Accreditation

This program fulfills the training requirements as defined by the American Board of Surgery and is accredited by the Accreditation Council for Graduate Medical Education (ACGME).

Certification

American Board of Surgery CGSO qualifying and certifying exams.

Program history

While the Complex General Surgical Oncology Fellowship program is new with its inaugural fellow starting in 2024, Mayo Clinic is not new to medical education – with over 450 training programs across every medical, surgical, and health sciences specialties, including a general surgery residency, hepatobiliary and pancreas fellowship, a breast surgical oncology fellowship, colorectal surgery fellowship, and an endocrine fellowship. We will match one CGSO fellow per year into this two-year program.

Positions

There is one position available each year on a competitive basis in the Complex General Surgical Oncology Fellowship at Mayo Clinic in Rochester, Minnesota.

Women, underrepresented in medicine (URM), and anyone interested in a comprehensive, challenging, and innovative surgical oncology fellowship are encouraged to apply.

Qualifications

Applicants for the CGSO program must have completed an Accreditation Council for Graduate Medical Education (ACGME) five-year General Surgery Residency program.

Also see general admissions requirements for Mayo Clinic School of Graduate Medical Education.

How to apply

Interested applicants should apply through Electronic Residency Application Service (ERAS).

The following documents should be included with the application:

• A current curriculum vitae
• Personal statement
• Three letters of recommendation
• Medical school transcripts
• ABSITE scores
• USMLE scores
• Recent photograph

Candidates will be selected for interviews and notified in early March.

Mayo Clinic will participate in the national match program for Complex General Surgical Oncology administered by the National Resident Matching Program.

You will be exposed to a wide breadth and a large volume of complex and minimally invasive surgical oncology cases designed to refine surgical skills, improve clinical judgment, and expand intellectual skills encompassing all aspects of oncology. You will be actively involved in the initial evaluation of new patients, treatment planning including sequencing of multidisciplinary therapy, minimally invasive and open surgical approaches, and postoperative and long-term follow-up.

This clinical experience, combined with numerous opportunities for research, provides graduates with a rich experience that prepares them to lead productive academic careers, and establish successful surgical oncology practices and training programs. Graduates will be well-poised to take on future leadership roles in surgical oncology.

*Part-time rotations combined with dedicated research time.

Rotation descriptions

GI/PSM/Sarcoma: You will be assigned in a 1:1 preceptorship with a surgical oncologist who specializes in GI/PSM. You will develop experience with peritoneal surface malignancies including staging laparoscopy, laparoscopic HIPEC, PIPEC, open cytoreduction and HIPEC, IP port placement as well as other GI malignancies including GIST, NET, gastric cancer, etc. These rotations also include a high-volume exposure to gastric surgery including robotic total gastrectomies multi-visceral resections, double tract and j-pouch reconstructions, and gastric HIPEC.

HPB/Sarcoma: You will be assigned in a 1:1 preceptorship with a HPB surgeon. You will develop experience with complex liver, and pancreatic resections including vascular resections and reconstructions, hepatic artery infusion pump placement and management, splenectomy, and IORT for HPB malignancies. You will be exposed to a high volume of open, laparoscopic, and robotic HPB surgery. These rotations also include exposure to a high volume of retroperitoneal and truncal sarcoma surgery including multi-visceral resections, vascular resections, and reconstructions.

Breast/Melanoma: You will be assigned in a 1:1 preceptorship with a breast/melanoma surgeon. You will gain experience with the latest techniques in nipple-sparing and robotic mastectomy. You will rotate with a surgical oncologist who will perform all of the melanoma and high-risk cutaneous malignancy surgery as well as will gain exposure to tumor infiltrating lymphocyte (TIL) therapy and injectable therapies. Mayo Clinic is one of 50 approved sites approved for TIL.

Colorectal surgery: You will be assigned in a 1:1 preceptorship with a colorectal surgeon. You will develop experience with MIS and open oncologic colorectal resections including proctectomies, intraoperative radiation therapy (IORT), lateral pelvic lymph node dissection technique, and transrectal resection.

Endocrine surgery: You will be assigned in a 1:1 Preceptorship with endocrine surgery. You will gain experience with MIS adrenalectomy, thyroidectomy, pancreas enucleations, and radical neck dissection.

Research: You will have protected time for clinical research under the mentorship of 29 staff surgeons. Our faculty is actively involved in clinical trials, patient-reported outcomes, health disparities, surgical outcomes, and translational research. You will have access to statisticians and data analysts to help with research projects.

Pathology: We have world experts in oncologic pathology and a large active frozen section laboratory. You will gain insight into tumor margin and sentinel lymph node assessment, as well as rare pathology.

Medical Oncology: You will have the opportunity to work with the medical oncologist in your disease site of choice. Gaining both inpatient and outpatient experience with chemotherapy treatments for common and rare malignancies.

Radiation Oncology: You will gain experience with IORT, photon and proton beam radiation treatments, and planning.

Palliative care: You will collaborate with a full spectrum of care providers including primary care physicians, pharmacists, palliative care physicians and APPs, medical oncologists, dieticians, social workers, and chaplains to provide patient-centered symptomatic management for advanced malignancies.

Electives

You will have the opportunity in the second year for a six-week elective rotation in any of the core rotations or additional exposure in gynecologic surgery or basic/translational sciences.

Didactic training

Clinical conferences, small discussion groups, journal clubs, and one-on-one instruction are integral parts of the Complex General Surgical Oncology Fellowship. All fellows are required to attend morbidity and mortality conferences and Grand Rounds. Fellows are also required to attend Monday afternoon Surgical Oncology teaching conference. Protected time is provided.

