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Reviews written by CndP

Cleveland Clinic Foundation
 If you don't know about this program, find out now,  Thursday, 03 April 2008

Overall rating
9.1
Staff Surgeons
10.0
Didactics/Teaching
9.0
Operating Experience
10.0
Clinical Experience
9.0
Research
9.0
Residents
10.0
Lifestyle
10.0
Location
6.0
Overall Experience
9.0
Program Information
Staff/Faculty/Chairman: Another large department, but the quality is extremely high. Residents rotate only with those attendings who have proven themselves to be interested and effective teachers. When there is a rotation that residents don't rate highly, it is dropped. Chairman, Dr. Ianotti, PD, Dr. Kuivila, and Assistant PD, Dr. Goodwin, are all just ridiculously friendly, approachable, reasonable, and responsive to resident feedback. The mission of this program is resident education, not making money on the backs of resident labor - the Cleveland Clinic Foundation is efficient enough to make money regardless. All areas are well represented, except trauma, and everyone here is the first to admit that. Greatest strength is probably joints, and quite a few residents go that route for fellowship.
Didactics/Teaching: Every Tuesday morning is protected time for resident didactics. This usually means a basic science lecture and a talk on a clinical topic as well. Attendings fend for themselves (with PA/NP support) in OR/clinic while residents are at conference. There are also specialty-specific conferences at other times during the week and lots of OITE review sessions.
Operating Experience: I never saw residents operate as much as they do here. Attendings are incredibly focused on making their residents the primary surgeons. Most of the residency is set up as a preceptorship (1 resident per attending), so double scrubbing is rare, unless it's a call case where the attending doesn't scrub at all.
Clinic Experience: Clinics run efficiently, with plenty of PA/NP support. Nothing is too formal, and attendings are benign but very interested in teaching. I don't generally like clinic, but here is place where it's really not bad at all.
Research Opportunities: There is a 6-year research track as well as a 5-year clinical track. Although the numbers seem to change year-to-year, this year there were 3 spots for each. I was torn about whether I wanted to do the research year. All the residents I spoke to who did the research year had nothing but good things to say about it, although I don't know much about the specific research opportunities available. What I do know is that residents are required to apply for outside funding, although securing that funding is not a requirement. You could see this as a painful process, or you could see it as a good preparation for academics, depending on your perspective. Also, residents can get into the OR 1 day per week during the research year to keep up their skills or explore an area where they want more exposure.
Residents: Fantastic bunch of guys, with a good mix of single and married residents. Very cohesive group; humorous and happy beyond belief. They get great fellowships afterwards. Many go into joints; those who do this can really just pick their fellowship. Some peds and spine and hand and sports, etc., though, so there's a good amount of diversity as well.
Lifestyle: This is not a program that has trouble with the 80 hour workweek. Call is rather light, especially in regard to trauma, and there is a night float system, which makes for a painful 2 months as a PGY2 but saves everyone else a lot of headaches. This program is at the other end of the spectrum compared to your county-based trauma war-zones like Big County (USC) in L.A. or Ben Taub (Baylor) in Houston. BUT, you will operate as much as either of those places - just on elective stuff, rather than trauma/call cases. And meanwhile you won't be bogged down doing the uneducational stuff more appropriate for ancillary staff and nursing.
Location/Housing: The hospital is located in a poor part of Cleveland. Not too far away is University Hospitals (Case), which is in a much better location. Residents can still live in nice neighborhoods and commute short distances, however, and traffic is more than reasonable. There are some satellite hospitals and clinics that require more driving, however, as well as a peds rotation in Akron. Cleveland is a lot of ghetto, but there are also those aforementioned nice neighborhoods that are surprisingly affordable. If you want to live in a grand old house from the bygone era of Rockefellers etc., you can.
Overall Rotation Experience/Conclusion: This program blew my mind. I had no idea what to expect coming in, but I came away extremely impressed. The combination of a friendly, learning-focused atmosphere with tons of operating seems hard to beat. Not the best place if you want to be up all night nailing stuff, but otherwise an absolutely stellar program. I didn't match here, but I'm 100% positive I would have loved it.
Qualification
I rotated as a medical student at this program
Date of Rotation: fall 2008


Mayo School of Graduate Medical Education
 Lives up to the hype - one of the premier programs,  Thursday, 03 April 2008

