Rotations

Our residents benefit from challenging and robust clinical rotations throughout Mayo Clinic’s network of campuses to enrich their education. These unique opportunities will allow you to excel and thrive in any emergent situation. Whether you are at our Rochester campus, working on a longitudinal community shift at a nearby regional hospital or critical access ED, or doing an elective at our Arizona or Florida campuses, you will draw on the experiences of world class educators and the unique blend of bread and butter and highly complex referral center patients to become the best you can be. 

Our residency is dynamic and responsive to learner feedback and the changing specialty of Emergency Medicine. Through a commitment to constant improvement new rotations and electives are created in response to resident desires and growing areas of specialization in our practice. 

We also believe that learning in diverse environments and seeing a wide range of patients is critical no matter where one ends up practicing. Most residents take advantage of the generous financial support offered by Mayo GME to pay for housing and transportation costs while rotating away from the main campus in Rochester to augment learning opportunities. The most popular experiences include the major academic centers in Jacksonville, Florida and Scottsdale, Arizona but also include regional campuses and international experiences. 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.

Our off-service rotations are of high clinical and educational value. You learn from world experts in their respective fields to translate that knowledge and skill to the bedside of your practice. We spend time on: 

• Obstetrics and gynecology
• Orthopedic trauma (includes pediatric, spine, and hand surgery)
• 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 invaluable 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, except for certain off-service block rotations. The educational curriculum emphasizes engagement, drawing on a variety of educational and learning styles.

Conference days emphasize core content and deliver knowledge utilizing multiple models, including experiential learning, spaced repetition learning, in situ simulation, case-based learning, flipped classroom, and lectures delivered by consulting services and core EM faculty. Joint conferences with pediatrics, trauma, and internal medicine allow for collaboration and the sharing of cutting-edge knowledge. 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, ultrasound guided procedures, orthopedics, 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, hands-on educational days. The residency engages with our world-class anatomic pathology and cadaver lab for advanced training of high acuity and low frequency procedures. These include cricothyroidotomy, lateral canthotomy, chest tube and pigtail insertion, pericardiocentesis, and thoracotomy.

We spend a separate procedural day in the cadaver lab to master 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 management experience is a priority. Interns undergo a rigorous two-day airway bootcamp at the simulation center. This covers everything from bag mask ventilation and extraglottic devices to direct and indirect laryngoscopy techniques. Subsequently, all residents participate in the Levitan Airway course that provides 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 senior residents places junior residents in the team lead role of complex resuscitations in our simulation center to get you ready to take care of anyone, anywhere, anytime.

We also offer an entire day dedicated to experiential learning organized and executed in partnership with other regional organizations to augment EMS experience. Topics covering the 4-year rotating curriculum include HAZMAT, structural collapse, closed space and crush medicine, vehicular extrication, burns, inhalational injuries, fireground EMS, rescue taskforce and MCI. 

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 four 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

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 in your PGY-2 year (although often PGY-1 residents still have lots to teach other learners and are encouraged to develop these skills). 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 you acquire the knowledge and technical skills needed to meet both the personal and program expectations for clinical competency, we evaluate performance and growth in various ways throughout your training. Our shift-based evaluation system, rooted in the ACGME Milestones involves regular feedback from attending physicians. Twice a year, a diverse group of dedicated faculty members convene as the Clinical Competency Committee (CCC) to assess and summarize each resident’s overall performance. Program leadership uses this comprehensive review, along with resident self-evaluations and feedback from multidisciplinary colleagues, to collaboratively identify strengths and set goals for continued development toward independent practice. 

We actively encourage and incentivize resident feedback on educational experiences and individual faculty members. Committed to continuous improvement, we leverage both formal and informal feedback to enhance our educational offerings and support the growth of our faculty as outstanding medical educators.

We strive to equip you with the resources to be successful in residency and beyond. In addition to evaluations, we prepare you for board examinations by providing access to industry leading test preparation packages, such as Rosh Review. This tool helps you build a broad and deep medical knowledge base and refine your test-taking skills over the course of your residency. Additionally, we conduct annual oral board mock exams and incorporate case review in the oral board style into our didactic sessions, offering a low-stress, high-yield environment to build confidence with this exam format.