Rotations

Our residents benefit from challenging and robust clinical rotations throughout Mayo Clinic’s network of campuses to enrich their clinical education. Whether you are at our Rochester campus, working on a longitudinal community shift at a nearby regional hospital, or doing an elective at our Arizona or Florida campuses, you will draw on the experiences of world class educators to become the best you can be. 

Our residency is dynamic and responsive to learner feedback. Over the last several years, new rotations and electives have been created in response to resident feedback as part of a drive to constantly improve. This includes our longitudinal EMS curriculum, longitudinal community rotations, emergency neurology, and cardiac critical care rotations.

A priority for us is helping you design experiences that will best benefit you. If you can think of a rotation you would like to design, we want to partner with you to make it happen, if possible. Our residents can rotate to other campuses to augment their learning opportunities in areas such as pediatric emergency medicine, trauma, toxicology, international medicine, sports medicine, ultrasound, and general emergency medicine. As an added bonus, Mayo Clinic provides funding for transportation and housing for domestic and international experiences.

Our off-service rotations are of high clinical and educational value. We spend time on: 

• Obstetrics and gynecology
• Orthopedic trauma (includes pediatric and hand surgery experience)
• Anesthesiology
• Pediatric Intensive Care Unit (PICU)
• Anesthesia Mixed Surgical Intensive Care Unit (SICU)
• Emergency psychiatry
• Emergency neurology
• Cardiac Critical Care (CICU)
• Emergency Medical Services (EMS)
• Emergency ultrasound

Within these rotations, we work with world-renowned faculty who provide an excellent teaching experience, for which Mayo Clinic has been known since its founding.

Didactic training

Teaching is widely regarded as a strength within our residency program. Tuesdays are our dedicated conference day with five hours of high-yield educational experiences. You are excused from clinical duties during conference hours, with the exception of certain off-service block rotations. Conference days are engaging, drawing on a variety of educational and learning styles.

Conference days emphasize core content and deliver knowledge utilizing multiple models, including experiential learning, in situ simulation, case-based learning, flipped classroom, and lectures. Additional specific topics are emphasized, including orthopedic trauma, diagnostic imaging interpretation, ECG interpretation, administration and research topics, wellness, ethics, mock written and oral board examinations, and collaborative trauma care. One hour of lecture is dedicated to departmental Grand Rounds, which are given by experts in a variety of fields within Mayo Clinic as well as guest lecturers from throughout the world.

A very robust longitudinal curriculum exists for emergency medicine administration, electrocardiography, toxicology, quality improvement, health policy, and teaching residents to become educators.

Special clinical education days

In addition to our innovative didactic curriculum and dedicated simulation days, we host a variety of high yield educational days that our residents enjoy. The residency annually engages with our world-class anatomic pathology and cadaver lab for advanced training of high acuity and low occurrence procedures. This includes cricothyroidotomy, lateral canthotomy, pericardiocentesis, and thoracotomy. You will also have the chance to practice and perfect your chest tube placement, and master a myriad of other critical procedures!

We spend a separate procedural day in the cadaver lab to master critical hand procedures. Leading this didactic session are world-renowned hand surgeons at Mayo Clinic who will guide you through best practices so you can take these techniques forward in your own practice.

In addition to the above, providing our interns early emergency airway experience is a priority. Interns undergo a rigorous two-day airway bootcamp at the simulation center. This covers everything from mask ventilation and extraglottic devices to direct and indirect laryngoscopy techniques. Subsequently, all residents participate in the world famous Levitan Airway course. Dr. Levitan comes annually to Mayo Clinic to provide instruction on the most advanced airway techniques, including fiberoptic intubations and cricothyroidotomy. Residents often have the benefit of attending the course annually during their training. After developing skills on mannequins, the Levitan course moves to the cadaver lab for further experiential training to get you ready for the most difficult airways.

Another highlight of our didactic curriculum is the Beyond ACLS course. This course, taught by EM faculty and third year residents places interns and second year residents in the team lead role of complex resuscitations in our simulation center to get you ready to take care of anyone, anywhere, anytime.

Longitudinal training

We have a core belief that skills are developed through deliberate practice over time. Taking feedback from our residents, we modified our single block community rotation to a longitudinal model. This allows residents to work, often one-on-one with faculty, at different lower resource community sites throughout all three years of training. We believe this helps them to prepare to excel in any clinical practice environment. Learn more.

