Mayo Clinic Anesthesiology Residency Interview

The following entry summarizes my experiences interviewing for the anesthesiology residency program at the Mayo Clinic in Rochester, Minnesota. I enjoyed my time at Mayo, and hope that this entry proves useful for other medical students on the interview trail :)

First of all, the Mayo Clinic was an out-of-state facility, and roughly five hours away from Chicago by car. The Mayo Clinic graciously provided fully-subsidized housing for invited medical students, and had students stay at a middle-tier hotel [Staybridge Suites] located immediately across from one of the Mayo Clinic's primary hospitals.

My interview at the Mayo spanned two days. On the first day, invited students had dinner from 6pm to 9pm with current & chief residents at a middle-tier restaurant [300 First], and had a chance to ask questions about the residency program in an informal setting. The second day started at 8:15am, and was kicked off with a presentation about the Mayo Clinic by the residency director [T.L.]. After the presentation, medical students were given a 2-hour guided tour of the Mayo Clinic, with visits to the OR, the Dan Abraham Healthy Living Center, and the Stabile Simulation Center. After the tour, students had three 30-minute interviews with the residency director and two faculty members [Y.P., B.G]. After interviews, invited medical students had lunch in the upper-tier hospital cafeteria with current residents. In the afternoon, I had two informal 30-minute meetings with a current resident [K.G.] and a faculty member [Y.P] to discuss research opportunities at Mayo. The interview day ended at 3pm, and students were invited to keep in touch and return for 'second-look' interviews.

Given my MD/PhD background and personal interest in cardiac anesthesia, I was particularly interested if Mayo offered (1) opportunities to conduct clinical research in residency, and (2) offered robust clinical training in cardiac anesthesia. With regards to research, Mayo has impressive pre-existing infrastructure, with > 8000 active human studies, 365 active NIH awards, and 10 active R01 grants. Per report [Y.P.], anesthesiology residents can either informally work with faculty members of their choosing, join a formal 'Clinician-Investigator Training Program' to sharpen research skills, or join a 'Mayo Clinic Scholar Program' to be groomed for faculty & academic tenure. Personally, I was quite interested in Mayo's METRIC ICU epidemiology project and the Anesthesia Clinical Research Unit. With regards to cardiac anesthesia, Mayo offers a busy case-load, with 10 dedicated cardiac operating rooms, and yearly throughput of over 4,000 patients. Per report [A.F.], the cardiac anesthesiology fellowship is one of the best in the country, and offers fellows the unique opportunity to spend up to 6 months mastering echocardiography.

* * *

GENERAL QUESTIONS

1. Are the residents happy? What features of the program do they like or dislike?
The residents seemed quite happy. In particular, residents noted that they (1) enjoyed Mayo's unique "Hallway Rotation", which allows residents to gain experience in supervising anesthesia staff members, (2) enjoyed the strong alumni network and the possibility of receiving job offers as a CA-2, and (3) enjoyed the minimal scutwork. Some residents disliked the relatively small size of Rochester (181,000 people), but noted that one could take advantage of theatrical shows, ethnic restaurants, and athletic events in Minneapolis, roughly two hours away.

2. Would the residents choose the same program again?
All residents stated that they would choose Mayo again.

3. Does the program have trouble filling all its spots?
Unknown.

4. What is the salary compensation for first-year residents? Vacation weeks? Sick days?
First-year residents earn $46,653 and are offered 3 weeks of vacation and 90 sick days [per FRIEDA].

LOCATION

1. Is the program located in a safe part of the city? If not, what's the security system like?
Rochester appears to be a relatively safe and prosperous town -- main employers are IBM, Seneca Foods, and the Mayo Clinic, and median household income is $57,957. Security does not appear to be a problem.

2. What do residents do for fun around here?
Most residents take advantage of the "Dan Abraham Healthy Living Center", a well-furnished 127,000-sq.foot gym which is reserved exclusively for Mayo Clinic employees. Residents note that they enjoy outdoor activities (i.e. skiing, snowboarding, hunting), as well as relaxing with other residents.

3. What advantages are specific to the location (eg, unusual patient population, cultural opportunities, climate, low cost of living, etc.)?
Residents note that the housing market is quite good, and that it is relatively easy to buy a house on a resident salary.

