Endovascular Training of Vascular Surgeons in the USA

Abstract

Current trends in vascular surgery in the USA are driven by increased demand for endovascular procedures. Traditionally-trained vascular surgeons have adapted to these trends by acquiring endovascular skills; vascular surgery fellowships were standardized to 2-years to incorporate endovascular training. However, the traditional "5 + 2" training paradigm appears to be less appealing to the current generation of surgical students, resulting in fellowship positions going unfilled, and potentially predicting a shortage of vascular surgeons. Recognition of this trend has led to the adoption of alternative training pathways, in particular the integrated "0 + 5" pathway, to supplement the traditional "5 + 2" independent pathway. The integrated pathway has several perceived advantages for vascular surgery trainees including early teaching of endovascular skills. However, it has challenges that include maintaining open operative skills and changing strategies to attract candidates from among the pool of medical students instead of the pool of general surgery residents. Simulators, both open and endovascular, are playing an increasingly important role in training programs as well as for outreach programs to medical students. Recruitment strategies for future generations of vascular surgeons in the USA may need to consider residents' lifestyle preferences as well as outreach to traditionally underrepresented groups such as women and minorities.

Managing Peripheral Artery Disease in Diabetic Patients: A Questionnaire Survey from Vascular Centers of the Mediterranean Federation for the Advancing of Vascular Surgery (MeFAVS)

“…13 Simulators, both open and endovascular, play an increasingly important role in training programs as well as outreach programs for medical students. 14…”

Current Status of Endovascular Training for Cardiothoracic Surgery Residents in the United States

“…The specialty of vascular surgery underwent similar changes years ago when endovascular surgery flourished, with the successful incorporation of endovascular procedures into vascular training programs [8,9]. The specialty took an early and proactive approach, adapting its training paradigms to meet the demands of evolving technology while maintaining case volume and avoiding dilution of cases to other specialties.…”

Multispecialty involvement in the management of type B aortic dissections in the endovascular era-Implications for training cardiothoracic residents

“…Traditional open surgical procedures are now increasingly being reserved for patients with complex anatomies unfavorable for endovascular interventions while balloon angioplasty and stenting are commonly used as first line therapies. Catheter‐skilled specialists, including vascular surgeons, interventional cardiologists, and interventional radiologists are continuing to expand their training and use of endovascular technologies . One area where this trend is particularly noticeable is with the evolving management of acute type B aortic dissections (aTBAD).…”