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Curriculum

Clinical training

While PGY-1 and PGY-2 residents operate every other day like their senior resident colleagues, training during PGY-1 and PGY-2 is weighted to preoperative and postoperative patient care.

PGY-1 rotations include trauma, critical care and general surgery; vascular surgery; orthopedic surgery; plastic surgery; and rotations with general surgery staff and chief residents.

In PGY-2, you serve as the senior resident in the surgical intensive care unit and have rotations in general surgery, colon and rectal surgery, endoscopy, anesthesiology, gynecologic surgery, and pediatric surgery. Five weeks of elective time is often used to experience cardiac, general or other subspecialty surgery areas.

During PGY-3 and PGY-4, your training emphasizes surgical technique and skill refinement with rotations that include transplant surgery, vascular surgery, thoracic surgery, colon and rectal surgery, endocrine surgery, and hepatobiliary surgery. PGY-4 residents lead our trauma, critical care and general surgery team to care for critically injured patients coming to Mayo Clinic from throughout the Midwest.

As a chief resident in PGY-5, you lead your own surgical team and assume full responsibility for patient and resident team management.

Rotation schedule

PGY-1
Rotation Length
Trauma, critical care and general surgery 3 months
General surgery 5 months
Vascular surgery 1.5 months
Orthopedic surgery 1 month
Plastic surgery 1.5 months
PGY-2
Rotation Length
General surgery 4 months
Trauma, critical care and general surgery 3 months
Colon and rectal surgery 1.5 months
Endoscopy, anesthesia and elective 1.5 months
Gynecologic surgery 1 month
Pediatric surgery 1 month
PGY-3
Rotation Length
General surgery 5 months
Pediatric surgery 3 months
Transplant surgery 1 month
Thoracic surgery 3 months
PGY-4
Rotation Length
General surgery 3 months
Colon and rectal surgery 1.5 months
Vascular surgery 3 months
Trauma, critical care and general surgery 4.5 months
PGY-5 (chief resident)
Rotation Length
General surgery 7.5 months
Vascular surgery 3 months
Colon and rectal surgery 1.5 months

During PGY-3, you may elect to spend six weeks at one of two off-site rotations — managing pediatric surgical patients at the Children's St. Paul Pediatric Hospital in St. Paul, Minnesota, or caring for general surgery patients at Mayo Clinic Health System — Franciscan Healthcare in La Crosse, Wisconsin.

Both sites reside an hour from Rochester by car and have numerous busy surgeons (eight in St. Paul and four in La Crosse) in a friendly environment void of other residents or fellows. Mayo Clinic funds the authorized additional costs of housing and licensure fees for these rotations. Our residents consistently rate these rotations as highly educational.

Didactic training

Clinical conferences, seminars, small discussion groups, journal clubs and one-on-one instruction are integral parts of the General Surgery Residency. All residents are required to attend our weekly morbidity and mortality conferences and Monday evening Grand Rounds. Friday morning sessions are held every other week in both simulation and surgical skills centers to enhance resident learning.

During each subspecialty rotation, you also attend that subspecialty's weekly schedule of journal clubs, didactic presentations and conferences dealing with patient management problems, mortality and morbidity.

During PGY-2 and PGY-3, you meet monthly throughout the academic year for journal club, where you learn how to critically analyze and interpret scientific articles.

You are encouraged to attend regional or national general surgery meetings sponsored by Mayo Clinic, and most residents attend the Minnesota Surgical Society meeting one or more times in the five-year period.

Other didactic training during the residency includes:

  • Surgical basic science program. You receive basic science instruction in topics such as wound healing, immunology, infections and organ system pathophysiology. All residents are expected to attend this weekly session held on Monday afternoons before the chief resident conference.
  • Trauma, critical care and general surgery. Your PGY-1 trauma, critical care and general surgery rotation includes formal lectures as well as daily informal sessions on any number of topics in trauma and critical care. Ten Mayo trauma, critical care and general surgery staff members (board certified in both critical care and general surgery) actively participate in educating residents and students about all facets of trauma and critical care.
  • Surgical critical care program. During PGY-1 and PGY-2, your surgical critical care rotations include daily learning about the fundamentals of critical care management. Mayo Clinic has a high volume of tertiary care patients, so you have broad exposure to nearly all aspects of critical care. Additional senior-level rotations in cardiothoracic, vascular, pediatric and general surgery allow residents to mature their intensive care unit skills and care over the ensuing three years.
  • Advanced Trauma Life Support certification. As a PGY-1 resident, you have the opportunity to become certified in the American College of Surgeons' Advanced Trauma Life Support program. A recertification course is offered during PGY-3.

Research training

Research opportunities at Mayo Clinic are outstanding. Your particular project(s) depend on your interests and background. Research opportunities are divided into two broad categories — clinical research and basic science laboratory research.

Clinical research

You have access to Mayo Clinic's world-renowned medical records system for clinical research. During your residency, you conduct at least one clinical research project, publish the results, and make at least one regional or national presentation.

Basic science laboratory research

If you have an excellent clinical record and are interested in an academic surgical career, you are encouraged to pursue basic science laboratory research. You may begin a research project after PGY-2, or you may complete your residency training and then focus on research. Roughly one-third of our general surgery residents add one or more years of laboratory research to their five-year residency training. Credits can be applied toward an M.S. or a Ph.D. at Mayo Graduate School.

Mayo Clinic offers two basic science laboratory research opportunities: a one-year program and a two-year clinician-investigator program.

