Mankato Curriculum and Call

MORE ABOUT RESIDENTS AS TEACHERS

Family medicine residents are directly responsible for a portion of medical student clinical education during clinical experiences and clerkships.

Medical education features a closely connected cycle of teaching, learning, and progressive responsibilities; senior learners teach junior learners, and all learners are involved in ongoing professional and personal development.

Residents of the eight University of Minnesota family medicine residency programs have many responsibilities, including that of supervisors and educators. Most medical students encounter family medicine residents as teachers during the Family Medicine Clerkship. Therefore, residents receive instruction about clerkship/rotation goals and objectives as well as training in teaching methods.

Resources

Resources are available to aid residents in development as teachers.

  • Residents Teaching Students: Developed by family medicine medical student education director David Power, MD, MPH, and colleagues, it provides an overview of several teaching strategies. One of these is a common teaching method used by both residents and faculty, known as the One Minute Preceptor.
  • Faculty advisors and residency directors also can connect residents with resources to enhance teaching abilities.

Rotations

First-Year Rotations

CRITICAL CARE

Length: four weeks

Location: MCHS Hospital, Mankato

Each resident should carry a minimum patient load of at least two to three patients while on rotation and see a total of 15 patients during the four-week rotation.  
Attendings are very willing to have residents participate in procedures. Read about arterial lines, LP’s, central lines, paracentesis, codes and intubations. PGY1 should read on the basics of ventilator settings and use, i.e. why various settings are chosen in different situations such as ARDS, Status Asthmaticus and COPD exacerbation.


EMERGENCY MEDICINE

Length: four weeks

Location: MCHS Hospital, Mankato

This four-week PGY1 rotation is expected to give the resident a minimum of 38 – 42 hours per week (12 shifts) in the ED working under the supervision of ED physicians.   Residents will be in the family medicine continuity clinic at least one half-day per week during the PGY1 EM rotation.


FAMILY MEDICINE, CONTINUITY CARE

Length: varies per program year

Location: MCHS Hospital, Mankato

While the residents’ acquisition of knowledge, skills, and attitudes of family medicine will take place during all curricular elements, the primary setting for this training is in the Family Medicine Clinic, as residents provide continuing, comprehensive care to their panels of patients.

  • PGY1: One to two half days per week; there is not a PGY1 family medicine rotation, however, continuity clinic occurs during all rotations
  • PGY2: Three to five half days per week
  • PGY3: Three to five half days per week
  • Urgent Care: PGY2 and PGY3 residents will also spend occasional half days in the Family Medicine Center seeing acute care patients.   

FAMILY MEDICINE INPATIENT SERVICE

Length: twelve weeks

Location: MCHS Hospital, Mankato

This is the main inpatient rotation for all three years of training; three blocks (12 weeks total) in PGY1 and four weeks in PGY2 and PGY3. Residents on inpatient service are required to carry a minimum of five adult patients daily. G2 and G3 residents have the added responsibility of assisting and mentoring G1 residents. Residents are supervised by the hospitalists and family physicians to which they are assigned.


OBSTETRICS

Length: four weeks

Location: Park Nicollet Methodist Hospital, St. Louis Park

During this rotation the resident will develop skills in the assessment and management of low risk obstetrical patients. Skills will be attained through demonstration, participation, and self-directed learning. There may also be an opportunity for participation in the care of high-risk obstetrical patients.

One in four call during this rotation.


OPHTHALMOLOGY

Length: two weeks

Location: Ophthalmology Associates, Mankato

This experience includes ophthalmic examinations on patients from all age groups, presenting with a variety of eye related problems. Appointments are scheduled 8:30 am to 5 pm. Residents also obtain substantial additional ophthalmology training throughout the three years of their residency with their experience in the FMC and ER.


ORTHOPEDICS

Length: four weeks

Location: Orthopedic & Fracture Clinic, Mankato

Orthopedics is a required subspecialty rotation in surgery. Residents will spend six weeks on the orthopedic rotation; this is usually structured as one four-week block at OFC during PGY1 and one two-week block at MCHS with an additional two weeks of sports medicine at Minnesota State University, Mankato during PGY2. Some surgery is included but is mainly an outpatient experience.


