Surgeons .

PGY-3 Level
Pediatric Surgery (3 months)

Phoenix Children's Hospital, the only dedicated children's hospital in the Phoenix metropolitan area. The resident will also participate in pediatric surgical care at St. Joseph's Hospital and Medical Center when on this rotation.

Trauma and Critical Care Surgery (2 months)

St. Joseph's Hospital and Medical Center in Phoenix, Arizona, the only Level-1 Trauma Center in Phoenix designated by the State of Arizona and verified by the American College of Surgeons.

General Surgery (2 months)

St. Joseph's Hospital and Medical Center, which provides a private practice general surgery experience

Didactic Training
Clinical conferences, seminars, small discussion groups, and one-on-one instruction are an integral part of Mayo Clinic's General Surgery Residency Program. All residents are required to attend conferences each weekday.

Monday: Surgical Grand Rounds

Tuesday: Morbidity and Mortality Conference

Wednesday: Interactive Basic Science Conference

Thursday: GI, Endocrine, Evidence-Based Surgery, and Chief resident conferences (rotating weekly)

Friday: Core Curriculum, Pathology, Radiology, Clinical Management (mock oral exam) and Program Director Conferences (rotating weekly)

Surgical Skills and Minimally Invasive Surgery Lab
The General Surgery Residency Program has a formal curriculum for surgical skills and minimally invasive skills training. A dedicated lab with a nurse educator is provided along with direct faculty instruction. Simulators, laparoscopic training stations, a surgical robot trainer, and animal labs are all provided. Access to the skills lab is 24/7 for individual practice in addition to the formal curriculum.

Research Training
All surgical residents must complete two clinical research projects during their five-year residency. You will define a question, write a protocol, develop the methodology, collect and analyze data, and write an abstract and paper under the mentorship of our faculty.

You are expected to present your work at regional and national meetings, and submit your research to peer reviewed journals for publication. The residency finances resident travel (within the continental United States) for the presentation of your research.

A research nurse educator is dedicated to facilitating resident research and publication and recent graduating chief surgical residents completed their training with an average of more than 15 peer-reviewed publications per resident.

Note: One of the three categorical residents per class will dedicate one year of their training to research between the second and third year of their residency. The research year is in addition to the five clinical years of training, during which you will not have any clinical duties. During the research year, the residency provides a continued stipend and benefits, and this time may be used for basic (bench) or clinical research.

Recent research residents have enjoyed the opportunities for research at:

Board Examinations
You will be required to take the written American Board of Surgery In-training Examination (ABSITE) each year. Your status in the program will not be determined solely by your ABSITE results; however, a score greater than the 50th percentile is required.

Oral In-Service Examinations
During your fourth and fifth years of training you will participate in mock oral examinations given by Mayo and non-Mayo surgeons. These exams will prepare you for the certifying examination of the American Board of Surgery (ABS). Three one-half hour interviews will be conducted in a format similar to that used by the ABS.

Resident Responsibilities
Your responsibilities will vary according to the specific rotation and your level of training. Your supervising faculty member will delegate and supervise all aspects of patient care including diagnosis, preoperative, intraoperative and postoperative care, with subsequent outpatient follow-up.

Continuity of Care
Work rounds are held on all services at least twice a day; teaching rounds are conducted with the supervising faculty daily.

A unique aspect of Mayo Clinic's program is the institution's physician schedule, which alternates each day between operative and non-operative responsibilities. This scheduling permits surgical services to function as a team in the hospital and in the outpatient clinic. It also allows you to participate in the total care of patients under the supervision of a faculty member.

Call Frequency
As a PGY-1 resident, your call will be in-house every fourth or fifth night. You will average two of every three weekends off. Upper level residents are on pager call from home every fourth or fifth night, and every fourth or fifth weekend. You will have one day in seven free of all duty and will work no more than 80 hours per week.

Committee Assignments
You will be given an opportunity to gain experience in a number of administrative capacities during your residency. For example, appointment to the general surgery residency education committee will provide you with experience in administering the program, selecting and evaluating the curriculum, and determining resident rotations and call schedules. A variety of other Mayo Clinic committee opportunities are available.

Evaluation
To ensure you are acquiring adequate knowledge and developing your technical skills, your performance will be monitored carefully during the course of your residency. After each clinical rotation, you will be evaluated formally by your supervising faculty member. In addition, you will regularly evaluate the faculty to ensure that your educational needs are being met. Twice per year a summary evaluation incorporating the faculty evaluations, 360-degree evaluations, portfolios, videotaped procedures and all other evaluative tools will be given from the program director.

Career Development
You will meet every six months with the program director to discuss your individual goals and will be assigned a mentor based on your career plans. Mayo Clinic recruits many of its staff physicians from its own training programs; 29% of our graduates have been recruited onto the surgical staff to date. Ninety-one percent of our residents have gone on to surgical fellowships in a variety of fields including plastic surgery (23% of graduates), pediatric surgery (14%), minimally invasive surgery (14%), colon and rectal surgery (14%), transplant surgery (9%), trauma/critical care (9%), surgical oncology (5%), and cardiothoracic surgery (5%). Our residents' match rate with the fellowship of their choice over the past five years is 100%.

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