Review Detail

by John Langland     August 20, 2007    
(Updated: January 01, 2012)
Overall rating 
Staff Surgeons 
Operating Experience 
Clinical Experience 
Overall Experience 

Lives up to the hype - one of the premier programs

Program Review

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.
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.
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.
Operative experience overall may leave you "needing" a fellowship. This isn't just my opinion. I have heard this from many people and seen it first hand to some degree. This is not a research powerhouse but you will have no problem finding opportunities. They don't have many "big names" but they have a few.
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.


I rotated as a medical student at this program
Date of Rotation
Fall 2008
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