OTOLARYNGOLOGY

Length: two weeks

Location: MCHS Specialty Clinic, Mankato

This clinical experience provides several procedures opportunities and some OR time if the resident is interested and time allows. It is expected that you will evaluate new patients and perform appropriate procedures with the attending physician while in clinic. You will spend time in the vestibular lab and with the audiologist.


PALLIATIVE MEDICINE

Length: two weeks

Location: MCHS Hospital & Cancer Center, Mankato

Residents will be an integral member of the palliative medicine team in the care of seriously ill people and their families. Emphasis will be placed on symptom management and communication skills with patients, families and providers that will be useful throughout residency and career.


PEDIATRICS, INPATIENT

Length: four weeks

Location: Minneapolis Children’s Hospital

Residents work with pediatric and med/peds residents to admit and care for children in a busy regional pediatric teaching hospital. In addition, all team members work intimately with attending physicians in order to improve knowledge, efficiency, and patient care.

During this rotation, expect to be actively involved in continuation of care from previous shift; this may involve admissions, preparing or initiating discharge orders, updating families and answering questions, ordering medications or services for discharge preparation, cross-cover, or following up on tests and radiologic studies performed.


PEDIATRICS, OUTPATIENT

Length: four weeks

Location: MCHS Specialty Clinic, Mankato

The primary expectation for the resident is to see the majority of the patients in clinic with preference given to well-child visits, ADHD/mental health initial evaluations, and acute pediatric visits that would be most relevant to family medicine.


RADIOLOGY

Length: three weeks

Location: MCHS Hospital, Mankato

Residents will begin by spending the majority of their time with general pediatrics but must also have experiences with pediatric specialties (cardiology, urology, and neurology), pediatric telemedicine, and the pediatric medical-dental integration clinic.


SURGERY

Length: four weeks

Location: MCHS General Surgery Facility, Mankato

This rotation provides instruction in the diagnosis and management of surgical problems and emergencies and the appropriate and timely referral of them for specialized care. The resident will receive instruction regarding the varieties of surgical treatments, the potential risks associated with them in order to be able to give proper advice, and explanation and emotional support to the patients and their families. The resident will receive training in pre- and post-operative care, basic surgical principles, asepsis, handling of tissue, and technical skills to assist the surgeon in the operating room. Outpatient experiences in general surgery are encouraged in order for the resident to achieve competency in the diagnosis and management of a wide variety of common ambulatory general surgery problems.


Urology

Length: two weeks

Location: MCHS Specialty Clinic, Mankato

This rotation includes opportunities for rectal and genital exams and to gain knowledge in areas such as urological dysfunction and obstruction, manifestations of systemic disease, and test interpretation. Clinic begins at 8:30-9:00 a.m. depending on physician. Residents have the ability to be involved in both clinic and surgical procedures.

Second-Year Rotations

CARDIOLOGY

Length: three weeks

Location: MCHS Hospital, Mankato

Cardiology is a three-week longitudinal rotation scheduled with the Mayo Clinic Health System Cardiologists throughout PGY2. Residents will demonstrate an understanding of complex relations and mechanism of cardiovascular disease, as well as perform appropriate history and physical exams and order appropriate diagnostic studies. The resident will participate and gain experience in performing several cardiovascular exams. 


ELECTIVES

Length: four weeks

Location: varies

Residents have an opportunity to schedule four weeks of electives in PGY2. Several options are available within the Mayo Clinic Health System. See information on electives for more details.


EMERGENCY MEDICINE

Length: four weeks

Location: New Ulm Medical Center, New Ulm

As part of their PGY2 Emergency Medicine rotation, residents must complete a minimum of three 12-hour shifts in the New Ulm Medical Center Emergency Department. This rural emergency medicine experience will introduce the resident to the different resources and challenges of rural emergency medicine not experienced in Mankato.


