The time spent in clinical practice versus research time depends on the fellowship path you choose.

You may have the option of electing clinical and/or laboratory rotations with other neuro-oncology specialists at Mayo Clinic in Jacksonville, Florida, or Mayo Clinic in Phoenix/Scottsdale, Arizona.

Clinical training

Over the first three months of the fellowship, you will undergo a period of acclimation, during which your role as a physician in the care of patients is reviewed by mentors.

During this period, you gain insight on how to inform new patients of the trials available to them and enrolling them on the basis of patients informed consent. Over the course of the fellowship, you will be trained in the comprehensive evaluation of patients with neuro-oncologic disorders. This includes experience in the management of relapses and progressive disease and the appropriate choice of medicine for each disease stage.

Required clinical rotations include medical and surgical neuro-oncology, radiation oncology and the Gamma Knife Radiosurgery Unit.

Electives are available in neuropathology, Cancer Center statistics, neuroimaging and other specialty areas.

In the second and third years, you may elect a research project under the supervision of a program investigator in one of several areas that relate to neuro-oncology. These include, but are not limited to:

• Experimental neuropathology
• Neuro-imaging
• Molecular medicine (including gene therapy and gene transfer therapy)
• Tumor genetics
• Basic tumor biology

Research training

Mayo Clinic Cancer Center is a National Cancer Institute (NCI)-designated comprehensive cancer center. It has been continuously funded since the Center's Program began in 1971. The Neuro-Oncology Program is one of only a few NCI-funded Programs. In addition, Mayo has received an NCI Specialized Project of Research Excellence (SPORE) for brain cancer research.

Mayo Clinic is a premier site for the conduct of clinical trials involving the use of new prescription drugs, combination therapies, rescue treatments and novel therapeutic agents. You are expected to participate actively in clinical trials that enroll patients in the early stages of their disease, as well as those that enroll progressive patients.

You will participate in these trials as an examining physician and gain experience in the use and interpretation of clinical outcome measures.

You are expected to participate in weekly neuro-oncology seminars to review research progress and to interact with other research members.

Didactic training

Clinical conferences, seminars, small discussion groups, journal clubs, didactic courses and one-on-one instruction are an integral part of Mayo Clinic's Neuro-Oncology Fellowship Program.

Formal didactic courses are required during the fellowship. Understanding statistical principles as applied to biomedical investigation is an important component of the fellowship. Mayo Clinic offers a number of courses in epidemiology, biostatistics, and design and conduct of clinical trials.

Conferences

Throughout your fellowship, you will participate or make presentations in weekly teaching conferences. There are scheduled departmental conferences on Mondays, Wednesdays, and Fridays. These conferences focus on the pathophysiology, diagnosis and management of neuro-oncologic disorders.

Research presentations are given by either Mayo Clinic or visiting faculty and by "in-house" residents and fellows. Clinical pathological conferences are held several times a year.

On Wednesdays, clinical neurology hospital conferences are held and alternate between the adult, the child and adolescent hospital services, neurosurgery and neuro-ophthalmology.

Subspecialty conferences are presented on Fridays by all divisions of the Department of Neurology including neuro-oncology. In addition, there is a weekly program-wide research seminar and a weekly 'work conference' (similar to a Tumor Board).

Evaluation

To ensure that you acquire adequate knowledge and develop your technical skills, your performance is monitored carefully during the course of your program training.

At the completion of each rotation, fellows are evaluated by the faculty to whom they were assigned. This is accomplished through Mayo Clinic's Residency Management System, MedHub. MedHub is linked to the six core competencies identified by the Accreditation Council for Graduate Medical Education (Patient Care, Medical Knowledge, Interpersonal Skills and Communication, Professionalism, Practice-Based Learning and Improvement, and Systems-Based Practice).

Completed faculty evaluations are reviewed by the program director, who assigns a pass/fail grade based on the scores and comments by the faculty member. Upon approval of the evaluation by the program director, the evaluation immediately becomes available electronically to the fellow in the MedHub system.