The Development of an Academic Medical Center in Rochester

In 1915 the Mayo brothers created the Mayo Foundation for Medical Education and Research and established a formal relationship with the University of Minnesota, located ninety miles away in Minneapolis. Louis Wilson, a pathologist the Mayo brothers had hired in 1905, championed a more rigorous system of specialty training. An educational reformer, Wilson focused on the need to improve postgraduate training at a time when the emphasis in the United States was on closing or reforming substandard medical schools. The fellowship program established in Rochester, Minnesota, was unique in that it required candidates to have graduated from an acceptable medical school and to have completed an internship. Mayo fellows spent three years preparing for careers as medical or surgical specialists. Fear of competition led several physicians in the Twin Cities to attempt to end the affiliation between the Mayo Foundation and the University of Minnesota. Their efforts failed.

Supreme Court Holds in Mayo Foundation that Medical Residents are Not Students

ABSTRACT In Mayo Foundation v. U.S., the United States Supreme Court recently ended a dispute as to whether stipends paid to medical residents are subject to FICA. A statutory provision excludes “students” from FICA, and the question was whether medical residents could be considered students, thereby making them eligible for the exclusion. The Treasury Department amended its definition of “student,” as that term is used in the Internal Revenue Code (IRC), following adverse decisions in several circuits. What began as a case of statutory construction turned into one of administrative authority. Ultimately, the Court upheld the regulation, which categorically denies medical residents from being eligible for the student exemption. The Supreme Court's decision reaches far beyond this narrow issue, however, because the underlying analysis applies in all areas of administrative law. The Court made clear that a uniform standard of deference applies not only to the Treasury Department, but to all administrative agencies. That standard, which was announced by the Court in Chevron USA v. Natural Resources Defense Council, Inc. in 1984, states that an agency's rule or interpretation will be upheld as long as Congress was silent or ambiguous with regard to the issue at hand, and the rule or interpretation is a permissible construction of the statute.

Alveolar Microlithiasis

• Appearance is that of flicking a toothbrush dipped in paint • One-third of patients are asymptomatic • Good example of how far lung goes down behind diaphragm • A picture says it all, except what causes it! Mayo Clin Proc. 1983 May;58(5):290–300. Used with permission of Mayo Foundation for Medical Education and Research....