FAMILY MEDICINE, CONTINUITY CARE

Length: varies per program year

Location: MCHS Eastridge Clinic, Mankato

While the residents’ acquisition of knowledge, skills, and attitudes of family medicine will take place during all curricular elements, the primary setting for this training is in the Family Medicine Clinic, as residents provide continuing, comprehensive care to their panels of patients.

  • PGY1: One to two half days per week; there is not a PGY1 family medicine rotation, however, continuity clinic occurs during all rotations
  • PGY2: Three to five half days per week
  • PGY3: Three to five half days per week
  • Urgent Care: PGY2 and PGY3 residents will also spend occasional half days in the Family Medicine Center seeing acute care patients

FAMILY MEDICINE, INPATIENT SERVICE

Length: four weeks

Location: MCHS Hospital, Mankato

This is the main inpatient rotation for all three years of training; three blocks
(12 weeks total) in PGY1 and four weeks in PGY2 and PGY3. Residents on inpatient service are required to carry a minimum of five adult patients daily. G2 and G3 residents have the added responsibility of assisting and mentoring G1 residents. Residents are supervised by the hospitalists and family physicians to which they are assigned.


FAMILY MEDICINE, RURAL

Length: four weeks

Location: MCHS, New Prague

This rotation is structured to give residents exposure to rural hospital medicine, which increasingly involves transitional care and which is the transition from acute care hospitalizations to return to home/residential facilities. These patients often have complex and prolonged hospital stays prior to arrival at rural hospitals and are dependent on rural family physicians to take over and continue to manage and address their unique health care needs. This exposure to rural hospital care will allow residents to better understand the needs of their patients and the rural health care team when transferring inpatients from Mankato back to rural communities.

In addition, rural family physicians find themselves in leadership positions in the communities they serve in both medically related areas and general community organizations. This rotation will expose residents to knowledge needed for medical leadership in a small community and advance their skills in medical management.

Residents will be at the rural site for two full days with two nights of emergency room shifts each week, and may round/follow up on admissions in the inpatient unit on both post-call days.


GYNECOLOGY

Length: four weeks

Location: MCHS Specialty Clinic, Mankato

Resident will have two separate experiences through which they demonstrate complex relations and mechanism of disease in the evaluation of common gynecologic conditions. The longitudinal care will occur during the entire three years of continuity clinic at the Eastridge Family Medicine Clinic. The rotational experience in gynecology will occur during one four-week block usually scheduled during the second year of residency. During this rotation, residents will be under the supervision of the OB-GYN faculty and will be actively involved in the outpatient practice of delivering women’s health care at the Specialty Clinic Department of OB-GYN.


OBSTETRICS

Length: four weeks

Location: MCHS Hospital, Mankato

The PGY2 rotational experience in obstetrics is a four-week inpatient Labor and Delivery rotation at MCHS Hospital Mankato with the Mayo Clinic Health System Obstetricians.  In-house MCHS OB rotation call occurs two times per week.


ORTHOPEDICS

Length: two weeks

Location: MCHS Specialty Clinic, Mankato

Orthopedics is a required subspecialty rotation in surgery. Residents will spend six weeks on the orthopedic rotation; usually structured as one four-week block at OFC during PGY1 and one two-week block at MCHS with an additional two weeks of sports medicine at Minnesota State University, Mankato during PGY2. Some surgery is included but is mainly an outpatient experience.


PEDIATRICS, INPATIENT

Length: four weeks

Location: MCHS Hospital, Mankato

Residents participate in any inpatient pediatric admissions, consults, deliveries, nursery admissions, etc., as requested by the pediatric hospital attending physician from 7 a.m. until 7 p.m., Monday through Sunday.


PEDIATRICS, OUTPATIENT

Length: four weeks

Location: MCHS Specialty Clinic, Mankato

Residents will begin by spending the majority of their time with general pediatrics but must also have experiences with pediatric specialties (cardiology, urology, neurology), pediatric telemedicine, and the pediatric medical-dental integration clinic.


SPORTS MEDICINE

Length: two weeks

Location: Minnesota State University, Mankato

This is a two-week PGY2 rotation usually in the fall and winter that follows the PGY2 Orthopedic rotation. This aspect of the musculoskeletal curriculum will focus on aspects of sports medicine relevant to family physicians. For those residents who have an interest in more sports medicine training, there are many elective opportunities to get involved in area school sports and community recreation.