  • One-year research program. This program gives you the opportunity to assess your aptitude for bench research and develop your fundamental research skills. To enhance your productivity, you are encouraged to initially base your research on an existing research project. Current areas of basic science laboratory research include:

    • Cardiac surgery
    • Colorectal physiology
    • Gastrointestinal physiology
    • General thoracic surgery
    • Laparoscopic surgery
    • Oncology and immunology
    • Pediatric surgery
    • Plastic surgery
    • Transplantation, including xenotransplantation, heart and lung, hepatic, and renal and pancreas
    • Vascular surgery
  • Clinician-Investigator Training Program. Mayo Clinic's Clinician-Investigator Training Program is two years in length. When you complete this program, you will be academically prepared, competent in clinical surgery, technically skilled in research and capable of competing in today's research environment.

    The Clinician-Investigator Training Program includes two years in basic science laboratory research and a core curriculum of research seminars, guest seminars and didactic courses in subjects such as:

    • Advances in cell molecular biology
    • Cellular and quantitative biology
    • Physiology
    • Statistics

    If you are interested in the Clinician-Investigator Training Program, you should indicate your interest early in your residency training. You will then be assigned to a faculty member who can help you develop a competitive written research proposal.

Teaching opportunities

You have the opportunity to supervise and teach Mayo Medical School students and visiting student clerks through bedside instruction, operative interaction and formal didactic lectures.

Conferences

In addition to clinical experience, didactic training and special courses, Mayo Clinic offers a wide variety of professional conferences and online learning. Whether as part of Joint Commission regulations or Mayo School of Graduate Medical Education recommendations, dozens of online modules teach current best practices for infectious diseases, professionalism, record keeping and more.

The main department teaching conference is weekly General Surgery Grand Rounds, which is a common meeting ground for all of the subspecialties within the Department of Surgery. Attending consultants openly critique case presentations by chief residents who are assigned to the general surgery, vascular surgery, and colon and rectal surgery services. Additionally, senior-level residents in pediatric, thoracic, transplant, and trauma, critical care and general surgery present their operative lists for scrutiny and education. After discussing the management issues involving patients on such services, staff members make a formal didactic presentation on an area of their expertise.

Monthly video teleconferences with staff and residents from Mayo Clinic's campuses in Phoenix/Scottsdale, Arizona, and Jacksonville, Florida, in general, endocrine and vascular surgery provide education for staff and residents about diverse and difficult surgical problems.

Additional conferences, which include staff pathologists and radiologists, are held monthly to educate surgical residents in managing all facets of patient care, with preoperative, intraoperative and postoperative lessons all being taught.

Certification

You are required to become certified in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS). ACLS courses are held during the last week of June, just before the start of the academic year. An evening ACLS course also is offered every three months to facilitate recertification. You must be certified in BLS and ACLS before you begin your trauma, critical care and general surgery rotations.

Case studies

During your residency, you frequently prepare case study presentations. You present pertinent information from an interesting case and conduct an in-depth discussion of that case using evidence-based material.

In-training examinations

Each year, you take the written American Board of Surgery In-Training Examination (ABSITE). During PGY-4 and PGY-5, you participate in oral clinical examinations given by Mayo Clinic's surgical staff. These mock oral exams use the same format as the oral certification examination given by the American Board of Surgery.

Committee assignments

You are given an opportunity to gain experience in a number of administrative capacities during your training. Class representatives meet with the General Surgery Residency Committee each month to improve the surgical program. Additional committees led by residents focus on improving all facets of resident training, from camaraderie to laparoscopy and robotic experiences.

Moonlighting

Moonlighting is permitted for licensed residents only when you do not have clinical responsibilities, such as during research time or while you are on vacation.

Evaluation

To ensure that you acquire adequate knowledge and develop your technical skills, your performance is monitored carefully during the course of the General Surgery Residency.

Your supervising faculty member formally evaluates you after each clinical rotation. Each evaluation is reviewed carefully by the program director. Electronic access allows you to develop a portfolio of evaluations, curriculum vitae, educational competence and academic effort that will be yours upon graduation.

Annual reviews of each resident at our General Surgery Residency Committee meetings occurs, and your performance in all aspects of surgery must be satisfactory at each level of training before you will be promoted to more-advanced levels. Mayo goes to great length to help struggling trainees improve their performance, and a track record of graduating chief residents successful in fellowships or private practice is testimony to a wonderful system of learning.

In addition, you regularly evaluate the faculty and our program to ensure that your educational needs are met.

Career development

You meet periodically with various faculty members, administrators and the program director to discuss your individual career goals. Mayo Clinic recruits many of its staff physicians from its own training programs, so when you successfully complete your general surgery training, job opportunities may be available at one of Mayo Clinic's group practices.

Operative experience

The operative experience of residents completing the General Surgery Residency Program is well within the guidelines of both the Residency Review Committee for Surgery of the Accreditation Council for Graduate Medical Education and the American Board of Surgery.

For example, the average total numbers for 10 residents who finished the General Surgery Residency were:

Major operations
As chief resident 228 operations
As junior surgeon 793 operations
As teaching assistant 16 operations
Total 1,037 operations

Additional training

After you successfully complete the General Surgery Residency, you will be highly competitive for fellowship training programs at Mayo Clinic and throughout the United States.

Mayo Clinic offers fellowships in many surgical specialties that complement the General Surgery Residency.

These fellowships offer in-depth, daily, one-on-one training with a consultant and the opportunity to increase your surgical, supervisory and administrative skills. During your residency, you can talk with your faculty adviser about these opportunities.

  • Sep 11, 2014
  • ART832603