Variability in 2-year training programs in vascular surgery based on results of an Association of Program Directors in Vascular Surgery survey

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Abstract

Objective:

Although a great deal of attention has recently focused on 5-year integrated (0+5) training programs in vascular surgery, a paucity of data exists concerning variability of daily assignments in 2-year (5+2) vascular fellowships.

Methods:

We polled Association of Program Directors in Vascular Surgery members with 2-year vascular fellowships to determine the number of days in a 5-day work week that first- and second-year fellows were assigned to open vascular operations, endovascular procedures (hospital vs nonhospital facility), arterial clinic, venous clinic, noninvasive vascular laboratory (NIVL), and research.

Results:

Of the 103 program directors from 5+2 vascular training programs, 102 (99%) responded. The most common schedule for both first- and second-year fellows was performing both open and endovascular procedures in the hospital on the same day 4 days of the week and spending time in combined artery and vein clinic 1 day of the week. Program directors developed different schedules for each year of the 2-year fellowship in about half (55% [56]) of the programs. A small minority of programs devoted days to only open surgical cases (13% [13]), a separate venous clinic (17% [17]), or a separate arterial clinic (11% [11]) and performed endovascular procedures in a nonhospital facility (15% [15]). All but three programs had mandatory time in clinic both years. Approximately one-third (30% [31]) of programs designated time devoted to research, whereas the others expected fellows to find time on their own. Although passing the Registered Physician in Vascular Interpretation examination is required, there was devoted time in the NIVL in only 60% (61) of programs.

Conclusions:

Training assignments in terms of time spent performing open and endovascular procedures and participating in clinic, the NIVL, and research varied widely among Accreditation Council for Graduate Medical Education-accredited 5+2 vascular fellowships and did not always fulfill Accreditation Council for Graduate Medical Education guidelines. In the current era of emphasis on endovascular-based interventions, few programs devoted days to purely open surgical procedures. Endovascular experience in a nonhospital facility (where these procedures will likely become more common in the future), outpatient venous procedures, and designated time devoted to the NIVL and research were lacking in many programs. These results provide a valid data set for the Association of Program Directors in Vascular Surgery to consider establishing guidelines for training assignments in 5+2 vascular training programs.

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