Program Description

Mayo offers a five-year categorical general surgery residency program. During your training in this program, your responsibilities will increase with your experience, capability and performance.

Throughout your residency, you will write all orders and be responsible for managing your patients. You will participate in rounds each morning as part of a resident/student/ consultant team. During rounds new patients will be presented, inpatient management will be reviewed, and teaching sessions will be held. You also will make independent early morning and late afternoon rounds to review the results of tests and therapy, discuss progress with patients and their families, make further decisions, and write orders.

Faculty

In addition to caring for patients in their clinical practices, Mayo Clinic's faculty members are committed to teaching and facilitating the growth of medical knowledge. Our faculty has published more than 300 papers/year and lectured extensively more than 200 presentations/year and are recognized leaders in their field. You will have direct access to these individuals throughout your training program.

Advisers
You will be assigned a faculty adviser who can provide comprehensive educational advice and personal support. Your adviser also will serve as a contact point, introducing you and your family to Rochester and the Mayo Clinic system.

Visiting Professors
Many prominent surgeons and surgical professors visit Mayo each year. They present their work during noon and/or morning lectures and participate in hospital rounds. You will be encouraged to take full advantage of these opportunities.

Curriculum

While junior-level residents operate every other day, training in years PGY-1 and PGY-2 is weighted to pre-operative and post-operative patient care. In PGY-2, you also will serve as a senior resident in the surgical intensive care unit. During PGY-3 and PGY-4, your training will emphasize surgical technique and skill refinement. As a chief resident in PGY-5, you will lead your own surgical team and assume full responsibility for patient and resident team management.

Clinical Training
The specific rotations for the five-year program are shown below.

Off-site Rotations
During PGY-3 you will spend six weeks in an off-site rotation, managing pediatric surgical patients at the St. Paul Children's Hospital in St. Paul, Minn. St. Paul is about 75 miles from Rochester.

Mayo Clinic funds the authorized additional costs of travel, housing, auto rental and licensure fees for these rotations. Our residents consistently rate them as highly educational.

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

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

You are encouraged to attend all regional and 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.

Surgical Basic Science Program
You will 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. You will be given a copy of the program reference text when you arrive at Mayo Clinic.

Trauma, Critical Care and General Surgery
Your PGY-1 TCCGS rotation will include a formal lecture series. You will learn about various aspects of emergency surgery and trauma management.

Surgical Critical Care Program
During PGY-1 and PGY-2, your surgical critical care rotations will include daily lectures about the fundamentals of critical care management. Mayo Clinic has a high volume of tertiary care patients, so you will have broad exposure to nearly all aspects of critical care. Additional senior level rotations in cardiothorasic, vascular, pediatric and general surgery allow residents to mature their IW skills and care over the ensuing three years.

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

Advanced Trauma Life Support Certification
As an intern, you will have the opportunity to become certified in the American College of Surgeons' Advanced Trauma Life Support program. A re-certification course is offered during PGY-3.

Surgical Skill Workshops
During PGY-2 through PGY-4, you will receive specialized instruction in a formal laboratory course for one weekend each year.

Professional Conferences
In addition to clinical experience, didactic training and special courses, Mayo Clinic offers a wide variety of professional conferences.

The main department teaching conference is weekly general surgery Grand Rounds. This is a common meeting ground for all of the subspecialties within the department. Attending consultants openly critique case presentations by chief residents who are assigned to the general surgery, emergency room surgery, vascular surgery, and colon and rectal surgery services. Additionally, senior-level residents in pediatric, thoracic, transplant, TCCGS 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 in Scottsdale and Mayo Clinic in Jacksonville in general, endocrine and vascular surgery provide education for staff and residents about diverse and difficult surgical problems in a high-tech environment.

Additional conferences, which include staff pathologists and radiologists are held monthly to educate surgical residents in managing all facets of patient care: pre-, intra- and post-operative lessons will be taught.

