Toothman23

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Jun 12, 2012
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Mayo Clinic is accepting externs again. Pretty much everyone who externs here will receive an interview. Here's an update on the program from the one posted a few years ago.


Mayo Clinic OMFS, Rochester, Minnesota

Structure/Schedule:


6 year dual degree program with 2 residents per year.

PGY1-10 months OMFS, 2 months medical school. Interns scrub for every OR case. Intern year is very hands on. You learn the foundations of surgery and are 1st assisting and closing most cases. Midway through intern year, most are cutting Leforts, comfortable with all impacted 3rds, placing implants, etc. Often the intern is running the 2nd/3rd OR. The pager is held by our NP/PAs during the day so interns aren't having to scrub out to see consults or check on floor patients for routine things.

PGY2-2nd year of Mayo Medical School (systems based), 2 months OMFS, 1 week Dermsurg, 1 week Occuloplastics, Dedicated 1 month USMLE Step 1 study time with no clinical responsibilities. No call responsibility unless on OMFS service. Still have stipend but reduced. Med school cost ~$20k after scholarships. Residents regularly comeback to help in the OR on days off or non-mandatory med school classes.

PGY3-3rd year of Mayo Medical School (clinical rotations) 2 months OMFS, graduate med school in May, Dedicated 2 week USMLE Step 2 study time with no clinical responsibilities. Still have stipend but reduced. Med school cost ~$20k after scholarships. No call responsibility unless on OMFS service. Residents regularly comeback to help in the OR on days off or non-mandatory med school classes.

PGY4-5 months of anesthesia, 6 months of general surgery (SICU, Plastics, Endocrine - primarily thyroids/paratyhroids), 1 month OMFS, 1 week Microvascular rat lab. General surgery is subdivided into 6 weeks surgical ICU, 6 weeks plastic surgery, and 3 months endocrine surgery. We get lots of time in the neck (thyroids, parathyroids) during general surgery, and pretty much no butts and guts.

PGY5-6 weeks vascular surgery, 6 weeks pediatric surgery, 6 week OMFS trauma rotation in Portland or Puerto Rico, 1 week cleft mission trip to Central America, rest of the year on OMFS. The mission trip is where we predominately get experience with primary cleft lip and palate.

PGY6-12 months OMFS.

Facilities:

All facilities are in Rochester, Minnesota at the Mayo Clinic. Mayo Clinic is comprised of primarily 2 areas: "downtown" and St. Mary's Hospital which are less than a mile apart and have continuous shuttles between. Our consultation clinic and outpatient procedure clinic are downtown in connected buildings. While we operate out of St. Mary's Hospital. Top of the line facilities and equipment.

Consultation Clinic:
We wear suits (Mayo tradition) for consulatation clinic. We typically only do consults and follow ups here. Some small biopsies and nasopharyngeal scopes.

Procedure/outpatient clinic:
Typical schedule has ~7 sedations in the AM and ~7 local anesthetics only in the PM. Upper level resident will run the sedation and split the case with the intern/junior resident as they feel. But most 5th and 6th year residents feel very comfortable with all 3rds and allow the intern to do at least half of the case unless they are falling behind. Consultant typically hangs out in the workroom and just says hi to patients unless the residents are falling behind or consultant from other department comes for a procedure. Procedures include typical dentoalveolar including 3rds, implants, sinus lifts, grafting, biopsies, expose and bonds, etc. We have 3 procedure rooms here fully staffed with surgical techs. Sedations will have 2 techs assisting and local anesthestics will have at least 1 assistant. We have nurses that help to pre-op and recover patients after sedations. This clinic runs 5 days a week. Residents regularly finish the program having done over 300 sedations, placing ~300 implants, and proficient with all 3rd molars and implant cases over the 6 years.

OR Scope:

We are a full scope program with excellent numbers for dentoalveolar, implants, orthognathic, TMJ, infections, pathology, reconstruction, and trauma. We have 2 start OR's 5 days a week and often get a 3rd room.

Cosmetics is limited here as its not a big interest or expertise of our consultants. Most of our experience will come on our plastics rotation where you'll assist on typical full body and facial cosmetic cases. We do alveolar clefts, distractions, and orthognathics on craniofacial patients but we do not do primary cleft lip or palate or cranial vault. We are part of the craniofacial clinic here that meets regularly.

We are the primary service for our free flaps and commonly perform trachs, fibulas, radial forearms, ALTs, scapulas, and parotids. Our fibulas and scapulas are all planned by VSP and we use custom cut guides and plates. Its not uncommon for us to have stretches of doing 2-3 flaps per week. While we do a lot of oncology and reconstruction, there is very little scut work and the overall efficiency of the Mayo system and allied health staff puts busy work to a minimum. Nurses do the flap checks and there is no in-house flap call. Upper levels residents that have interest in H&N have the opportunity to raise flaps, perform neck dissections, ablations, and do the micro as we do not have fellows. We perform all flaps with a 2 team approach so regularly get done around 2- 3pm.

We do a lot of TMJ procedures such as arthrocentesis, arthroscopies, and total joint replacements. Upper level residents become proficient in performing total joint replacements on their own.

All of our orthognathic cases are planned virtually with no labwork. We perform a lot of traditional orthognathic cases as well as jaw cases on craniofacial patients and maxillomandibular advancement for OSA. Residents are very hands on with all cases getting to do half of the case or more.

We are not heavy on trauma but as a level 1 trauma center we get trauma from the community as well as Wisconsin, Iowa, and the Dakotas. Most trauma comes from MVCs, assaults, farm accidents, and ATV/snowmobile accidents. We typically have a few GSW and several panfacial fractures per year on top of plenty of mandbile, mid face fractures, and lacs. Fifth year residents go to Portland or Puerto Rico for a 6 week trauma rotation.