Third-Year Rotations

ELECTIVES

Length: four weeks

Location: varies

Residents have an opportunity to schedule four blocks of electives in PGY3. Several options are available within the Mayo Clinic Health System. Away rotations must be scheduled six to 12 months in advance. See information on electives for more information.


FAMILY MEDICINE, CONTINUITY CARE

Length: varies per program year

Location: MCHS Eastridge Clinic, Mankato

While the residents’ acquisition of knowledge, skills, and attitudes of family medicine will take place during all curricular elements, the primary setting for this training is in the Family Medicine Clinic, as residents provide continuing, comprehensive care to their panels of patients.

  • PGY1: One to two half days per week; there is not a PGY1 family medicine rotation, however, continuity clinic occurs during all rotations
  • PGY2: Three to five half days per week
  • PGY3: Three to five half days per week
  • Urgent care: PGY2 and PGY3 residents will also spend occasional half days in the Family Medicine Center seeing acute care patients. 

FAMILY MEDICINE, INPATIENT SERVICE

Length: four weeks

Location: MCHS Hospital, Mankato

This is the main inpatient rotation for all three years of training; three blocks
(12 weeks total) in PGY1 and four weeks in PGY2 and PGY3. Residents on inpatient service are required to carry a minimum of five adult patients daily. G2 and G3 residents have the added responsibility of assisting and mentoring G1 residents. Residents are supervised by the hospitalists and family physicians to which they are assigned.


FAMILY MEDICINE, SKIN CARE

Length: four weeks

Location: MCHS Specialty Clinic, Mankato

Residents complete a four-week skin care rotation through which the resident will demonstrate competency in the evaluation and management of common dermatologic conditions, treatments, and procedures.


NEUROLOGY

Length: two-week elective

Location: New Ulm Medical Center, New Ulm

Neurology is a two-week elective rotation which usually occurs in the PGY3 year.  Residents typically work at the New Ulm Medical Center three days per week and continuity clinic at Eastridge Clinic in Mankato.


NEUROSCIENCE

Length: two weeks

Location: MCHS Specialty Clinics, Mankato

Neurosciences is a two-week block rotation which usually occurs in the PGY3 year:

  • One week in Neurosurgery, and
  • One week in Physical Medicine and Rehabilitation (PM&R) 

PEDIATRICS, EMERGENCY MEDICINE

Length: four weeks

Location: MCHS Hospital, Mankato

The Pediatric Emergency Medicine rotation is a two-week PGY3 rotation that focuses on the evaluation and management of pediatric patients in the emergency room.  

Electives

Electives

Local and international electives are available to meet the future practice needs of residents. Allow yourself 6 to 12 months of planning for away electives.

See more information about family medicine resident international electives

Examples of some elective options offered through various MCHS Providers and facilities include:

  • Allergy
  • Anesthesia
  • GI/hepatology
  • Hematology/oncology
  • Infectious disease
  • Laboratory medicine & pathology
  • Nephrology
  • Orthopedics
  • Physical medicine are spine care
  • Procedures elective
  • Pulmonology
  • Trauma surgery
  • Wound care

Other non-MCHS elective options

  • Community Health FQHC
  • Dermatology
  • Rural family medicine
  • Forensic science/psychiatry
  • Advanced orthopedics
  • Program in Human Sexuality
  • Neuromuscular medicine
  • International family medicine

Longitudinal Curriculum

Longitudinal Rotations

Most longitudinal rotations are integrated into the entire three year program.

BEHAVIORAL HEALTH
Location: MCHS Eastridge Clinic

Throughout all three years of training, residents see their own patients while in the Family Medicine Residency Clinic with psychology consultation and training provided via precepting and integrated care. Our clinic’s integrated behavioral health model means that residents co-manage their patients jointly with psychologists or therapists and behavioral health practitioners may see patients in the room alongside residents. This allows the integrated behavioral health team to both model and supervise patient assessment and intervention.


