During the first year, fellows rotate on the vascular surgical services on main campus and the community hospitals. One of the general surgery chief residents and a PGY-3 resident from general surgery also participate in this rotation. The fellow manages the patients admitted and operated by his attending staff surgeon. A junior level, PGY-1 or PGY-2 general surgery resident, along with a physician assistant, is also assigned to each service. Each of these teams, consisting of two staff members, a specialty resident and junior assistant, operates together four days a week and sees outpatients one day per week. As a result of this organization, each fellow, including the general surgery chief resident, has an opportunity to manage his/her own patients. Discussion and decisions regarding the course of patient care, including diagnostic evaluation and recommendations for surgical treatment, are carried out during daily patient clinical care rounds.
During the noninvasive vascular diagnostic laboratory rotation, the vascular fellow is expected to become experienced in the use of noninvasive techniques to evaluate vascular disease. Sufficient experience is obtained for the fellow to become familiar with the use of duplex ultrasound to evaluate carotid, mesenteric and renal artery occlusive disease. The fellow becomes familiar with the use of ultrasound vein mapping for lower extremity bypasses, as well as bypass graft surveillance techniques in the lower extremities. The use of ultrasound-guided therapy for acute traumatic false aneurysms is also learned.
During the second year of training, the vascular fellow has rotations on the Endovascular Service, Vascular Medicine Service and research. On the Vascular Medicine Service, the fellow becomes familiar with the nonsurgical management of vascular conditions such as deep venous thrombosis and pulmonary embolism, as well as the management of patients with medical conditions such as systemic vasculitis, Buergerâ€™s Disease, or hypercoagulable conditions. The vascular fellow is expected to complete a research project that may be a clinical study, endovascular technology development or basic science research. The Vascular Surgery Department maintains a case registry, and research coordinators are available for assistance with clinical projects. The institution provides a library, along with editorial, statistical and audiovisual services to complement the development of oral and written presentations.
On Call Schedule»
The first-year vascular fellows and the chief resident from general surgery take call every fourth night and every fifth weekend. During the weeknight call, the fellow is responsible for in-hospital consultations or hospital transfers. The second year fellows participate in the call schedule, which averages every sixth or seventh weekend. During weekend call, the vascular fellow and staff are responsible for coverage of the entire Department of Vascular Surgery. Night call for the vascular fellow may be taken from home. A junior-level general surgery resident is on call in the hospital for the department. An attending staff member in the Department of Vascular Surgery is also continuously available on call.
A didactic lecture is given by an attending staff member each week. This conference covers medical and surgical topics related to vascular disease and includes related basic science topics.
A Vascular Surgery Teaching Conference is held each Thursday. This is a multidisciplinary endovascular/cardiology conference that provides review and discussion of the endovascular management of patients with peripheral vascular disease.
A weekly quality management/case management conference is held on Wednesday morning. It covers morbidity/mortality and quality issues on the surgical and interventional services. The fellows present selected cases for discussion.
On the third Wednesday of the month, a Journal Club is held. Each of the vascular surgery fellows, as well as the chief general surgery resident, is responsible for reporting on an assigned vascular paper from the current literature. The staff members of the department also participate in Journal Club.
Each fellow is allowed three days of meeting time during their first year and five days during their second year of training to attend a postgraduate course or society meeting. The institution provides financial support. Additional meeting time may be supported if the fellow is presenting a scientific paper.
Medical Student Rotation»
The Department of Vascular Surgery offers senior medical students elective rotations in vascular surgery. This experience consists of a four-week rotation with one of the attending staff members and his/her vascular team. Senior medical students are integrated into the clinical program with an experience comparable to a sub-intern.
Physicians who are members of our military services are encouraged to inquire about our training programs. We have opportunities for additional experience in the area of vascular surgery and/or endovascular techniques. Please contact our program coordinator.
0+5 Integrated Vascular Surgery Residency Program
The Department of Vascular Surgery was recently approved for an accredited Integrated Vascular Surgery Residency Program to begin July 1, 2009. The program will provide graduated, incremental training in general surgery and vascular surgery during a five-year program. The rotation schedule integrates appropriate rotations during the first four years, and provides chief residency experience in vascular surgery during the fifth year. A total of 26 months will be spent on Vascular Surgery, 4 months on Vascular Medicine and the stroke service, and 24 months on core or general surgery rotations that include general surgery, intensive care unit, cardiac surgery, thoracic surgery, and pediatric surgery at the appropriate level to optimize learning. It provides 6 months experience as the chief resident on general surgery in addition to the 12 months as chief resident on vascular surgery during the last year of the training.
Vascular surgery inpatient training will be obtained on our dedicated vascular surgery service. The service is composed of five separate teams. Each team performs both endovascular and open cases. The resident will have substantial exposure each year to outpatient and inpatient management, catheter-based therapies, and open operative treatment of vascular patients with progressively increasing responsibility for patient evaluation, diagnosis, and management during the course of training. During each rotation, residents will spend 1 day per week in the outpatient clinic, under direct faculty supervision. Each vascular surgery trainee spends time with all teams during the course of their training.
Vascular interventional training will occur during each vascular rotation. Progressively increasing responsibility will be provided so that the PGY-1 resident performs primarily diagnostic arteriography and venography; the PGY-2 resident will perform basic interventional procedures; the PGY-3-4 residents perform more complex intervention, and the PGY-5 chief resident performs the most complex interventions. During the fifth year, the PGY-5 will rotate on the endovascular service for three months and be focused solely on endovascular procedures. During three months on Vascular Medicine, the trainee will learn vascular laboratory techniques and interpretation. This provides the opportunity for the resident to become proficient in vascular duplex imaging, and to interpret sufficient studies to qualify for the Registered Vascular Reader examination.
Core surgical training will occur primarily on general surgery services that are focused on abdominal surgery, trauma and critical care, that also include laparoscopic procedures. Rotations on thoracic, cardiac, and pediatric surgery will provide experience in the techniques of median sternotomy and thoracotomy, and care of cardiothoracic and pediatric patients. This experience in cardiac surgery will be enhanced by a rotation on the VA cardiac service where no CT fellows rotate. ICU rotations, both in the Surgical ICU and in the Cardiac ICU will supplement the critical care experience associated with care of VS patients while on the VS service.
Vascular Surgery Fellowship & Residency Applications
For a Vascular Surgery Fellowship application, go to:
ERAS®, the Electronic Residency Application Service at The Association of American Medical Colleges
The application process begins December 1 and extends through February 1.
For a Vascular Surgery Residency application, visit:
ERAS® - the Electronic Residency Application Service
The application process begins September 1st.
Specific information regarding either the Vascular Surgery Fellowship or Residency program may be obtained by contacting:
Local 216.444.4766 or toll-free 800.223.2273 ext. 44766
Elective Rotation Applications
Medical students and residents interested in submitting an application to the Department of Vascular Surgery for an elective rotation may contact the Division of Education (Graduate Medical Education at 216.444.5690) or go to the Graduate Medical Education website and follow the instructions under the application process.