Vascular surgery fellowship application

I am! How are others doing?

Yup.

maverick_pkg said:

Hi all...anyone else applying?

Click to expand...

My knowledge of the vascular world is limited, but there are a couple of Wichita grads that trained at U. South Carolina- Greenville and had wonderful things to say about it. One of them is now faculty there. It would definitely be worth a look based on their endorsements.

I also have friends who have trained at Baylor and Mich State-Grand Rapids, and they also had good things to say.

anybody knows about the number of applicats this year? how is Hershey PennState vascular fellowship?

Anyone interested in starting a list of interview invitations? Might be helpful ...

hey guys, remember this blog from surgery interviews...

here's what i've gotten so far:
umich, upenn, stanford, ucsf, usc, loyola, u of C, pitt, maryland, Uw-madison, yale, emory, uva, rush, indiana, osu, wash u

still waiting to hear:
ucla, northwestern, u washington, georgetown, ny programs

definitely not going to all of these, the bulk of mine are march and april

curious as to what you think about these programs as the months progress

Thanks! To this list I can add:
Georgetown
NYU
Cleveland Clinic

lakers514 said:

hey guys, remember this blog from surgery interviews...

here's what i've gotten so far:
umich, upenn, stanford, ucsf, usc, loyola, u of C, pitt, maryland, Uw-madison, yale, emory, uva, rush, indiana, osu, wash u

still waiting to hear:
ucla, northwestern, u washington, georgetown, ny programs

definitely not going to all of these, the bulk of mine are march and april

curious as to what you think about these programs as the months progress

Click to expand...

yea i'm kind of curious myself. From what I've heard from those around the block:
west: ucla/ucsf/stanford
midwest: wash u, michigan, northwestern
east: penn, pitt, UF (although have change in leadership), emory?

i guess that makes 10, not sure how accurate this is as it all comes from word of mouth...what have you guys heard?

How is Mayo-Rochester second tier for vascular? I mean, the location might be bottom tier for a lot of people but the complexity and volume of cases must be nearly unparalleled.

the tiers sound accurate, its all hearsay i guess. i've heard very good things about rochester, probably belongs a tier up. anyone know of a thread that was started from last year with thoughts on the programs?

Many big-name places like Mayo have not had top-notch vascular training programs because they were behind the curve with the endovascular revolution. In Mayo's case, WAY behind. A weak endo experience can be the kiss of death for a Vascular Surgery training program. In contrast, some no-name places, like Southern Illinois U., suddenly became extremely popular based on the endovascular program.

ESCrawford said:

Many big-name places like Mayo have not had top-notch vascular training programs because they were behind the curve with the endovascular revolution. In Mayo's case, WAY behind. A weak endo experience can be the kiss of death for a Vascular Surgery training program. In contrast, some no-name places, like Southern Illinois U., suddenly became extremely popular based on the endovascular program.

Click to expand...

What's the current status of Mayo's endovascular program? I've heard that some programs have swung the other direction and now don't have enough open cases. I imagine (assume?) Mayo doesn't have that problem.

That is a lot of tiers. The list has half of all the vascular programs in the country. Are they all pretty good, or all pretty bad? What is the list based on... academic rank, case load, endovascular complexity?

Fyi eastern Virginia is more top 1 or 2 tier. Huge volume and lots of complicated endovascular/ fenestrated grafts, etc and WONDERFUL faculty. Ask around, Evms may not have a big university name but they are one of the biggest/ best vascular experiences

maverick_pkg said:

what I have heard:

1st tier: UCSF, Mass gen, Pitt, Brigham, Northwestern, Wash U, Dartmouth, UPenn, UCLA

1st-2nd tier: Emory, Wisconsin, Wake Forest, Michigan, Oregon, UTSW, UFlorida, Columbia-cornell

2nd tier: UVA, Henry Ford, Utah, Baylor Houston, methodist houston, Mayo rochester, Stanford, Indiana, Maryland, CClinic, UT Houston

2nd-3rd tier: Vandy, Tufts, UChicago, Loyola, Hopkins, Texas A&M, UCLA harbor, Yale, Georgetown, BIDMC, U Mass, UNC, Duke, Jeffreson, U wash, Mayo AZ, Geisenger

3rd tier: Eastern Virginia, Minnesota,U S. Florida, UArkansas, UArizona, U S. Carolina, Temple, Albany

4th tier: Rest of the programs

what do you think about these tiers? Accurate.

