Mayo Question

[BlahtoThis]

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I was wondering what people thought of Mayo. The only downside I see to the IM program there is the location. They have great fellowship placement nation-wide, an extremely supportive system, and are debatedly more universally known in medicine (among laypeople and medical professionals) than ANY other place in the country (MGH, Brigham, Hopkins, etc.). People say it's a "fellow driven" program, but I would think it's nowhere near as bad as places like Cornell/BIDMC with all the private patients. Also, it seems like people lump Mayo with the Cleveland Clinic as a fellow-driven place, though it seems like it's far less the case with Mayo. I talked with some of the international medical grads and they seem amazing (more impressive than any US medical grads I've met because of their experiences, and many of them had interviews at MGH and the other big names but picked Mayo in the end).

Can anybody offer a reasonable review, leaving out the issues with the location?

 

[Loopo Henle]

There are a few experiences with Mayo in the interview experiences thread, but I will throw in my two cents here. I did an away rotation at Mayo. The weather and the location were not huge factors for me. I am an old married man so middle of nowhere Rochester did not concern me. I don't do much clubbin'. I thought the residents were great, very smart. The program is massive as are the two giant hospitals associated with it (St Marys and Rochester Methodist). The largeness of the program was a relative turn off for me due to the dilutional factor. Many residents did not know other residents which was odd for me coming from a small community program. The facilities were awesome and beautiful. I have never seen so much marble in my life. As for the actual experience, I came away thinking that Mayo was an awesome place to prepare for subspecialty training, but maybe not as great a place to prepare for general internal medicine. The patient population is very homogenous (read: >95% white). If you want experience with HIV, you have to do an away rotation. The subspecialties at Mayo were incredible, and they do awesome research. The relationship between the consultants (attendings) and the residents seemed very open. The medicine department administration were very approachable and friendly. The all suit thing takes some getting used to, but is essentially a pocketspace issue. All in all I think Mayo is a great place to train if you plan to specialize, but I think maybe other places are stronger if you want a very strong clinical residency.

 

[pintsized]

Please correct me if I'm wrong, but when I was looking at the fellowship match for GI, I was less than impressed... what do u guys think?

As for how the place looks, most of the time you spend in a more run-down hospital, not the pretty building u see when u first meet up for the interview.

 

[Jackie1.]

I felt as if Mayo does not get as quality of applicants because people turn it down based on weather/location. I do think it is fellow driven and I think speciality program directors do not hold it in as high of esteem as hardcore work your butt off IM programs like Hopkins, MGH, U Michigan, and U of Chicago. This has been confirmed by various fellowship program directors at my home institution. Having everything protocol'd for you makes learning hard, although one could argue they don't need to deal with all the petty corss cover issues, but I think that is needed to build your stamina and learn acute care of patients. I think they do an EXCELLENT job recruiting as in advertising that 1/3 of their class is AOA, what applicants fail to realize is taht top programs in teh nation have 3/4 of their residents AOA, if not more. I think if you want a hands off experience with some well known people and a great smooooth path into clinical research, its AWESOME, but as for the clinical training and the experience you'll have after the completion of an IM residency there is questionable at best.

 

[Loopo Henle]

Please correct me if I'm wrong, but when I was looking at the fellowship match for GI, I was less than impressed... what do u guys think?

As for how the place looks, most of the time you spend in a more run-down hospital, not the pretty building u see when u first meet up for the interview.

In fairness, Rochester Methodist is old and run down, but you mainly do a few subspecialty rotations there. St Mary's is a massive hospital, also old, but they are rehabbing it extensively. The gazillion units are very open with lots of work room. The newly rehabbed floors are very nice with plasma screen TV's in the pt rooms. Residents have pretty large workrooms all around. You better be in pretty good shape if you go there, because if they call a code on the opposite side of St Mary's you may die on the way. Residents did talk about getting lost in there, but how many other hospitals have a giant meditation roon?

 

[BlahtoThis]

Thanks for all the great replies. They really do help.

The reputation among fellowship directors was what I wasn't sure of. When you check out their match (I'm interested in cardiology at the moment, but probably would never go the GI route), they match at pretty great places (Mayo, Texas Heart, Cleveland Clinic, Cornell, Emory, Hopkins, etc.) and they say 26% of their residents go into cardiology. I agree that they are a bit more "mixed" than top institutions with places like St. Luke's, Loyola, and others on the list.

Also, the one thing I don't understand is how this "lack of clinical training" is so different from a place like Cornell or the Deaconness, where, despite statements made by residents, it seems like there are a large number of private patients. I agree that MGH, BWH, U Chicago, Hopkins, etc. are a giant step above. But then there seems to be a bunch of places whose value lies more in the name, the education, and the people there than in the clinical training.

With regards to the *only* 1/3 AOA, I would wonder if this takes into account the fact that Mayo probably has a larger number of top top international grads than other places (I'd say there is a good number of them there). This is not a rant at the place since these are pretty big people who have often accomplished much more than many American grads. I just wonder if this may dilute the number of people who are AOA since these international grads can't be AOA.

