5-year Vascular Surgery Programs

Wow. This is the real deal. Match into 5 years of vascular surgery (no GS BE/BC) straight out of medical school. I looked at the dartmouth page (they have separate pages for the 5+2 fellowship and the 5+0 residency). It's 2 years GS + 3 years Vasc, but it's not really 2+3. You spend 6 months on vasc from PGY1-4 and PGY5 is all vascular. Should address some of the manpower/training issues that moving to a strict PGY1-2 GS, PGY3-5 vascular model would have created.

Looks like the program - 1 lonely spot at dartmouth - will be open for the match this year.

Isn't plastic and thoracic that way already?

I see a future trend in surgery...

Pretty much 3 years general surgery and 3 years subspecializing....Sorta like Internal Medicine and their subspecialties. In surgery I think that's good...the more you do something the less complications / LOS and better mortality. There are some negative things to worry about like degeneration of reimburisement for the general procedures as more people subspecialize.

Faebinder said:

Isn't plastic and thoracic that way already?

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Thoracic - no. You can't match into thoracic out of med school. There are some 4+3 programs for people who originally matched into GS

Plastics - sort of. There are spots in the med school match, but many of them are 3 years almost full-time GS followed by 2-3 years of full time plastics.

I wonder if the new vascular programs would take current PGY2s, etc for a PGY3 spot next year in categorical vascular surgery? Just curious. I don't think I'd want to do Vascular. I bet this new speciality will be very heavy on interventional radiology procedure. The right step to taking back our turf from rads.

Just got back from an interview at University of Michigan. They will be accepting one 5+0 vascular resident in 2007.

Rochester was offering to interview GS applicants for a new (and to be approved in Feb 2007) 3+3 vascular program.

toxic-megacolon said:

I wonder if the new vascular programs would take current PGY2s, etc for a PGY3 spot next year in categorical vascular surgery? Just curious. I don't think I'd want to do Vascular. I bet this new speciality will be very heavy on interventional radiology procedure. The right step to taking back our turf from rads.

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At the last Society for Vascular Surgery meeting where this topic was discussed heavily, most program directors said they would not consider current General Surgery residents for transfer into a 5+0 Vascular Surgery program. People felt "poaching" from General Surgery would not be politically prudent.

Very interesting. The three programs that offer 5yr vascular - what is the quality of these programs? Are they elite or middle of the road places?

GuP said:

Very interesting. The three programs that offer 5yr vascular - what is the quality of these programs? Are they elite or middle of the road places?

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Dartmouth, Michigan, and Pitt are elite vascular surgery programs.

I imagine that my 218 step one score will preclude me from being considered in these programs.

ambientbaby said:

I imagine that my 218 step one score will preclude me from being considered in these programs.

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Maybe but then maybe not. Just boost up other areas of your app as best as you can.

GuP said:

Maybe but then maybe not. Just boost up other areas of your app as best as you can.

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OK, I'll jump in as the voice of reason.

Yes, your score of 218 disqualifies you from getting the one of 3 integrated vascular spots this year. Even if 30 people in the US want a spot, that makes it vastly, vastly more competitive than derm, plastics, rad onc, etc. The people who get these spots won't have any weak areas on their application.

Pilot Doc said:

OK, I'll jump in as the voice of reason.

Yes, your score of 218 disqualifies you from getting the one of 3 integrated vascular spots this year. Even if 30 people in the US want a spot, that makes it vastly, vastly more competitive than derm, plastics, rad onc, etc. The people who get these spots won't have any weak areas on their application.

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Well I was trying to be positive.

BUT you have to wonder how many people will apply to these. Maybe 10 or maybe 100. I am not quite sure if everyone knows of these.

Can anyone comment on how they decided to go into vascular surgery as a med student?

I imagine most people wouldn't have a whole lot of exposure to vascular surg in med school, and am curious how you made this decision.

TheMightyAngus said:

Can anyone comment on how they decided to go into vascular surgery as a med student?

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No one has ever done that. There are people who "decided" as med students and ended up pursuing it as a fellowship 5 years later, but no one has yet committed to vascular as a 4th year med student.

That having been said, it will probably end up being similar to how people commit to most surgical subspecialties (plastics, nsurg, etc) - they pursue experience as med students and think they like it.