Resident Schedule
Scheduling is based on a mentorship model where residents are assigned to a consultant for 3 months at a time and follow the consultant's schedule. Typical schedule will be 1-3 days per week in the consultation clinic, procedure/outpatient clinic, and OR. Residents round in the AM and PM on patients' who are under the care of the consultant they are following.

Residents of all levels have great autonomy and get excellent hands-on surgical experience. Staff is great about letting us do whatever we are comfortable with while still having over sight and back up as needed.

Call:

All call is home call. There is an OMFS call room at the hospital if its needed. Interns take the vast majority of first call throughout the year with an upper level resident on second call. Upper levels take second call split equally between all upper levels on service. We are always on call for our inpatients, post op calls, hospital consults, and ED tooth call (infections and dentoalveolar trauma). There is no GPR and we are the only service with dental training that takes call, so all tooth calls come to us. The ED is very good about only calling us if there is CT confirmed pus to be drained. They don’t call us for odontogenic pain/cellulitis very often. No extractions or arch bars in the ED. Interns typically take tooth call 1 week on/1 week off.

Trauma is every 3rd week, split equally with ENT and plastics. Whatever comes in during those 3 weeks is ours. Interns typically take trauma call every other day.

Didactics:

Usually there are 3-4 conferences per week, in the mornings between rounding and the OR. Both staff and residents present at conferences covering a wide range of topics.

Consultants:

Kevin Arce MD DMD -oncology fellowship trained at Legacy Emmanuel, Division Chair
Practice is primarily benign and malignant pathology and recon. Also does a good amount of zygomatic implants.

Jonathan Fillmore MD DMD - program director
Practice is primarily arthroscopies and arthroscopic procedures, total joint replacements, orthognathics, and dentoavleolar.

James Van Ess MD DDS
Practice is primarily orthognathics and dentoalveolar

Christopher Viozzi MD DDS
Practice is primarily alveolar clefts, orthognathics, OSA, some TMJ, and dentoalveolar

Kyle Ettinger MD DDS - H&N fellowship trained at UF Jax
Practice is primarily benign and malignant pathology and recon.

All are full-time with no private or faculty practice. All consultants take whatever trauma comes in when they're on call.
We have an NP and a PA who during the day see ED and hospital consults, manage inpatients, take patient phone calls, and see post ops and coordinate care. We also have a PA dedicated to the H&N practice that sees patients in the clinic and assists in the OR.

Staff are very nice and approachable. Residents get along and have a team mentality and have get togethers outside of work. We are the opposite of a malignant program. We regularly go for happy hour and golf with our consultants.

Rochester:

Rochester is located in Southeastern Minnesota roughly 1 hour south of Minneapolis/St Paul. Rochester’s population is 115,000 and continues to grow as part of a $5.6 billion investment into Mayo Clinic and Rochester. Rochester is centered around Mayo Clinic. Its not going to have the night life or as many entertainment options as living in a big city. But cost of living is low here and traffic is nonexistent. They have been adding more and more new restaurants and breweries. Mayo Clinic has their own credit union and will give mortgage loans to residents despite coming in with large student loan debt so all of the residents in our program buy homes or townhomes. The housing market has been extremely favorable to sellers. Rochester has a nice golf and country club that gives residents an extremely good deal so many residents that golf join.

Perks:

Food money, textbooks, Mayo issued iPad and laptop

Two attendance trips paid by Mayo during 6 years of residency.

If selected to present at a meeting, Mayo covers travel, food, and registration.

Excellent staff and midlevel support allows residents to focus on patient care and learning.

Garage parking at all Mayo facilities.

See link for updated yearly stipends.

Medical School:

Excellent education, pass/fail, step 1 taken during 2nd year with dedicated study time. Residents receive stipend during medical school and receive scholarships from the medical school and the OMFS department. Residents typically take out loans (~20k/year) during medical school for the 2 years.

Recent Graduates:

Most graduates enter private practice however other recent graduates have matched into H&N and cosmetic fellowships.

Externships:

As an extern you will assist in the OR and outpatient procedure clinic following the residents/consultants. Externs typically visit for 1 week at a time however longer externships are welcomed.

Website:

Oral and Maxillofacial Surgery Residency, M.D.-O.M.S. (Minnesota) - Mayo Clinic School of Graduate Medical Education - Mayo Clinic
 
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dentmass

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Mar 7, 2019
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Looks solid. Can you post some case numbers?

Sorry also just wanted to clarify but the clinic but the numbers don’t add up. 7 sedations a day is about 1750 sedations in a year meaning that each of your upper levels (4 of them) are doing 437 sedations per year each taking into account some vacation. There’s 2 upper level years so double that number is 874 but then you’re saying they graduate with 300 meaning they only do 150 per upper level year approximately.
 

Toothman23

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Jun 12, 2012
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I can PM you specifics for case numbers.
As for the sedation numbers, 300 is an approximate. Residents are finishing with 300+. A more accurate number from a paper we published in JOMS, our department did 17,600 sedations over 15 years so ~1,200 per year. Because of varying resident coverage, there isn’t always an upper level resident scheduled with the consultant so it can just be a consultant with an intern. We don’t get anesthesia privileges until after completing our anesthesia rotation.
 
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Toothman23

7+ Year Member
Jun 12, 2012
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Another benefit I forgot to mention is that through the Mayo medical insurance our loupes are covered.
 
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