 

[hemoglobin]

I am one of the categorical interns here at Mayo. I remember hearing so many rumors when I was interviewing... "Mayo is a fellow-driven place", "There is no autonomy at Mayo", "Rochester is a cold and horrible city", "Mayo does not attract strong applicants", "Mayo only has referral patients and all cases are zebras", etc etc etc. Out of all of these rumors, only one is true: "Rochester is cold".

After looking around and visiting some of the other great programs in the country, I chose to come to Mayo and do not regret it. I doubt that any other programs would offer me such strong trainining, both in clinical and academic fields. Some of the world specialists in many different areas are here and learning from them is just an awesome experience. Here at Mayo we not only have the chance to manage common cases like community acquired pneumonia, hypertensive urgencies and emergencies, mental status changes in the elderly, etc, but also see some of the rarest conditions like Wegener's, limbic encephalitis, Fournier's gangrene, etc. Also, everyone is just so friendly, and ancillary services are so good, that coming to work every day is a true pleasure.

Also, as a resident you will have the opportunity to spend a month abroad doing an international elective, and spend some time in Scottsdale to get some more HIV experience. And Mayo will pay for your trip to present your research anywhere, at any time.

Intern year is tough, as anywhere else, but I still get to go home at 5pm or earlier most days, and my work hours hardly ever go beyond 70h/week. The program is strongly comitted to education and we have several great conferences throughout the week. Research is all over the place. It's been only 7 months into my intern year and I already had the chance to finalize a manuscript, write 90% of a second manuscript, and still work on a case report and case series. If you are not into research, then don't come to Mayo. Even if you don't want to do it, they will make you complete at least one project. 🙂

One may argue that Mayo does not attract applicants from the top medschools in the US. That is somewhat true. However, we do attract the top students from other great Universities and from abroad, and our class is just outstanding. My view of it is: It is easy for other programs to attract a super competitive applicant and match him/her at a competitive fellowship, however, Mayo has the ability of transform not-so-competitive medstudents into very very competitive residents in the end of the 3 years. Our fellowship match could not be better.

Now, my 2 cents about Rochester: I come from a warm, beautiful, huge tropical city from South America, and just moved here 7 months ago or so. If I like Rochester, than anyone else will!!!!! Hehehe. Seriously, Rochester is a small, cute city, very cheap to live in. It is cold, indeed, but I have to admit that I expected the winter to be a lot worse. We have a great social life and there is a party at someone's place every week. We do a lot of fun stuff. If you have kids, Rochester has great schools, and it is a very safe place to raise them. And if you have a "craving" for a big city, then Minneapolis is about 1h 15 mins away, and Chicago is 6hours away.

In summary, I am very very happy with my residency training here at Mayo, and have no doubts that this is one of the top programs in the coutry!

Please let me know if you have any more questions. 🙂

Hb

 

[panopticon1]

...People say it's a "fellow driven" program...

Just a few comments:
I am also a categorical resident at Mayo Rochester. I agree almost entirely with Hemoglobin. In terms of the "fellow-driven" criticism, we really only work under fellows on the ICUs and on the Heme/Onc services.

I rotated at BIDMC as an MS-IV and the fellow in their unit ran the vent too.

With Heme and Onc, the fellows are responsible for picking the chemo protocol. Otherwise, the residents run the show. Those patients are generally very, very sick; it can be a big show. Specifically on the Onc service, the admitting INTERN is in-house by themselves at night (with backup available from the Heme and ICU services and the fellow on beeper-call).

On consult services, you may find yourself working along-side a fellow, but not under one.

Many services are sub-specialty oriented, but that is not dissimilar from other programs. Hopkins runs things the same way. However, 4 months of internship and 4 months of the 3rd year are devoted to general IM or primary care. When people say that Mayo "won't train you well in General Internal Medicine," they might be accurate if that translated to "run a rural clinic/hospital in Alaska, without Radiology or a Pharmacy, by yourself." Otherwise, you'd be well-equipped to practice IM in an academic or hospitalist setting, as about 20% of our graduates do.

With regard to fellowship placement, your research track record is the single most important factor. The concept of ranking programs, based on reputation alone, to match later in a subspecialty is a bit misguided. Ranking programs with available, suitable mentors who are interested in advancing your career is more worthwhile.

 

[Red58]

I am also a categorical resident at Mayo and I wanted to echo what HgB and panopticon1 stated. This place is NOT fellow driven. On cards, the teams consist of only residents, no fellows. You only work with a fellow in the CCU. In the MICU, the residents make all the decsions. The fellows are there for Vents and supervising procedures. You have a LOT of autonomy here and their are NO private patients. Something that can't be said of other programs. The clinical pathology you see here is amazing. Believe me, you see all the bread and butter cases plus all the zebras. I've seen more CAP and cellulits in my 7 months as an intern than I did at my inner city medical school. As for not attracting residents from big name schools, who cares! Just becuase you went to medical school at xyz, best-ever medical school doesn't mean you're a competent physician and it doesn't reflect anything about an IM program.

What you won't see is a lot of inner city medicine with regards to illegal drug use and its assoicated disease and HIV. Although, the exception is Meth. There's plenty of that around rochester. As for the patient population being >95% white, that's not true either. It's probably more like 60-70%. There is a large population of Hmong and Somilians here in rochester as well as hispanics who all recieve their care at Mayo. If you have any more questions, let me know.