COMMUNITY MEDICINE/POPULATION HEALTH
Location: Various facilities within Mankato and surrounding area

The four distinct components to teaching population health include the domains of

  1. Public health
  2. Community engagement
  3. Critical thinking
  4. Team skills

By focusing on these domains, the resident will attain the knowledge, skills, and attitudes necessary to care for patients within the context of the integrated medical neighborhood.


ETHICS AND CULTURAL COMPETENCE
This section of the curriculum does not involve a clinical rotation, but rather, is a continuous emphasis throughout residents’ three years of training. Discussing ethical principles related to patient care is an important aspect of each clinical rotation. Faculty and attending staff incorporate discussion of relevant ethical principles as they are pertinent to patient care. Additionally, residents participate in noon seminars related to ethics bimonthly.


FAMILY MEDICINE
Location: Predominantly MCHS Eastridge Clinic and Hospital settings.

Family medicine is a comprehensive specialty. The FM physician assumes the responsibility for the total health care of the individual and family, taking into account the social, physiological, economic, cultural, and biologic dimensions. Therefore, this program emphasizes the importance of comprehensive patient and family medical care.  The residents are given the opportunity to achieve high levels of competence in health maintenance, in disease and problem management, and in the development of knowledge, skills, and attitudes which reflect competence in comprehensive patient management and patient education.

The responsibility to provide health care to families is a fundamental concept of the discipline of FM. This program provides the opportunity for residents to acquire knowledge and experience in the provision of longitudinal health care to families. This includes assisting family members in coping with serious illness of other family members. A major responsibility of the resident is also the maintenance of health among family members.

Comprehensive care is taught longitudinally in didactic and clinical settings during the entire period of residency training.


GERIATRICS

Location: Janesville Nursing Home or Laurel’s Peak, determined by team assignment

Length: one half day per month on selected Tuesday morning for three-year program duration

Geriatric training is longitudinal, allowing residents to maintain continuity of care throughout all three years of training. Geriatric training occurs through the residents’ continuity of care patient panel in the family medicine center, general hospital service, nursing home continuity of care experience, and during clinical rotations. Residents care for geriatric patients and manage acute illnesses and injuries, chronic illnesses, disease prevention, health promotion, and end of life issues. This includes instruction in the physiological changes of aging, pharmacokinetics in the elderly, functional assessment of the elderly, extended care facility management, Hospice, and home care.

Long-term care rounds are scheduled one half day per month on a Tuesday morning, potentially totaling 144 hours over three years. Each resident is assigned to one of four teams that follow patients at one of three community-based sites. Residents have geriatric patients assigned to them and assume the role of primary care provider for these patients.


NEWBORN NURSERY ROUNDING SERVICE

Location: MCHS Hospital, Mankato

The newborn nursery rounding service is done one week at a time. Residents round on all well newborns of the MCHS Eastridge, Northridge, and Lake Crystal clinic providers and any assigned newborns. This includes admissions, progress notes, discharges, and circumcisions.

Each PGY1 is responsible for four sessions of weekend rounds.


OBSTETRICS, CONTINUITY

Location: MCHS Hospital and Eastridge Clinic, Mankato

The longitudinal continuity OB care will occur during the entire three years at the Eastridge Family Medicine Clinic and at the hospital. Residents will assume responsibility for providing antenatal, natal, and postnatal care on a continual basis to their patients. These patients will be derived from the panel of patients each resident develops at their Family Medicine Clinic.

For those who choose to not do deliveries in practice after residency it is highly recommended that you share your continuity OB patients with another resident who is planning on doing OB deliveries after residency. You and your sharing resident will be required to follow your continuity OB patient’s prenatal course.

Share Care
Resident continuity OB patients will participate in the Share Care model of OB care for prenatal care, but will be delivered by the resident with direct supervision by either the MCHS OB on-call physician or the UMN Family Medicine OB faculty.

Call
For the longitudinal OB rotation PGY2 and PGY3 residents will take call from home. This can be together with family medicine call. Residents will cover all residency OB patients when their primary resident physician cannot be available.