4. Does the department offer subsidized resident housing / housing stipends? Does the department offer free parking?
Mayo does not offer subsidized housing, but does offer free hospital parking.

REPUTATION

1. Do graduates of the program have problems finding jobs?
Per report, residents do not have a hard time finding jobs. Residents note that they are well-received at other academic institutions (i.e. Residents can do their OB rotation at the Brigham & Women's Hospital)

2. How difficult is it for residents to get a good fellowship?
Per report, residents do not have problems getting into a fellowship of their choice.

EDUCATION

1. Is the program fully accredited?
Yes. The program has a strong track record, and is currently scheduled for RRC [Residency Review Committee] visits every 5 years.

2. How are the residents evaluated? By whom?
The current ABA certification passing rate for Mayo is 100%, as compared to 81% nationally [5-year aggregate].

3. Is there an organized curriculum? What is its emphasis?
Mayo offers didactic training for all residents. Residents noted that the faculty instructors for didactic courses were quite good, but that true mastery of the field of anesthesia predominantly comes from self-directed learning and clinical experience.

4. How many conferences/week are there? Do conferences emphasize practical knowledge or state-of-the-art research?
Per report, all residents attend at least one didactic conference and one Grand Rounds conference. Residents may also attend additional conferences when on sub-speciality services [i.e. cardiac, neuro]

5. What is the quality of the attendings? What are their responsibilities? Do they get along?
Most residents report that attendings ("consultants") are easy to get along with, and are very willing to teach clinical skills and procedures to students. Many residents remarked that attendings are very supportive and will "watch their back" in case [the resident] runs into trouble or needs help.

6. How interested are the faculty in the education and welfare of the house staff?
Per report, faculty are strongly interested in teaching house staff.

7. What proportion of attendings are private?
Unknown. There are 109 anesthesiology attendings at Mayo, with a mix of both private and academic physicians.

8. Are there medical students on the wards? What school(s) do they represent? What are the resident teaching responsibilities to the students?
Per report, medical students from the Mayo Clinic often rotate through the anesthesiology department. Additionally, the Mayo Clinic hosts several visiting students from other institutions. Residents are encouraged to teach medical students.

9. What research opportunities are there? Are faculty research preceptors readily available?
As noted previously, Mayo has >8000 active human studies, 365 NIH awards, and 10 active R01 grants. Without a doubt, resident research is certainly possible at the Mayo Clinic.

WORK ENVIRONMENT

1. What is the patient load like? Does the department offer CRNA support?
During their first year, residents work 50hrs/week, have a maximum consecutive-hours-on-duty limit of 30 hrs, and have an average of 1.8 days off per week [per FRIEDA]. The anesthesiology department has a substantial number of full-time CRNAs, and [per report] the residency program does not explicitly depend on residents for cases. This arrangement allows residents to staff their choice of advanced cases, and prevents residents from exceeding their work-hour limitations.

2. Is the caseload sufficiently varied?
Yes. Residents do note that there is relatively little sharp trauma cases (knife wounds, bullet injuries), but plenty of farming accidents and motor vehicle accidents.

3. How much autonomy do residents have to manage patients?
Per report, residents have substantial autonomy in managing patients.

4. What is the patient population like? Ethnicity/language? Socioeconomic status?
Rochester carries a predominantly Caucasian, middle-class, English-speaking demographic.

5. Is there continuity of care for patients after discharge?
Yes.

6. What is the extent and quality of the ambulatory experience?
Ambulatory care at Mayo is given at the Gonda Center, a facility with 13 operating rooms and a case load of 120 procedures per day. The Gonda center handles cases in urology, opthomology [GO 7], and orthopedics, general surgery, gynecology, plastic surgery, and ENT [GO 15].

7. How strong is nursing support? Consult services? Radiology? Pathology? Emergency services?
Per report from residents, the Mayo Clinic has strong protocols in place to maintain continuity of care, and clinic patients are well-served by service providers of all levels.

* * *

All in all, my impressions of the Mayo Clinic are strongly positive -- it offers robust clinical training and has extensive resources for individuals who intend to go into academic anesthesia.