Overall rating
8.2
Staff Surgeons
10.0
Didactics/Teaching
9.0
Operating Experience
9.0
Clinical Experience
7.0
Research
9.0
Residents
9.0
Lifestyle
9.0
Location
3.0
Overall Experience
9.0
Program Information
Staff/Faculty/Chairman: It's hard to make a sweeping statement about the faculty here, especially based on a 4-week sub-I, as the department is just huge. Even as a resident you won't get to know everyone. But this is arguably the premier place for Hand and Adult Recon, and perhaps Tumor as well. Spine is strong, while Sports is a weakness according to most residents. Trauma is mostly the cold variety, and there's less volume trauma-wise here than at your big city trauma centers. That was a plus for me, but may be a minus for others. Peds is another relatively weak area; residents are sent to Mayo-Jacksonville to do a Peds rotation. Chairman, Dr. Berry, I didn't meet personally, but seemed quite friendly at conference. PD, Dr. Hanssen has a rep for being a blunt, no-BS kind of guy; I found him to be straightforward for sure but also good-natured and helpful. Same goes for Assistant PD, Dr. Turner. Most of faculty were former Mayo residents who did their fellowship elsewhere. This is by design, as it was explained to me that the department has been far happier with grads of their residency than grads of others. The fact that the faculty did their fellowship training elsewhere is seen as a sufficient injection of new blood/knowledge to the department.
Didactics/Teaching: Unique among ortho residencies, Mayo blocks out 6 months out of each resident's PGY2 year for "Basic Science," which is a concentrated series of lectures, workshops, dissections, simulators, etc. designed to put all the juniors on a level playing field for their last 3 years of residency. I went to the Microvascular Skills Lab, which was fantastic. During the 6 months of Basic Science, PGY2 residents are assigned to a service, but they operate or go to clinic just in the morning; the afternoon is protected time for didactic learning. Conferences otherwise are specialty-specific, with the exception of grand rounds. Hand conference is excellent for learning (great cases, incredible faculty all willing to chime in), as is Joints and Tumor, but there's a lot of pimping going on, especially in Tumor conference, where faculty from ortho, radiology, rad onc, and even path all jump on the poor PGY2's who line up to go through cases as if they're French aristocrats waiting to be guillotined.
Operating Experience: Because Mayo's residency is structured in a preceptorship-style format, where 1 resident is attached at the hip to 1 consultant, this could in theory vary a lot, depending on the level of the resident and the personality of the consultant. But all the consultants I worked with, even the somewhat ornery ones, were dead-set on getting their residents operating and teaching them operating skills (the atmosphere is here is very conducive to that). What you won't find, of course, is seniors leading juniors through cases, as there is almost no double-scrubbing. But that means you're always learning from a seasoned pro rather than an unboarded resident just a few years more senior than you. The cases themselves can be somewhat out of the ordinary: off the top of my head I recall an MCP arthroplasty, a massive distal femur prosthesis revision, and an axillary lymph node dissection (!) during my rotation. But there's also a lot of bread and butter stuff, too, especially joints, and you will do A LOT of joints if you come here. All consultants have PA's or NP's to assist in the OR also, and they definitely make things like closing go faster. Sometimes they will volunteer to do the closing or dressing themselves so that the resident can take care of whatever other business there is; otherwise, they will see all the cast room patients (who are there for suture removal, wound checks, etc.), while the resident operates.
Clinic Experience: Residents spend more time in clinic than other programs - approximately 40% vs. 60% in the OR. As most are aware, suits/sport jackets are the rule rather than white coats. Patients are for the most part not formally presented to the consultant; instead, the resident writes a note (which might be handwritten or typed, depending on the service), which is briefly looked over by the consultant.
Research Opportunities: Not all the faculty are heavily involved in research, but within such a huge department, you can find some outstanding investigators. Superb biomechanics and motion analysis stuff here, as well as lots of tissue engineering. Of course the patient databases are unmatched by any other institution, probably in the world, so clinical research is a ridiculous abundance of riches. Most residents do these clinical projects and have no trouble publishing them. There is no great pressure to do so, however, and most residents don't have academics in mind.
Residents: Like the department itself, the residency is huge, so I could only meet a handful of residents during my 4 weeks there. All were good people; smart, humorous, and good-natured, with OR skills that seemed above their level of training. They like to teach, and did more operating here. What really impressed me is how they had nothing but good things to say about their colleagues, as well - the camaraderie is good, even if each resident is not exactly tight with all 49 others.
Lifestyle: You carry your pager 24/7, every day of the year (except vacation), which can be a pain, but this is Rochester, not the big city, so things are generally less crazy. You do have to do patient callbacks, answering questions (that range from legit to crazy) from patients. Reps for Stryker, Zimmer et al. treat residents well, buying them books. Loupes are not provided by the department, but can be purchased using funds allotted for vision/dental care (can be done in the PGY2 year - very helpful as there's a lot of hand experience here). Residents get whatever fellowship they please in hand or joints, and very good ones for all the other specialties.
Location/Housing: Rochester is very small but very affordable - a good place for a family or an adaptable couple, but considerably less so for singles. But the Twin Cities are ~2 hrs or less away, and if you like the outdoors there's plenty of hunting, fishing, canoeing and the like. Most residents own homes and are married. There are 2 hospitals, Rochester Methodist and St. Mary's, but they're less than a mile apart, and there are continuous shuttles in between. Traffic seemingly doesn't exist here, a nice plus that gives you the freedom of really choosing where you want to live.
Overall Rotation Experience/Conclusion: This was a superb experience. The preceptorship style really maximizes teaching and minimizes mindless retracting. The hospital is efficient, and the support staff minimizes scut. The "weaknesses" here are only relative, compared to unbelievable strengths in other areas. Location is the biggest issue for most people, and you need to think long and hard about whether you can be happy in a small town in the Upper Midwest is where you. But keep in mind that there are advantages, too, to living here, like the affordability and lack of traffic (which can matter a lot for poor, time-strapped residents). And lastly, there is a rumor that circulates outside of Mayo that their residents are placed on one of 2 tracks, one of which has the "good" consultants, and the other of which has the bad personalities. Everyone here denies that is the case, and I couldn't find any evidence of it, either, so I believe this is just another unfounded rumor of the sort that unfortunately pervade the residency application process.
Qualification
I rotated as a medical student at this program
Date of Rotation: Fall 2008


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