Our residency also has adopted a longitudinal EMS model. You will be offered opportunities to fly with the flight team, work with our paramedic crews, or ride with our EMS physicians in a dedicated physician response vehicle throughout all years of training. Learn more.

Wild shifts and resource shifts

In our residency model, PGY-2 years take on the "senior" role in the department. As part of this, you will take on several new rotations throughout the second and third year.

Wild shifts are unstructured clinical education time. As a learner, you will reflect on your individual clinical needs and use this time for focused and deliberate practice. If you want extra time with ventilators and airway equipment, you can work with our respiratory therapy team. Develop your triage skills with our front desk nursing staff to help identify the order in which patients are seen. You can spend time with our ED social work team to develop your knowledge of local resources to offer our patients or focus on specialty care with our ED cardiology consult service. Community experiences in our free dental clinic or service of the homeless population are available. If you have a clinical goal and vision, we will partner with you to develop new experiences. Wild shifts are essentially single day "electives" sprinkled throughout the ED months to optimize your individual learning needs.

Resource shifts are also longitudinal in our ED. The resource resident covers a scheduled shift from 2 p.m.-11 p.m. (high volume time in the ED) and is available to the entire department. The goals for this shift are to gain increased resuscitation, procedural, ultrasound, sedation, and educational experiences and develop overall global situational awareness of the department. Residents grow immensely and learn how to best support the ever changing needs of a dynamic department.

Research training

Our goal is that every trainee, regardless of their ultimate career destination, has a clear understanding of how new information is generated, disseminated, and integrated into the practice of medicine. One way we accomplish this is through our research training.

We will aid you in generating ideas and provide all the support to see your project succeed. We have a dedicated research team that will help you develop your methodology, as well as statistical support for your projects. Mentorship can occur from within or external to the department of emergency medicine at Mayo Clinic. We even provide protected research time in your curriculum to focus on your work.

If you see a future in academics, you will have every tool available to assist in your development. Many of our residents publish their work and present at national conferences. A project can be as big or as small as you would like, so things are flexible for those who are ultimately not interested in doing a lot of research in residency. Regardless of your goals, you will leave residency confident in your ability to interpret and apply the most current literature and contribute in a meaningful way to the advancement of EM. 

Journal club

We have a dual purpose for our journal clubs which are hosted in faculty homes. We want to engage our residents through selected articles to move the practice forward through informal, yet engaging discussions regarding research methodology, critical appraisal of literature, or interesting perspectives on clinical questions. In addition, these journal clubs are designed to facilitate relationship building between residents and faculty outside of the clinical environment. We also host multidisciplinary journal clubs involving faculty and residents from other specialties such as surgery, radiology, etc. to further enrich our discussions and strengthen interdepartmental relationships.

Teaching opportunities

As part of your development, you will take on the responsibility of teaching others as a senior resident. This will include supervising junior residents as well as medical students. Your development as an educator will occur not only in our clinical areas, but also through numerous didactic opportunities. Residents give several presentations yearly, and participate in procedural education courses for other residents and medical students. Interested residents can become more involved in the medical school curriculum or take on a leadership track assisting faculty with the emergency medicine clerkship. EM residents are recognized as among the best educators in our institution, and several have been awarded the Golden Stethoscope, a Mayo Clinic recognition of residents for their superb educational contributions. You will also benefit from the residents-as-educators longitudinal didactic curriculum to give you a structured and evidence based approach to developing yourself as an educator.

Evaluation

To ensure that you acquire the knowledge and develop the technical skills to meet personal and program expectations of clinical competency, your growth and performance are assessed in various ways throughout training. You are formally assessed, using ACGME Milestone based tools, by faculty on a regular basis and have access to this information immediately upon their completion. Twice annually, a diverse group of invested faculty participate in the clinical competency committee (CCC) to summarize each resident’s aggregate assessment data. This information is presented to the resident by program leadership and combined with a resident self-evaluation (using a similar Milestone-based tool) in a collaborative manner to highlight strengths and determine next-step goals and opportunities for ongoing development.

We encourage and incentivize resident provided feedback and evaluations of educational experiences and faculty. We have a continuous improvement mindset and utilize both formal and informal feedback to improve educational offerings and develop our faculty as educators.

We provide you with resources to be successful in residency and beyond. In addition to general evaluations, we will set you up for success with written and oral boards. Each resident gets access to an industry leading test preparation software package, such as Rosh Review, to develop test taking skills over their three years of residency. We incorporate annual oral board mock examinations, as well as case review in the oral board style in our didactic conferences.