PRACTICE MANAGEMENT

Location: MCHS Hospital and Clinics

The University of Minnesota Mankato Family Medicine Residency Program has developed a curriculum with a combination of didactic instruction and practical experience focused primarily in the second year at the Eastridge MCHS Clinic. This will occur through several organized activities:

  • Didactic lectures
  • Hands-on practice management in the MCHS Mankato organization,
  • Leadership experience through sessions with MCHS leaders
  • Leading resident team meetings with fellow residents and clinic nurses
  • Practice management course offered by the University of Minnesota Department of Family Medicine

 

Osteopathic Recognition Track Curriculum

Our residency program has osteopathic recognition through the ACGME. We have a rich culture of teaching osteopathic principles and practices as well as providing clinical experience for incorporating OMT into daily family medicine practice. All of our DO residents participate in our formal osteopathic track. Our MD residents have the opportunity to participate in osteopathic-focused education throughout their residency and if desired can enroll in our formal osteopathic track as well.

Residents receive training in a variety of settings:

  • Ambulatory family medicine clinic – longitudinal
  • Inpatient family medicine – longitudinal
  • Nursing home - longitudinal
  • Neurosciences rotation
  • Sports medicine rotation
  • Mankato Marathon – osteopathic finish line


Didactic training throughout residency includes:

  • Local OMT workshops/procedure labs
  • UMN OMT workshop
  • Bimonthly didactics/case series
  • Yearly FDM module

We offer opportunities for teaching and scholarly activity within our osteopathic track and have a variety of resources including OMT tables, patient teaching aids, journal memberships, and more.

Osteopathic Requirements

Residents that have graduated from an allopathic medical school will have the opportunity to participate in osteopathic-focused education throughout their residency.

To enroll in the osteopathic track, the following requirements must be met:

  • Complete a minimum of 120 hours of instruction in osteopathic philosophy and techniques in manipulative medicine before beginning residency. At least a portion of the hours should be formally accredited instruction (AOA, AACOM, ACOFP)
  • A personal statement explaining interest in an osteopathic track
  • Letter of recommendation from an osteopathic physician who actively performs OMT in their practice
  • Successful completion of an interview with a member of the osteopathic faculty
  • Successful completion of a written exam covering OPP
  • Successful completion of the program’s OMT competency performance evaluation
  • Recommendation from the local program director to join the osteopathic track

Non-Clinical Training

Mankato Non-Clinical Training

An equally important focus is to promote life-long learning and empower residents with the skills to balance personal and professional responsibilities for a rewarding career in family medicine.

The following are non-clinical, longitudinal training that residents receive:

  • Ethics and cultural competence
    Discussion of ethical principles related to patient care is an important aspect of each clinical rotation. Residents also participate in noon seminars related to ethics bimonthly.
  • Evidence-based medicine
    Residents learn to adequately use information technology to find and use the best evidence from scientific studies to improve patient care and knowledge.
  • Interpersonal and communications skills
    Residents learn how to establish effective therapeutic relationships with patients, families, and colleagues by using listening, narrative, and non-verbal skills. Residents also learn how to adequately educate patients, families, colleagues, and learners.
  • Resident wellness and professionalism
    Monthly peer group meetings allow residents to provide support, guidance, and nurturing to one another throughout residency. Guidance from peers and faculty is provided. Seminars related to resident emotional and physical well-being, communication, and professionalism are scheduled monthly.
  • Scholarly activity and practice-based learning and improvement
    Residents learn to develop the skills necessary to evaluate scientific literature that's important to practicing evidence-based medicine in a primary care setting.

Call

Call


First year

  • Night call occurs on two rotations: Minneapolis Children's inpatient rotation - approximately six nights of admissions and cross over with preceding and following days off
  • Methodist Hospital OB - every fourth night (seven shifts) of 24-hour call

Second year

  • Every ninth night and every ninth weekend
  • In-house night call occurs on 2 four-week rotations:
      • In-house MCHS OB rotation call occurs two times per week
      • In-house New Prague Family Medicine occurs two times per week

Third year

  • Every ninth night and every ninth weekend