I can. I had lots of experience with surgery and surgeons growing up. Kept going into surgeries and hanging out with surgeons in undergrad and knew that I wanted to be a surgeon by the time I applied to med school but not what kind. I spent my free time in the surgery lab or in the OR as a 1st and 2nd year med student. Toyed with NS (way more punishment then any person ought to suffer), trauma (decided that I did not want to be a baby sitter), thought about MIS (did'nt want GS call for the rest of my life), plastics briefly interuged me (I think it was more the personality of the plastics guys I knew rater then the surgeries or the patients). Some where along the way I got interested in wound care and diabetes complications.

As I watched different types of surgeries I became attracted to the delicate nature of vascular anastamosis. I liked the fact that when you were fixing a AAA's or clamping the carotid art you were racing the clock. You have to quick but also very precise. (Kind of weird cuz I actually kind of lacksidasical and disorganized if something ifsnot at stake.)

What got me seriously thinking about VS was in my third year when I saw a CAS being placed. One min there was a 90% occluded ICA and the next second it was open. As I was exposed to more and more Interventional procedure I also really began to dig that aspect of VS. I think what finally sealed VS for me was when one of my attendings let me drive the guide wire and catheter and let me do an AFIP run-off. I've had attendings let me peel GB from the liver and take out lipomas before but I never had the same kind of rush with those as I've had with that AFIP.

Did I also mention that I like toys? Vasc Surgeons have some cool toys.

I've applied to Umich and Pitt but have'nt gotten any love from either of them... UMich was probally laughing their ass off when they saw that I was an Osteopahtic student.

Docgeorge said:

I think what finally sealed VS for me was when one of my attendings let me drive the guide wire and catheter and let me do an AFIP run-off. I've had attendings let me peel GB from the liver and take out lipomas before but I never had the same kind of rush with those as I've had with that AFIP.

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Docgeorge, that's an awesome story, and I'm sure you'll eventually see love from a vascular surgery program, even if it's after finishing GS.

For those of us that don't know, can you tell us what an "AFIP run-off" is?

Blue Rover said:

Docgeorge, that's an awesome story, and I'm sure you'll eventually see love from a vascular surgery program, even if it's after finishing GS.

For those of us that don't know, can you tell us what an "AFIP run-off" is?

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Opps I had a transcription error. it's supposed to be AIFP for aorto-illeo-femoral-popleteal angiogram. Basically an angiogram of the aorta and illiac,femoral and popleteal arteries. To get a good view of the contralateral leg you need to hook over aortic bifurcation and place the catheter in the common femoral artery.

Docgeorge said:

Opps I had a transcription error. it's supposed to be AIFP for aorto-illeo-femoral-popleteal angiogram. Basically an angiogram of the aorta and illiac,femoral and popleteal arteries. To get a good view of the contralateral leg you need to hook over the illiac bifurcation and place the catheter in the common femoral artery.

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Actually, in some cases, to get a good view of either leg, you only need to squirt above the aortic bifurcation. At my institution we usually do place the catheter tip in the common femoral/distal ext. iliac though because our fluoro setup won't allow us to view the leg and the aorta at the same time.

As far as the acronym "AIFP", I think these things are institution dependent. For example at my medical school, they were called AFROs... aorto-femoral-runoffs.

And I agree with you. Arteriograms are fun to do.

Sorry to digress, but is there a list of approved 6 year vascular programs anywhere?

ambientbaby said:

Sorry to digress, but is there a list of approved 6 year vascular programs anywhere?

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See the first post in the thread.

http://www.vascularweb.org/_CONTRIB.../New_Vascular_Surgery_Training_Paradigms.html

The link you gave has a list of 5 year programs. I would like some info on 6 year programs. Thanks.

Blue Rover said:

See the first post in the thread.

http://www.vascularweb.org/_CONTRIB.../New_Vascular_Surgery_Training_Paradigms.html

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I believe the only program that is pending approval for a 6 year (3 + 3 ) program is Univ of Rochester. They will find out if they get approval at the end of Feb. There may be several other programs that have applied for the 3 + 3 paradigm but the SVS won't know who else 3/07.
Hope this helps...

TheMightyAngus said:

Can anyone comment on how they decided to go into vascular surgery as a med student?

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Pilot Doc said:

No one has ever done that. There are people who "decided" as med students and ended up pursuing it as a fellowship 5 years later, but no one has yet committed to vascular as a 4th year med student.

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In the US no, but in Europe, yes.

My husband went into a 6 year vascular program. Basically he had to decide btwn General and Vascular but the test for General overlapped that of Vascular. He had better chances of getting into Vascular so he went for that. He did his internship (you do your internship in your final year of med school in Italy) in Vascular.