Graduate Medical Education

Goals and Objectives – PGY-6

Fellowship Vascular

Residents will be assigned to cases at St. Luke’s University Health Network at the following locations:

St. Luke’s University Health Network – Bethlehem Campus
801 Ostrum Street – Fountain Hill
Bethlehem, PA

St. Luke’s University Health Network – Allentown Campus
1736 Hamilton Street
Allentown, PA 18104

St. Luke’s Cardiology Associates – Cardiac & Vascular Testing Center – The Vascular Center
1648 Hamilton Street
Allentown, PA 18104

Preoperative experience occurs in both outpatient and inpatient settings. The residents gain operative experience in vascular surgery through the care of patients admitted to the vascular service.

Postoperative experience in vascular surgery is obtained through the care of patients on the surgical floors and in the ICU. Residents evaluate the patient’s postoperative course, identify abnormalities, and institute treatment with indirect and direct supervision by the vascular surgeon. Fellows are expected to continue to follow the course of the patients in the attending surgeon’s office.

The clinical and basic science curricula include topics related to vascular disease. Vascular surgery is included in Surgical Grand Rounds, Mortality & Morbidity Conference, SCORE TWIS, and other teaching and ward rounds.

PATIENT CARE: Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health

Vascular Surgery Fellows are expected to:

  1. Make informed decisions about diagnostic and therapeutic intervention based on patient information and preferences, up-to-date scientific evidence, and clinical judgment.
  2. Synthesize patient data to arrive at an organized differential diagnosis including all treatment options.
  3. Counsel and educate patients and their families as appropriate.
  4. Work with health care professionals, including those from other disciplines, to provide patient- focused care.
  5. Provide supervision of advanced clinical practitioners in the evaluation and management of complex perioperative problems in the vascular patient.

MEDICAL KNOWLEDGE: Resident must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of knowledge to patient care.

Vascular Surgery Fellows are expected to:

  1. Demonstrate mastery of all knowledge and skills acquired in prior years (vascular knowledge accumulated from general surgery training).
  2. Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness.
  3. Describe the rationale for the selection of intermediate vascular surgical procedures.
  4. Describe areas for potential complications and measures for procedural success with intermediate vascular surgical procedures.
  5. Anticipate patient-specific risk for complications following intermediate vascular surgical procedures and describe appropriate treatment algorithms should these occur.
  6. Discuss, in detail, the management of:
    1. Dialysis access
    2. Vascular emergencies
    3. Extracranial cerebrovascular disease
    4. Venous disorders
    5. Abdominal, thoracic and thoracoabdominal aneurysms
    6. Peripheral arterial occlusive disease
    7. Visceral and renal disorders
  7. Demonstrate mastery of knowledge of endovascular instruments: catheters, guide wires, catheter-mounted balloons, balloon-expandable and self-expanding intravascular stents, stent-grafts infusion catheters, embolization coils, and snares.
  8. Handle surgical instruments proficiently and make independent intraoperative decisions.
  9. Master and perform the following procedures with indirect supervision:
    1. Angiography
    2. Venography
    3. Iliac angioplasty and stenting
    4. Femoral artery angioplasty and stenting
    5. Arteriovenous fistula and graft creation
    6. Placement of dialysis and central venous catheters, placement and retrieval of vena cava filters
    7. Lower extremity amputation, temporal artery biopsy
    8. Femoral endarterectomy
    9. Endovascular Aneurysm Repair (EVAR)
    10. Endovenous closure of the saphenous vein
    11. Sclerotherapy and phlebectomy of varicose veins.

INTERPERSONAL & COMMUNICATION SKILLS: Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals.

Vascular Surgery Fellows are expected to:

  1. Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families.
  2. Create and sustain an ethically sound relationship with patients.
  3. Use effective listening skills and elicit and provide information using effective nonverbal, explanatory, questioning and writing skills.
  4. Work effectively with others as a member or leader of a health care team or other professional group.
  5. Provide leadership and organization for those patient's receiving endovascular interventions.
  6. Provide patients with clear informed information to provide informed consent regarding endovascular procedures.

PROFESSIONALISM: Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.

Vascular Surgery Fellows are expected to:

  1. Demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients and society, and the profession; and a commitment to excellence and on-going professional development.
  2. Demonstrate a commitment to ethical principles pertaining to provision or withholding of critical care, confidentiality of patient information, informed consent, and business practices.
  3. Ensure that under his or her supervision respond appropriately to responsibilities in a timely fashion.

PRACTICE-BASED LEARNING & IMPROVEMENT: Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning.

Vascular Surgery Fellows are expected to:

  1. Analyze practice experience and perform practice-based improvement activities using systematic methodology.
  2. Locate, appraise, and assimilate evidence from scientific studies related to their patients’ health problems.
  3. Develop ability to critically analyze the endovascular literature in order to practice evidence-based medicine.
  4. Present and discuss endovascular patient management at preoperative vascular conference, attending rounds and morbidity and mortality conference.

SYSTEMS-BASED PRACTICE: Residents must demonstrate an awareness of a responsiveness to the larger context and system for health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.

Vascular Surgery Fellows are expected to:

  1. Thoroughly evaluate patient’s health record and history to avoid over prescribing of medications and testing.
  2. Demonstrate cost effective endovascular care by being knowledgeable in the costs of endovascular devices and pharmaceuticals.
  3. Understand principles of endovascular therapy and quality assurance practices to ensure effective and efficient care.