Vascular Surgery Fellowship Program

Application Procedures

Requirements

• Satisfactory completion of an accredited residency-training program in General Surgery.
• Eligibility to sit for the qualifying examination in General Surgery administered by the American Board of Surgery
• Completion of the application and interview process

Timetable

Applications: ERAS applications are preferred, but traditional paper applications are still accepted. Applications are typically received from December 1 – January 31st during the 4th year of residency.

Letters of Recommendation: Three letters of recommendation are a required component of the application and others are encouraged.

Interviews: All application materials must be completed prior to scheduling an interview. Interviews are held February through April of the applicants 4th year of residency.

Selection: The Division of Vascular Surgery participates in the National Resident Matching Program (NRMP). Match lists are usually submitted in April approximately one year prior to the start of fellowship.

Please address all inquiries and other correspondence to:
Linda M. Harris, M.D.
Division of Vascular Surgery
Millard Fillmore Gates Hospital
3 Gates Circle
Buffalo, NY 14209
Phone: 716-887-4807
Fax: 716-859-4220
Email: lharris@kaleidahealth.org

Vascular Surgery - Residency Training Program

Vascular Surgery Overview: The Division of Vascular Surgery at the University of Buffalo offers an ACGME-approved residency-training program in Vascular Surgery. Successful graduates are eligible for certification in Vascular Surgery as provided by the American Board of Surgery. The program is two years in length and one candidate is selected annually through participation in the NRMP matching program.

Goals: The goals of the Program are to provide a learning and training environment which facilitates the development of expert vascular specialists who will have the tools and abilities to be leaders in both the clinical and academic community of vascular surgeons. These goals are accomplished by providing:

• Didactic instruction and basic laboratory research experience in vascular physiology and pathobiology.
• Instruction and direct clinical experience with the technology, clinical applications, and professional interpretation of all forms of noninvasive vascular testing.
• Instruction and direct clinical experience in the performance and interpretation of non-surgical vascular interventions including arteriography, angioplasty and stenting, and endovascular repair of aortic aneurysms and vascular trauma.
• Supervised performance of all forms of major non-cardiac vascular surgical procedures.

Following successful completion of the training program the trainee should be eligible for certification as an RVT and eligible for certification in Vascular Surgery by the American Board of Surgery. It is expected that the trainee would be a competitive candidate for the professional position of his or her choice, whether private practice, academic, or a combination.

Residency Training Program - Curriculum

Curriculum Overview

The residency training program in Vascular Surgery at the University of Buffalo is a two-year program comprised of a balance of all the clinical and academic components of:

• Endovascular diagnostics and therapeutics
• Noninvasive vascular testing with ultrasound-based therapeutics
• Clinical and basic research
• Open surgical procedures
• These activities are carried out in the Kaleida Health System and the Veteran’s Administration Medical Center. Trainees are exposed to a wide variety of care-delivery systems and clinical practice structures.

First Year

The first year trainee is involved in four main areas of activity:

1. Endovascular training
2. Non-invasive vascular laboratory
3. Clinical research

1. Endovascular Training

In both the first and second years, the vascular resident masters basic and advanced endovascular skills through the following activities:

• The resident will be instructed in endovascular management including basic and advanced catheterization skills, principles of diagnostic and therapeutic procedures including angioplasty, stenting, thrombolystic therapy, embolization, and endografting.
• Endovascular procedures are performed in the angio suite or operating rooms dependent on procedure and hospital.

2. Non-invasive Vascular Laboratory

Goals and Objectives:

• The trainee will be able to deal with ultrasound-guided interventions.
• The trainee will acquire knowledge of ultrasound physics as it applies to current established techniques of vascular diagnosis.
• The trainee will become familiar with all major forms of instrumentation associated with routine noninvasive vascular diagnosis, including plethysmography, continuous-wave and pulsed Doppler, and Color-flow duplex ultrasound scan technology.
• The trainee will learn to perform, supervise, and interpret the results of noninvasive testing modalities performed for major non-cardiac vascular disorders.
• The trainee will learn the applications of noninvasive vascular testing in the development of practice guidelines, surveillance, outcome assessment, and clinical research in vascular disorders.
• The trainee will learn the administrative skills necessary to serve as a medical director of a noninvasive vascular laboratory.
• The trainee will be qualified for certification as a Registered Vascular Technologist (RVT).

