(My) Disclaimer: these are the notes that I wrote immediately post-interview; they merely represent my impressions and are being posted solely as an attempt to help future applicants…

Positive
-Mentorship model: rotate and operate with ~2 attendings and oversee their service: get to do complex cases earlier, gain trust of the attendings more quickly
-Chief year = junior attending with only requisite faculty oversight (get to choose attending on record), treated as attending by the junior resident on chief’s service
-Flexibility is highly emphasized: 2 y of research and/or enfolded fellowship during R5-6 years
-Opportunity to rotate at Mayo AZ and/or FL
-Meyer is an exceptionally approachable chair/PD who advocates strongly for residents
-Large faculty that receives high volume of complex/rare/unique referrals from all over the world
-Incredible facility
-Call q >7 with infrequent weekends (since 3 residents/y cover 1 hospital), although residents carry pager full-time for their own service (<10 pts on most services)
-Strong neurology dept; choice of neurointensive service involvement on ICU patients; good working relationship
-Each OR staffed with an experienced surgical assistant who is there to help the residents position, open, close, answer ?’s when the attending is out of the room
-Experienced PA’s help with clinical management of patients
-6+ dedicated Neuro OR’s that are frequently all running
-Small town: ease of living, low cost, family friendly, no commute
-Didactic session on interview day was top-notch, educational and thought-provoking

Neutral
-Experience limited primarily to one large hospital (St. Mary’s)
-Minimal trauma exposure
-Several faculty are Mayo grads
-Endovascular owned by IR

Negative
-Limited research within the dept
-Only 1 dedicated peds faculty
-residents have a wonderful training experience and seem very satisfied, but the setup is fairly unique and therefore might not prepare you as well for the real world as some other programs
-Rochester, MN is less than desirable for most: small size, harsh winters, isolated (80 miles SE of St. Paul)
-Chief service is primarily trauma/ED admissions/chief clinic admissions (though chiefs reportedly also perform complex cases independently)

Positive minimal trauma

I think the best part of the Mayo residency program is the mentor-apprentice style structure. You cover 2 consultant’s services at one time (occasionally 3).  The surgeons operate on alternate days so you are always in the OR, and almost never in clinic (good and bad). This intimate relationship between consultant and resident (mentor and apprentice) creates a very unique learning environment. Because of this structure, the hierarchy of junior-senior-chief does not exist.  You are like the chief resident your third year for your services.  The second year resident does report to the chief, but the chief at Mayo acts fairly autonomously like a consultant.  If you can stand the cold winters, it seemed to me like a great place to train.

The only other place I know of that has an apprenticeship style residency structure was Dartmouth.

Can someone explain the concept of “consultant” vs. attending?  This is something I wondered about during the interview, but I forgot to ask about it.  Don’t really have any feelings about it either way, I am just curious as to how/why the term was created.

I’m not sure what the origin is, but a consultant is what you call an attending at Mayo.  Mayo has many unique traditions: like in the OR you glove the left hand first because the Mayo brothers were both left handed. After I rotated at Mayo, I went to my next Sub I and put out my left hand first.  The surgical tech looked at me like I was a newbie.

In UK(United Kingdom, not Univ. of Kentucky), attendings are called consultants. Maybe that’s where Mayo got the term from. Also in UK, each trainee is assigned to one consultant for a period of 3-6 months and then the trainees rotate to another consultant. During each rotation they are responsible for their consultant’s patients and service, attending their ORs, their Clinics, even trying to be on call together as a team. This helps to maintain great continuity of care and builds good consultant-trainee and trainee-patient relationships (in my personal opinion, having trained in the British system). As Mayo training is modeled similarly, maybe they use the British nomenclature as well.

2010-2011 Interview Season:

Tremendous clinical program. Seemingly great group of attendings and residents that get along well. Covers all specialties well. High volume of clinical elective cases and one on one time with the faculty appears unparalleled. Hospital runs like a machine. No doubt you come out being able to operate well from this program. Extremely cold winters and like other places, difficult to get to. Lacking the research of other institutions. Lacks an affiliated university which limits the research abilities and collaborations. Overall, great place if you want good clinical training.

I rotated here, figured I’d bump this rather than start a new thread. (2010-2011)

Overall, strong program - good operative training, wide diversity of pathology coming thru the door. Cool PGY7 mostly independent year, doing clinic as well as most cases coming thru the ER. Unlike at some places where you are a quasi-attending as a 7, the Mayo chiefs do seem to keep the “good” cases that come in as well as the traumas. Ie I saw chiefs doing medial sphenoid wing meningiomas and multi-level thoracic fusions after IMSCT resection, etc.

Research time here seems to be what you make of it - some do mostly fellowships, others do clinical research, a few have done basic science - the truth is that without a big research university attached, the basic sciences here are not as strong as elsewhere.

Call schedule is pretty sweet, ~Q4-5 as a junior and much less after that. However, to a degree you’re always on-call for your service. This actually worked out well IMO because you were never out of the loop on what was happening with your patients, but you also didn’t need to usually come in at night for emergencies as the in-house guy handled it.

Mayo is an awesome machine of a place as others have mentioned - stuff just happens, they have discharge planners, people who load the stealth, PAs putting in ventrics in the daytime, guys helping you position/prep/open in the OR, the support staff is just amazing.

Cons are, I would say, Rochester (unless you have family, in which case it might be good), the freezing cold, and the future of the chairmanship - Meyer won’t be chair in 7 years and it was unclear to me who was planning to be the next chair. A lot of the personality of the program comes from him.

Mayo 2011 impression:
The name of course is a draw to some. The chairman was extremely down to earth and appeared approachable. The mentorship model seems to have its pluses and minuses. After assessing things and speaking to rotators, you get to excel at your own pace more or less. You have the chance to develop under one attending for 3 months, which seems like a great learning experience. On the flip side (from what I felt/observed at interview and with conversation with rotators) there is not as much a “family tight feel” at Mayo than other places (despite being a “family friendly” residency). What is meant by that is the residents are sort of separated from eachother, without that fraternity vibe of a BNI or UVA if that is your thing. For people who want that type of residency/support program Mayo may not be your thing. They talked a lot about the research opportunities at the interview, and how it bothers them that people say they are not research oriented. It does in fact seem like if you want to make your way there you can. It is Mayo, with great name and clinical experience. With desire I don’t doubt you can get there. On the flip side, I have heard not as academic as some of the more research oriented programs with Universities. I liked the program a lot, I thought the people were nice. People who rotated there though said they wouldn’t rank it high because they couldn’t live in Rochester. I didn’t think Rochester was that bad (of course I didn’t see it that much).

Overall: Great program, great chairman; amazing amazing AMAZING clinical experience; hardcore academics may be elsewhere though.