During each subspecialty rotation, you also 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 national surgical oncology surgery meetings during your fellowship.

Lastly, you will be directly involved in multiple weekly tumor boards including presenting and discussing cases throughout their fellowship. This includes Pancreas Tumor Board, Gastroesophageal Tumor Board, Colorectal Tumor Boards, Cutaneous Malignancies Tumor Boards, Breast Tumor Boards, Endocrine Tumor Boards, and Sarcoma Tumor board.

Call frequency

The fellow call schedule is different for each rotation. Mayo Clinic follows the requirements of the Accreditation Council for Graduate Medical Education (ACGME) work hour restrictions, most likely resulting in two- to three-weekend home-call per six-week rotation block while on a surgical service. You are never on night float and do not provide Acute Care Surgery/Trauma coverage for the emergency department.

Procedures

You will have broad and comprehensive surgical experience with both MIS and open common and complex oncologic operations. This includes hepatic artery infusion pumps (HAIP), intraoperative radiation therapy (IORT), hyperthermic intraperitoneal chemotherapy (HIPEC), pressurized intraperitoneal aerosolized chemotherapy (PIPAC), radical multivisceral resections, and vascular resection and reconstructions, which are often performed independently by many of the Surgical Oncologist/HPB surgeons. Fellows will easily exceed minimum CGSO case volumes during their training. Video: Dr. Travis Grotz explains the steps of a robotic-assisted procedure.

Conferences

The fellowship offers active involvement in numerous dedicated multidisciplinary tumor boards, including presenting cases in a multidisciplinary discussion format. Examples of tumors boards that fellows will routinely be involved in depending on the rotation include gastroesophageal, colorectal, sarcoma, pancreas, hepatobiliary, breast, melanoma, and endocrine tumors boards.

There is a twice monthly-run M&M conference in which fellows will present cases they were involved in. You will also participate in educational and journal club conferences relevant to rotating services. There are opportunities to participate in Quarterly Perfusion video conferences as well as didactics based on the SCORE CGSO curriculum.

Research opportunities

There are six months of dedicated research time. Mayo Clinic has immense research support services including access to clinical research, translational research labs, and basic sciences labs/cores. The Department of Surgery has its own statisticians and research coordinators.

The Kern Center for the Science of Health Care Delivery includes a rich resource of applied clinical informatics and data science. They have analysts with extensive experience in working with large databases including the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP), National Cancer Data Base (NCDB), Surveillance, Epidemiology and End Results (SEER), Rochester Epidemiology Project (REP) and others. We have several surgeon scientists on staff with full basic and translational research labs as well as numerous PhD.

The Department of Surgery has numerous scientists with basic and translational research who are eager to collaborate and provide grant-writing mentorship to help future scientists develop a foundation to allow for the development of a basic/translational science lab after graduation.

The Mayo Clinic Cancer Center is very robust with hundreds of clinical trials available and collaboration through several cancer clinical trials networks including the Minnesota Cancer Clinical Trials Network (MCCTN), and the ALLIANCE for clinical trials in oncology. You will have the opportunity to write grants and be involved in clinical trial development if interested.

Additional training opportunities

You will have opportunities to participate in additional training programs including robotic training programs and the SSO Fellows Institute.

Moonlighting

Moonlighting is not permitted.

Teaching opportunities

You will routinely have a junior resident on service with you and be expected to supervise and teach junior residents basic surgical skills and techniques in the operating room as well as teach principles of patient care and cancer management in the clinic and on the hospital floor. You will also gain experience educating junior residents in conference and didactic sessions.

Evaluation

You will receive constructive and formative feedback from your attendings as well as peers and colleagues using MedHub. The program director meets with the fellows quarterly to review feedback, case logs, research progress, and overall progression in the program.

Mentorship

You will have assigned mentorship with the program director and associate program director but are strongly encouraged to seek out mentorship from the over 29 surgical staff involved in the training program. The PD and APD will meet with you regularly to assess goals and progress and career development.

Facilities and locations

You will work only at the Mayo Clinic Hospital in Rochester, MN. This includes two campuses (Saint Mary’s and Methodist), which are one mile apart and connected via shuttle. These two campuses offer over 100 cutting-edge surgical suites with DaVinci robotic surgery platforms, 4K laparoscopic equipment, and intraoperative radiation therapy. Both sites have complex endoscopy, interventional radiology, and other supportive services.

Back row, left to right: Mary Mrdutt, M.D., M.S., Jeff Johnson, M.D., Amy Degnim, M.D.
Front row, left to right: Tina Hieken, M.D., Judy Boughey, M.D., Shon Black, M.D., Mara Piltin, D.O.

Back row, left to right: Travis Grotz, M.D., Cornelius Thiels, D.O., M.B.A., Mark Truty, M.D., M.S., Patrick Starlinger, M.D., Ph.D.
Front row, left to right: Rory Smoot, M.D., Michael Kendrick, M.D., Susanne Warner, M.D.

Back row, left to right: Anne-Lise D'Angelo, M.D., M.S., Sherief Shawki, M.B., B.Ch, M.D., Kristy Rumer, M.D., Ph.D., William Perry, M.B., Ch.B., M.P.H., Nicholas McKenna, M.D., M.S., David Larson, M.D., M.B.A., Kellie Mathis, M.D.
Front row, left to right: Kevin Behm, M.D., Eric Dozois, M.D., Robert Cima, M.D., Scott Kelley, M.D.

Left to Right: Melanie Lyden, M.D.; Trenton Foster, M.D.; Travis McKenzie, M.D.; Benzon Dy, M.D.