3. Clinical Research

The goal of the research component is to enhance the residents understanding of research methodology, to stimulate translational research, and to enhance the understanding of vascular biology and cellular mechanisms of disease. Residents have participate in clinical research dependant on their future goals and interests.

This experience includes project selection, literature review, experimental design, data collection, analysis, presentation skills and manuscript preparation.

Past fellows have had presentations at the annual meetings of the Eastern Vascular Society, Society for Clinical Vascular Surgery, ISCVS, ACS and the Venous Forum.

Second Year

The clinical year is divided between rotations at the Kaleida Health System and the Veteran’s Administration Medical Center.

The vascular resident is the senior trainee on a service that is supported by junior-level general surgical residents.

The clinical curriculum includes:

• Performance of all forms of non-cardiac vascular surgical, and endovascular procedures.
• Refinement of inpatient management skills for pre- and post-operative patients on the Vascular Surgery Service.
• Outpatient evaluation of patients with known or suspected vascular disorders in the vascular surgeons office.
• Didactic conference and lecture programs.
• Teaching general surgical residents and medical students.
• Completion of research activity.
• Instruction on the development of evidenced-based treatments, quality outcomes assessments, practice guidelines, and other practice management skills.

Surgical Procedures

The vascular resident performs all categories of major vascular surgical procedures under the direct supervision of the attending staff.

Vascular residents in our program have generally performed major open surgical procedures during their clinical year. Surgical case totals are generally balanced with regard to case mix (e.g. carotid, aortic, extremities. A typical clinical year would be expected to include:

• 34 carotid endarterectomies
• 5 repairs of suprarenal and thoracoabdominal aortic aneurysms
• 7 visceral artery reconstructions
• 28 aortic reconstructions for occlusive or aneurysmal disease
• 91 infrainguinal vascular reconstructions
• 230 Diagnostic
• 12 Thrombolytic
• 47 Angioplasty
• 60 Endo AAA

Endovascular Procedures

During the clinical year the vascular resident performs diagnostic and therapeutic angiography.

1. During the clinical year the vascular resident performs a substantial number of aortic endograft procedures in the operating room. Aortic and peripheral stent graft procedures are performed routinely at all of our training sites. Trainees have experience with all approved endograft and stent graft devices available.
2. Upon completion of the training program, the vascular resident will have both the skills and experience to qualify for independent performance of all approved percutaneous interventions and aortic endografting based upon all current established credentialing guidelines.

Inpatient Management

The vascular resident serves as a supervisory resident in the clinical management of all inpatients on the teaching Vascular Surgery service at all institutions. The vascular resident is assisted by a fourth and first year general surgical resident on all services.

Outpatient Experience

The vascular resident participates in the weekly outpatient clinical activities at the offices of the full-time faculty or the VAMC Clinic. The resident examines and evaluates patients and confers with the attending staff to plan further diagnostic evaluation and treatment.

Conference Experience

The resident is responsible for choosing case presentations and topics for the weekly main Vascular Conference, and coordinating preparations and topics of educational materials for discussion. The resident is also responsible for write-ups for M & M or complications and attending the joint conference with the general surgery residents. Both residents participate in the monthly Vascular Lab Teaching Conference and the monthly Vascular Lab QA meetings.

Support for Academic and Scholarly Activities

The Division supports travel and expenses for residents to present scholarly material to meetings of all major vascular societies.

Work Environment

On call responsibilities are shared among the fellows and conform to current New York State and ACGME guidelines. Long-range pagers are provided and call may be taken from home. Residents have a total of 4 weeks of vacation time each year.