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Graduate Medical Education

Curriculum

Fellowship Vascular

ACGME VASCULAR FELLOWSHIP PROGRAM REQUIREMENT:

There must be structed educational activities beyond direct patient care such as patient care-related educational activities like morbidity and mortality conferences, tumor boards, surgical planning conferences, case discussions, basic science, etc., to allow fellows to gain medical knowledge directly applicable to the patients they serve.

Definition of the protect timed conferences can be found below:

Patient care related educational conferences such as mortality and morbidity conferences, tumor boards, surgical planning conferences, case discussion, basic science including….

  • Weekly review of all current complications and deaths including radiological and pathological correlation of surgical specimens and autopsies.
  • A course or a structured series of conferences to ensure coverage of the basic and clinical sciences fundamental to vascular surgery as sole reliance on textbook review is inadequate.
  • Regular organized clinical teaching, such as clinical conferences.

Participation in the following educational conferences is expected as a Faculty Member in the Department of Vascular Surgery:

1) Vascular Mortality and Morbidity Conference


The Vascular M&M conference is held monthly where cases involving mortality and morbidity, as well as interesting cases are discussed. The cases are selected by the Vascular Fellow and discussed with the Vascular Program Director. The cases are presented by the Vascular Fellow who served as the primary surgeon with commentary and discussion with the associated attending. The conference is attended by faculty and trainees from the Vascular Fellowship and General Surgery training program. The fellow presents the medical and surgical history of the patient, diagnosis and any diagnostic test, procedure performed, outcome of the procedure and what could have been done to prevent this from happening again. This conference is open to all Members of the Department of Vascular and General Surgery. It is the responsibility of the Teaching Faculty to attend this conference on a regular basis.

This conference meets the following ACGME Competencies:

  • 1) Patient Care
  • 2) Medical Knowledge
  • 3) Interpersonal and Communication skills
  • 4) Systems Based Practice
  • 5) Practice Based Learning

2) Combined Department of Surgery Mortality and Morbidity Conference


This weekly conference consists of patient cases involving complications including mortality and morbidity, as well as interesting cases. The cases are selected by the Chief Administrative Fellow and then presented to the Vascular Fellowship Program Director for approval. Residents are assigned to present the complication or interesting case. All cases are discussed in an educational format, which is open to all Members of the Department of Surgery. It is the responsibility of the Teaching Faculty to attend this conference on a regular basis.

This conference meets the following ACGME Competencies:

  • 1) Patient Care
  • 2) Medical Knowledge
  • 3) Interpersonal and Communication skills
  • 4) Systems Based Practice
  • 5) Practice Based Learning

3) Fellow Focused Vascular Case Conference


This conference is held three to four times per month and will cover the diagnosis and management of the patient care problem for all etiologies to include atherosclerosis, trauma, infection, etc. where appropriate. A general understanding of each topic in the Clinical Curriculum is expected at the completion of vascular surgery training. In addition, the trainee is expected to know the natural history of the various diseases. Knowledge of additional/non-core topics will be encouraged but not required. Educational objectives have also been developed for each section of the Clinical Curriculum. It is expected that these objectives will be achieved by each trainee at the completion of training. Included are selected references for each set of objectives that are suggested as minimal background reading for each section.

This conference meets the following ACGME Competencies:

  • 1) Patient Care
  • 2) Medical Knowledge
  • 3) Practice Based Learning

4) General Surgery Resident Vascular Case Conference


Vascular case conference is held monthly where interesting and varied cases are presented by the residents on the vascular surgery service. This is followed by a short didactic presentation including the pathophysiology of the disease process, indications for treatment and treatment options available based on current literature. This is followed by a discussion and questions from the audience lead by one of the attending vascular surgeons. Attendees at this conference include vascular lab technologist, interventional radiology technologists and nurses as well as residents, students, attending interventional radiologists and vascular surgeons. This leads to a broad discussion about all aspects of vascular disease from presentation through diagnosis and treatment.

