The Mayo Clinic David Farley, MD
August 21, 1883
F5 Tornado
Sisters of St. Francis
W.W. Mayo
St. Mary s Hospital 1889
Dr. Will
Dr. Charlie
1907
1913: Incoming Interns
1914 Building
Mayo Foundation for Medical Education and Research Donation to U of Minnesota $1,650,344.79 June 9, 1915 Half of trainee slots for UM students
1916: St. Mary s Hospital USA 6176 Canada 557 Germany 380 Catholic 1510 Methodist 1298 Non-Dem 1277
1916: St. Mary s Hospital Anesthesia 8309 Ether 706 Local 25 Ethyl Chloride
Nurse Anesthetists
1929
1933 OR
1939
Surgical Training Intern 1 st Assistant Nurse
Preceptorship
1 st Assistant Schedule Trainee Fall Winter Spring Summer 1 Charlie Charlie Charlie Charlie 2 Will Will Will Will 3 Judd Judd Judd Judd 4 Balfour Balfour Balfour Balfour 5 Beckman Beckman Beckman Beckman 6 Masson Masson Masson Masson
Monday, March 18, 1918 1 2 3 C.H. Mayo W.J. Mayo E.S. Judd Exophthalmic Goiter Thyrtoxic Goiter Duodenal Ulcer Tumor Left Breast Left Hydronephrosis Trachelorrhaphy Appendix Gall bladder Left Inguinal Hernia Explore Pelvic Mass Gall bladder Duodenal Ulcer Gall bladder Zenker Diverticulum Laryngeal Tumor Suprapubic Prostatectomy 4 5 6 D.C.Balfour J.C.Masson W.E. Sistrunk Gall bladder Uterine Myomata Appendix Parotid Gland Tumor Exophthalmic Goiter Ligation Thyroid Adenoma Gall bladder Subtotal Abdominal Hysterectomy Excision Tubercular Lymph node Thyroid adenoma Subtotal Hysterectomy Right Breast nodule Appendix Cleft Palate
Tuesday, March 19, 1918 1 2 3 C.H. Mayo W.J. Mayo E.S. Judd Gall stones Duodenal Ulcer with Obstruction Remove Distal Fragment Sigmoid Lacerated Cervix & Perineum Duodenal Ulcer Abdominal myomectomy Left nephrectomy Explore Appendix region Laparotomy for Ovarian Cyst Duodenal Ulcer Appendix Gall bladder Laryngeal Tumor Suprapubic prostatectomy 4 5 6 D.C.Balfour J.C.Masson W.E. Sistrunk Exophthalmic Goiter Thyroid Adenoma Gall bladder Left Varicocele & Appendx Amputation Cervix Varicose Veins Exophthalmic Goiter Ligation Thyroid Adenoma Colloid goiter Gall bladder Excision gland neck D&C Hemorrhoids & Anal Fissure Exophthalmic goiter. Ligation. Exophthalmic goit Thyroidectomy Laparotomy for ovarian cyst? Post-op Ventral hernia D&C Hemorrhoids & Fistula
Wednesday, March 20, 1918 1 2 3 C.H. Mayo W.J. Mayo E.S. Judd Goiter. Ligation. Gastrojejunal Ulcer? Carcinoma Rectum. Mixter colostomy. Ureterolithotomy Subtotal Abdominal hysterectomy Gall bladder. Explore ducts. Kraske operation for rectal cancer 4 5 6 Gall bladder Duodenal ulcer Gall bladder Gall bladder Bevan operation for diverticulum Resection carcinoma bladder D.C.Balfour J.C.Masson W.E. Sistrunk Exophthalmic Goiter Gall bladder Internal shortening of round ligaments & appendectomy Appendix Trachelorrhaphy. Bovee operation. Appendix Gall bladder Right Inguinal hernia Tuberculous glands neck Right inguinal hernia Duodenal ulcer Varicose veins right leg Excision pedunculated fibroid
Saturday, March 23, 1918 1 2 3 C.H. Mayo W.J. Mayo E.S. Judd Duodenal Ulcer Perforating Gastric Ulcer Left Pelvolithotomy or Nephrectomy Epididymectomy Ovarian Cyst Gastric Ulcer Ureterolithotomy. Gall bladder. Anal stricture 4 5 6 Thyroid adenoma Parotid tumor Right Femoral Hernia Internal Alexander operation. Repair cervix and perineum. Mayo operation - prolapsed uterus D.C.Balfour J.C.Masson W.E. Sistrunk Gall bladder Duodenal ulcer Right inguinal hernia. Tumor shoulder. Appendix. Kraske operation for carcinoma of rectum Thyroid adenoma Gall bladder Appendix. Examine Stomach. Pelvic tumor Excision specimen cervix for dx Thyroid adenoma Duodenal ulcer Appendix Bovee operation. Internal Alexander operation. Femoral H. Dilitation vulva Hemorrhoids
March 18-23, 1918 M T W Th F S Thyroid 6 7 3 2 4 3 Appendix 3 3 3 0 1 3 Hernia 2 1 2 2 3 3 Gallbladder 5 3 6 2 2 3 GI Ulcer 1 3 3 2 5 5 Gyn 5 7 3 3 6 7 Other 9 10 9 15 7 9 25 13 13 21 19 31 59 Total 31 34 29 26 28 33 181
1916: St. Mary s Hospital 3436 Males 4617 Females Age < 12 121 12-20 375 20-30 1606 30-40 2040 40-50 1988 50-70 1847 >70 76
1916 St. Mary s Hospital Number Deaths % Thyroid 1841 21 1.1 Stomach 368 18 4.9 Duodenum 494 9 1.8 Appendix 887 6 0.7 Small Intestine 74 3 4.1 Large Intestine 130 13 10.0 Rectum 159 10 6.3 Hernia 623 2 0.3 Gallbladder 1024 23 2.2 Pancreas 154 2 1.3 Total 10,209 193 1.9
Clinical & Path Demonstrations S M T W Th F S 5:00 X-Ray Diagnosis Diseases Of the Alimentary Canal Diseases Of the Thyroid, Heart, & Esophagus Diseases Of the Blood and Spleen Diseases Of the GU System Carman & Staff Graham Eusterman & Staff Plummer & Staff HZ Griffin & Staff W Braasch & Staff Visiting Surgeons Club Mayo Staff Visiting Surgeons Club
Visitors to Mayo
Daily Visitors
Did this training work?
Repetitions
Mastering Surgery Deliberate Practice Feedback Drive
Cortisone Synthroid
A Day at Mayo Patients: 5000 Operations: 300 CT scans: 600 MRIs: 400 Lab Tests 40,000 Blood products 300 50 states 136 countries
Mayo Clinic is BIG SMALL 63,000 employees 4,720 physicians/scientists. 3,000 studies/yr 7,200 publications/yr 292 residency & fellowship programs Trainees = 1800 PhD = 35 MD = 54
Simulation Lab
Short Intros Brevity Offer ideas Q & A Breaks Lunch Dr. Cook Mastery
Saturday 8:00 Geffen Auditorium Sim Fellows Sim Center: 6 rotations Lunch Debriefing