Mayo School of Graduate Medical Education

This is the big question with Mayo I think. From what I saw I think the residents were pretty good and got their hands dirty regularly. Each resident does 3-month rotations with an attending, so they do more the longer into the rotation that they are. Three or four of the chiefs this year are going directly into private practice, which makes me think they are very happy with their operative training. Also, your PGY5 year contains 9 months of elective time, so that is almost a mini-fellowship right there. Lots of PA and surg tech help in the OR with things like draping and dressings.

This has always been the question regarding the Mayo Clinic, and I think just like any place it depends on the surgeon you are with. Some are very hands on, whereas others let the residents go. I saw a PGY2 doing a spine exposure with the fellow assisting him. PGY3 nailing tibia with chief assisting, and consultant watching from the hall. All the chiefs I spoke to felt comfortable with their skills.

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.

Their strengths are joints, hand, and spine. Their "weakness" is trauma. While their weakness really is trauma, I think it is only a relative weakness (because their other areas are so strong). While on service my trauma team had more than enough OR time, in fact we had a call day that we spent 20 straight hours operating. Not only this, but the PGY-2s were getting to perform some of the key parts of various operations (which discredits some of the rumors out there that you don't operate until late in residency.) I also spent time on a joints service and had a similar experience, with the junior residents being very hands on. Lastly, the rumor that fellows steal cases is 100% not true. The fellows are generally not on service with residents at all, but if they are they are with junior residents so there isn't much overlap on the things they would and could be doing anyway.