Click to expand...

These tiers seem a bit wonky. I would think Michigan would go on the first tier and Wake Forest seems to be the leader in vascular related stem cell research so I guess if someone was interested in that the tier wouldnt really matter. And in general I've found rankings to be extremely subjective and region dependent. In the end, in addition to the kind of experience one wants from vascular training (complicated endo, newest device trials vs bread and butter private practice stuff) I think its also important to look at where people at that institution end up going. I visited the Dartmouth program and thought it was a wonderful program, except is was extremely isolated. Looking at their list of fellow placements turns out a lot of people stay regionally. I don't plan on practicing in the NE area so going to Dartmouth wasn't worth the sacrifice if I could go somewhere else and get jobs in a region of my choice... I also think it matters how well connected the program is (e.g. how many current/former national society presidents).. that seems to mean A LOT when it comes time to find a job.

HitGirl said:

These tiers seem a bit wonky. I would think Michigan would go on the first tier and Wake Forest seems to be the leader in vascular related stem cell research so I guess if someone was interested in that the tier wouldnt really matter. And in general I've found rankings to be extremely subjective and region dependent. In the end, in addition to the kind of experience one wants from vascular training (complicated endo, newest device trials vs bread and butter private practice stuff) I think its also important to look at where people at that institution end up going. I visited the Dartmouth program and thought it was a wonderful program, except is was extremely isolated. Looking at their list of fellow placements turns out a lot of people stay regionally. I don't plan on practicing in the NE area so going to Dartmouth wasn't worth the sacrifice if I could go somewhere else and get jobs in a region of my choice... I also think it matters how well connected the program is (e.g. how many current/former national society presidents).. that seems to mean A LOT when it comes time to find a job.

Click to expand...

So are you a fourth year applying in surgery or applying for the vascular match? Because the strength of the vascular program is not always related to the general surgery program strength.

the strength of the vascular program is not always related to the general surgery program strength.

Click to expand...

This is great point. And in fact, sometimes it seems that the strength of a vascular program is inversely related to the strength of the GS training. Powerful old-school chairmen often regard peripheral vascular cases as an important experience for general surgery residents and do not like the development of an independent vascular section. At many of these programs, vascular residents/fellows are seen as competition for the GS residents, and this situation is sub-optimal.

She's applying for integrated vascular, so am I. We both have been to a lot of the top vascular programs in the country recently. She is correct in what she is saying in my opinion

joanofarc0907 said:

She's applying for integrated vascular, so am I. We both have been to a lot of the top vascular programs in the country recently. She is correct in what she is saying in my opinion

Click to expand...

I wasn't questioning the veracity of what she was saying but rather trying to place it in a context. I was also confused as to what she meant by Dartmouth's fellowship placement. Is she referring to the fellowships their general surgery residents get or their vascular residents? I didn't know there were fellowships for vascular surgery graduates.

HitGirl said:

These tiers seem a bit wonky. I would think Michigan would go on the first tier and Wake Forest seems to be the leader in vascular related stem cell research so I guess if someone was interested in that the tier wouldnt really matter. And in general I've found rankings to be extremely subjective and region dependent. In the end, in addition to the kind of experience one wants from vascular training (complicated endo, newest device trials vs bread and butter private practice stuff) I think its also important to look at where people at that institution end up going. I visited the Dartmouth program and thought it was a wonderful program, except is was extremely isolated. Looking at their list of fellow placements turns out a lot of people stay regionally. I don't plan on practicing in the NE area so going to Dartmouth wasn't worth the sacrifice if I could go somewhere else and get jobs in a region of my choice... I also think it matters how well connected the program is (e.g. how many current/former national society presidents).. that seems to mean A LOT when it comes time to find a job.

Click to expand...

joanofarc0907 said:

She's applying for integrated vascular, so am I. We both have been to a lot of the top vascular programs in the country recently. She is correct in what she is saying in my opinion

Click to expand...

I think there are a few points to hit.

1. As much as you guys know about a handful of programs you just saw, there is an inherent difference between applying for integrated 6 year training out of med school, and chief residents applying for fellowship.