This conference meets the following ACGME Competencies:

  • 1) Patient Care
  • 2) Medical Knowledge
  • 3) Practice Based Learning

5) Vascular Journal Club / Case Conference


A monthly interesting case presentation associated with Journal Club article review is held every month. This conference is open to the faculty, fellows, and general surgery residents on vascular rotation.

This conference meets the following ACGME Competencies:

  • 1) Patient Care
  • 2) Medical Knowledge
  • 3) Practice Based Learning

6) Vascular Basic Science - as per the Basic Science Curriculum put forth by the APDVS


The Basic Science conference held five times per year and is designed to review the topics associated with vascular disease. This curriculum covers a wide array of topics as per the APDVS Basic Science curriculum. This series includes the following topics: embryology of the vascular system, molecular biology, physiology and pathophysiology of blood vessels, hemodynamics and atherosclerosis; peptide growth factors, endothelial cells, vascular smooth muscle cells, macrophages, platelets, response of the arterial wall to injury and intimal hyperplasia, atherosclerosis: theories of etiology and pathogensis, histopathologic features of nonarteriosclerotic diseases of the aorta and arteries, regulation of vasomotor tone and vasospasms, venous system of the lower extremities: physiology and pathophysiology, structure and function of the lymphatic system, diabetic vascular disease, plasma lipoproteins and vascular disease, cigarette smoking and vascular disease, coagulations and disorders of hemostasis, blood rheology and the microcirculation, drugs in vascular disease, scientific basis for balloon embolectomy, basic principles underlying the function of endovascular devices, vascular grafts, statistics for the vascular surgeon, aneurysmal disease of the abdominal aorta, cerebral blood flow, renovascular hypertension, basic mechanisms in mesenteric ischemia, hemodynamic basis of portal hypertension, anatomy and physiology of normal erection, skeletal muscle ischemia and reperfusion: mechanisms of injury and prevention, spinal cord ischemia associated with high aortic clamping: methods of protection, arteriovenous hemodialysis access, arterial and vascular graft infections, and neuropathic and biomechanical etiology of foot ulceration in diabetics.


This conference meets the following ACGME Competencies:

  • 1) Patient Care
  • 2) Medical Knowledge

7) Vascular Lab Correlation Conference


Non-Invasive Vascular Lab Correlation Conference is held bi-monthly. Studies with discrepancies between the vascular lab studies and other imaging modalities are selected by the Medical and Technical Directors of the non-invasive vascular lab. The cases are presented by the Medical Director to a forum or vascular surgeons and vascular lab technicians who discuss test appropriateness, technical quality, safety of the imaging, interpretive quality, report timeliness and correlation with alternative modalities. Conference is attended by technologists, the vascular fellow, and vascular providers who introduce their thoughts on topics and treatment.

This conference meets the following ACGME Competencies:

  • 1) Patient Care
  • 2) Medical Knowledge
  • 3) Practiced Based learning

8) Vascular Skills Lab - Anatomage Table and other vascular surgical skills practice for self-assessment and surgical technique practice


The Vascular Skills lab will be held quarterly and will include the Vascular Fellow as an assistant working with General Surgery Residents to achieve basic vascular technical skills such as knot tying and performing vascular anastomosis. In addition, scheduled time with the Sim Center Director and/or Sim Tech for introduction to the Anatomage Table and how this simulator works. Faculty, fellows, and residents can load into the table all pertinent patient information and perform diagnostic and operative procedures prior to heading to the operating room with a patient.

This conference meets the following ACGME Competencies:

  • 1) Patient Care
  • 2) Medical Knowledge
  • 3) Interpersonal and Communication skills

9) Research Meeting


This conference is to enhance the scholarly activity of the Vascular Fellow as well as the Attending Staff. This conference is conducted by the Program Director and the Research Coordinator. Faculty members are invited to attend this monthly meeting where research design and analysis, as well as IRB approach is reviewed. In addition, discussion as to where a project could be submitted at a local, regional, and national forum for poster or oral presentation with eventual publication are reviewed.

This conference meets the following ACGME Competencies:

  • 1) Practice Based Learning
  • 2) Interpersonal and Communication Skills