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

Clinical Research
You will have access to Mayo Clinic's world-renowned medical records system for clinical research. During your residency, you will 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 will be 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 a M.S. or 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 will give 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/Immunology
• Pediatric Surgery
• Plastic Surgery
• Transplantation
• Xenotransplantation
• Cardiac/Lung
• Hepatic
• Renal/Pancreas
• Vascular Surgery

Clinician-Investigator Program
Mayo Clinic's Clinician-Investigator 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 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 Program, you should indicate your interest early in your residency training. You will then be assigned to a faculty member who will help you develop a competitive written research proposal.

Certification
You are required to become certified in Basic Cardiac Life Support (BCLS) 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 re-certification. You must be certified in BCLS and ACLS before you begin your TCCGS rotations.

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

In-Training Examinations
Each year you will take the written American Board of Surgery In-Service Training Examination (ABSITE). During PGY-4 and PGY-5, you will 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.

Teaching Opportunities
You will have the opportunity to supervise and teach Mayo Medical School students and visiting student clerks through bedside instruction and formal didactic lectures.

Committee Assignments
You will be given an opportunity to gain experience in a number of administrative capacities during your training.

Moonlighting
Moonlighting is permitted for licensed residents and fellows only when you do not have clinical responsibilities (e.g., during research time).

Evaluation
To ensure that you acquire adequate knowledge and develop your technical skills, your performance will be monitored carefully during the course of your general surgery training. You will be evaluated formally by your supervising faculty member after each clinical rotation. Each evaluation is reviewed carefully by the program director.

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.

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

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

Graduate Outcomes
The most important sign of the success of any training program is how its graduates fare after they begin their careers. Every resident who successfully completed Mayo Clinic's General Surgery Residency Program has been eligible for American Board of Surgery certification.

During the past five years, 98 percent of residents successfully passed the American Board of Surgery qualifying (written) examination and 97 percent passed the certifying (oral) examination on their first attempt. The overall success rate of Mayo graduates in obtaining ABS certification is 98 percent.

Operative Experience
The operative experience of residents completing Mayo Clinic's 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 (ACGME) and the American Board of Surgery. For example, the average total numbers for seven residents who finished the general surgery residency program in 2002 were:

Present Professional Status
Of the physicians who graduated from Mayo Clinic's general surgery program in the past eight years, 60 percent pursued additional fellowship training.

Academic appointments are held by 33 percent of the graduates, and the remaining are in private practice. These graduates are practicing in 22 different states.

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

Mayo Clinic in Rochester offers fellowship programs that complement the general surgery residency programs.

• Cardiovascular Surgery
• Colon and Rectal Surgery
• Critical Care Surgery
• Gastrointestinal Surgery
• General Thoracic Surgery
• Transplantation Surgery
• Vascular Surgery

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.

Admissions

Qualifications
Appointments for Mayo Clinic's General Surgery Residency are made through the National Residency Matching Program (NRMP).

Application Process

Positions
Mayo Clinic in Rochester offers 10 general surgery positions at the PGY-1 level.

Appy
To apply to the General Surgery Residency, you must submit an electronic application via the Electronic Residency Application Service (ERAS) through your medical school dean's office.

To use this application process, you need the following information:

• Official college, graduate school and medical school transcripts
• Official test transcripts for all applicable examinations (USMLE*, LMCC, COMLEX, NBOME, FMGEMS, FLEX or NBME)
• A dean's letter and two other letters of recommendation
• A curriculum vitae
• A personal statement
• A valid ECFMG certificate (if you graduated from medical school outside of the United States or Canada)

* USMLE scores must be provided with the application in order to be accepted

Foreign medical graduates should contact the ECFMG for information and instructions on how to apply using ERAS.

Applications for each academic year, which begins in July, should be completed by November 1 of each year.

If you are considered for an appointment, you will be asked to visit Mayo Clinic in Rochester for an interview with the program director and selected faculty.

Interviews are conducted from November through January each year.

Program Contacts

If you like more information about the general surgery training programs at Mayo Clinic in Rochester, please contact:

David Farley, M.D., F.A.C.S., General Surgery Residency Program Director

Judith Cook, General Surgery Residency Education Coordinator
(507) 284-8240

For more information about Mayo Clinic residencies and fellowships, please contact:

Mayo Clinic College of Medicine
Mayo School of Graduate Medical Education
200 First Street S.W.
Rochester, MN 55905
(507) 284-2220