2. I wouldn't worry too much about 1st/2nd/3rd tier. Rankings are inherently subjective, and the name of the place (e.g. Harvard vs. State U) doesn't always represent the quality of training in a specific field.

3. When looking for a training program 6 years long, I wouldn't focus too heavily on graduate placement. Who knows what the job scene will be like in 6 years, and who will be society presidents during that time (6 new fancy people). I would focus on somewhere that will provide excellent training in a tolerable environment, or you'll never make it to the end anyway.

4. It's easier than you think to find jobs after training, and vascular surgeons are relatively in demand.

5. I would find a program that still does a handful of open operations, especially if you are doing the integrated program versus a post-GS fellowship. A friend of mine in vascular mentioned that some 2nd-year fellows he met from the NE had done maybe 1 or 2 Fem-Pops, and 1 or 2 Open AAAs. There has to be a balance, as those often difficult operations are unlikely to go away.

----A sub-point here is that now that we are so good with catheters, all of the infrainguinal bypasses and open AAAs are going to be inherently difficult, since they represent the difficult few who could not be done with endovascular techniques.

SLUser11 said:

A friend of mine in vascular mentioned that some 2nd-year fellows he met from the NE had done maybe 1 or 2 Fem-Pops, and 1 or 2 Open AAAs.

Click to expand...

Yeesh. Our third year residents have done more than that. Which program is this? This is important for vascular applicants.

Getting this thread back on track:
Cornell/Columbia

Any others?

GenSurgMom said:

Getting this thread back on track:
Cornell/Columbia

Any others?

Click to expand...

Yeah because discussing vascular programs is so irrelevant...

How many programs do people usually interview at?

How many programs in a usual year take their in-house residents and don't participate in the match?

Guile said:

I wasn't questioning the veracity of what she was saying but rather trying to place it in a context. I was also confused as to what she meant by Dartmouth's fellowship placement. Is she referring to the fellowships their general surgery residents get or their vascular residents? I didn't know there were fellowships for vascular surgery graduates.

Click to expand...

I meant placement after vascular fellowship. No 5 year vascular program have a graduate yet so for interviews we med students get print outs on the vascular fellows track record... they may or may not be a good approximation of what the outcomes will be 0+5 trained vascular surgeons... but its all we have to go with for now.

maverick_pkg said:

you mind sharing the case logs and job placements of programs you interviewed at - here or as a PM? thanks

Click to expand...

Seconded.

maverick_pkg said:

you mind sharing the case logs and job placements of programs you interviewed at - here or as a PM? thanks

Click to expand...

Sorry, I threw those all out once I certified my ROL. Maybe another vascular applicant can share them. In the end they weren't all that useful because it seemed, at least to me, that every place that had an 0+5 program had case volumes in the 60th-90th+ percentile, and I'm assuming that's the only way they got approved for a residency program in the first place. The only things that stuck out for me was that Wisconsin had extremely low CEAs (~20th percentile) and the New York programs did much more endo with a lot less open cases than anywhere else I had seen in the country. And the traditional open places (Michigan, Pitt) did 50/50 open, whereas other places were more 60/40 (endo/open). Other than that, most programs I visited had high* case volumes (i.e. ~1400 fellow cases in the 2 years, including diagnostic studies). Even Cleveland Clinic averaged somewhere ~1200-1400, which was surprising to me given all their volume, but I guess at a certain point volume doesn't matter because one person can only operate so much!
(*High is relative, as I don't know what low case volumes look like)

Here are the programs w/ 5 year residencies:

http://www.vascularweb.org/students...programs/Documents/Integrated_List_071610.pdf

(This list is excluding UW and USC, which were recently approved)


As for job placements... I'm kind of sketchy on those details too

Georgetown - almost 90% go into private practice
Yale - 50/50
Stanford - 50/50
Dartmouth - 70/30 (academic/private)
U.Mass I can't remember but their current 2nd year fellow is likely going to Cleveland Clinic
U.Pitt can't remember but their fellows are HIGHLY recruited for academic and private positions

And that's all I remember...Sorry!

HitGirl said:

As for job placements... I'm kind of sketchy on those details too

Georgetown - almost 90% go into private practice
Yale - 50/50
Stanford - 50/50
Dartmouth - 70/30 (academic/private)
U.Mass I can't remember but their current 2nd year fellow is likely going to Cleveland Clinic
U.Pitt can't remember but their fellows are HIGHLY recruited for academic and private positions

And that's all I remember...Sorry!

