Program Coordinator: Jason B. Wheeler, MD, MSCR, RPVI
Duration: 4 weeks
Availability: Year round
No. of Students: 1-2

Prerequisite

Completion of all core clerkships. Open to senior medical students.

Objectives

To acquaint students with what Vascular Medicine is as a field, become comfortable with diagnosis and management of common vascular pathologies, be able to conduct a Vascular Specific Exam, learn to manage common anticoagulants, and interpret vascular physiologic and ultrasound studies. Students will also learn about major Vascular Medicine Trials relevant to general practice, hypercoagulable states and their testing/diagnosis.

Description

Vascular Medicine is a relatively new discipline but has existed for over 70 years at the Cleveland Clinic, Mayo Clinic, and Harvard hospitals. It is essentially the diagnosis, imaging, and treatment of peripheral vessels (blood and lymph). Vascular Medicine topics make up approximately 15-20% of the ABIM boards, and its core concepts are routinely encountered on inpatient and outpatient services. Currently, ACGME discussions are ongoing as to whether Vascular Medicine will be officially incorporated as a fellowship branch of Cardiology or a direct/distinct branch of Internal Medicine. Topics include common diseases of vessels in all organ systems. Therefore, Vascular Medicine training is highly beneficial for those considering General Internal Medicine, Cardiology, Oncology, Pulmonology, Nephrology, Neurology, General Surgery or Vascular Surgery.

The rotation is primarily outpatient in which you will see patients Monday – Friday from 8 am until approximately 5 pm. There is no call or weekends, though you may be informed about interesting cases over the weekend. You may be asked to see inpatient consults during your outpatient weeks. The Medical Student has a specific Staff Physician as an advisor, but may work with several physicians in the department. Students will interview and examine patients with guidance from a Staff member, eventually seeing patients alone in the last two weeks. 

There will be 2-4 hours of vascular physiologic and ultrasound teaching and reading with a staff member per week. The readings will include primary literature (major trials), textbooks, manuals, and commonly used medication inserts. There will be one-on-one teaching discussions led by the Staff about commonly encountered vascular conditions, the factors involved in selecting treatments, and the practical aspects of outpatient treatment.

Sample Topics:

  • Peripheral Arterial Disease
  • Dialysis Fistula/Graft Management
  • Lipedema
  • Venous Ablation/Phlebectomy/Sclerotherapy
  • Carotid Arterial Disease/Stroke
  • Aortic Aneurysm Monitoring and Management
  • Cancer Associated Thrombosis
  • Hypercoagulable Disorders
  • Anticoagulant Basics
  • Lymphedema
  • Obesity Management
  • Coronary Artery Disease/Antiplatelet Management
  • Venous Insufficiency
  • Arterial and Venous stenting
  • DVT/PE
  • Fibromuscular Dysplasia

Evaluation

Evaluations will be distributed by the UME department to the preceptor at the end of the rotation.