Click to expand...

Interesting breakdown. You know at all those "top academic" programs, EVERY applicant goes into the interviews saying, "yessir, Dr. PD, I know I want to academics. I'm DEFINITELY going to be an academic surgeon." Then they match and it's time for the job search, and they peace out.

maverick_pkg said:

thanks a lot...how was Cleveland Clinic fellow/integrated resident autonomy? From what we hear fellows dont do much. Agree?

Click to expand...

What? I've heard this about the gen surg residency, but if the FELLOWS don't do much, then that's pretty awful...

Guile said:

Interesting breakdown. You know at all those "top academic" programs, EVERY applicant goes into the interviews saying, "yessir, Dr. PD, I know I want to academics. I'm DEFINITELY going to be an academic surgeon." Then they match and it's time for the job search, and they peace out.

Click to expand...

Is that true at the fellowship level? My impression was that people are more honest after 5 years of residency. I know the opinion of only one fellowship director, and he says his goal is to train the best people regardless of whether they go into academics or not.

filter07 said:

Is that true at the fellowship level? My impression was that people are more honest after 5 years of residency. I know the opinion of only one fellowship director, and he says his goal is to train the best people regardless of whether they go into academics or not.

Click to expand...

From my recent experience on the fellowship interview trail, there are some places where the program directors are very open about the fact that they are only interested in training academic surgeons, or "future leaders in the field" for the ones that were more subtle.

SLUser11 said:

From my recent experience on the fellowship interview trail, there are some places where the program directors are very open about the fact that they are only interested in training academic surgeons, or "future leaders in the field" for the ones that were more subtle.

Click to expand...

My followup question to that would be is whether they consider themselves to have failed if one of their graduates goes on to private practice. After all, they took someone who supposedly has been interested in academics after 3.5-4.5 whole years in residency to think about it, and after just 1 year of fellowship they go into practice instead...

Personally I don't agree with the current approach of sending a bunch of people into the lab or expecting fellowship applicants to state their interest in academics. The number of people that actually go into academics is very low. The number of programs with mandatory research years and the sheer number of programs wanting to train only future academic surgeons, is evidence that academic surgeons are out of touch with reality.

maverick_pkg said:

thanks a lot...how was Cleveland Clinic fellow/integrated resident autonomy? From what we hear fellows dont do much. Agree?

Click to expand...

The fellows get to do a lot from what I understand. Its the vascular surgery residents that may get lost in the fellow pack. Not only do they have 3 fellows A YEAR, but they also have mini-fellowships where people from all over the world come and train. I think it would be awesome to be a fellow at CCF since they see so much pathology. As a resident I'd fear being lost in the mix until I was finally at the "fellow" level as an R4.. and even then who knows. But overall great hospital, seems to run really well and there is a lot of money flowing around so if you want to do research, funding is usually not an issue. And its also a place where I didn't get the vibe that they were "committed to training academic vascular surgeons." So its probably less pressure for someone who is undecided.

SLUser11 said:

From my recent experience on the fellowship interview trail, there are some places where the program directors are very open about the fact that they are only interested in training academic surgeons, or "future leaders in the field" for the ones that were more subtle.

Click to expand...

This is what I heard at most places. Only a few were ambivalent and only at one program did the program director say he was happy to train academic or private practitioners. Some programs have looked at their "private practice" track record as an example that people come out well-trained and ready to practice.

Although I've always thought academics all the way, I can see how people with an initial interest end up changing their minds. It seems as though it would take A LOT of time and energy to produce research of enough worth to land an academic position, especially if its basic science. AND that academic position is going to be paying much less than private practice... Hmmm, maybe I should reconsider my career objectives .

I also think the way research is built into general surgery residency is a bit odd. You leave after your 2nd or 3rd year. By the time you get to fellowship your research is likely to be outdated, isn't it? At that point trying to resurrect a meaningful research career can't be easy...

HitGirl, thanks for sharing your insight and thoughts on the programs you visited. This is great stuff.

What I heard about Baylor when I was there for gen surg interview (backup to the vascular residency match) The main people that made Houston good left when Methodist separated and joined Methodist. Hope that helps