Any route to vascular surgery residency or fellowship in the Navy?

[LTMCUSN]

Just noticed there aren’t any residencies/fellowships for vascular surgery listed in the annual BUMEDNOTE 1424. Are all our vascular surgeons direct commissions or are there occasional GME opportunities? I know we had one in my Medical Battalion when I was on AD but not met another one since.

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[Gastrapathy]

There have historically been outservice vascular surgery fellowship slots based on the service needs. I would presume that the opportunity will continue to exist to some extent but the future is cloudy.

 

[narcusprince]

Why vascular surgery?

 

[orbitsurgMD]

Why vascular surgery?

Yeah, what I thought.

I suppose there is only so much exhausting, painful, depressing and futile work needed. Or as my gensurg internship mentors summarized the subspecialty: "fem-pop, re-op, chop-chop, hop-hop." Portsmouth was a nest of dark hilarity at times.

 

[LTMCUSN]

I’m not necessarily interested in vascular surgery, just curious where the Navy sources there’s from and why more GME opportunities are offered, considering it’s a critical war time specialty.

 

[pgg]

I’m not necessarily interested in vascular surgery, just curious where the Navy sources there’s from and why more GME opportunities are offered, considering it’s a critical war time specialty.

It's less critical (numbers-wise) than one might think. Vascular surgery is a role 3+ capability, and there just aren't that many of those in any given theater at any given time. Between Army/Navy/AF, having a couple or three deployed at a time doesn't really demand a very deep bench.

 

[LTMCUSN]

It's less critical (numbers-wise) than one might think. Vascular surgery is a role 3+ capability, and there just aren't that many of those in any given theater at any given time. Between Army/Navy/AF, having a couple or three deployed at a time doesn't really demand a very deep bench.

I imagine VS is like RADS and a few others that are close to or at 100% manning at the moment. I’m sure there’s a way to project out what Navy Medicine’s GME opportunities will be several years in advance but haven’t seem anything like that from BUMED or NAVPERSCOM. Oh well.

 

[militaryPHYS]

I’m sure there’s a way to project out what Navy Medicine’s GME opportunities will be several years in advance but haven’t seem anything like that from BUMED or NAVPERSCOM. Oh well.

MEDMACRE was supposed to do that for us during downsizing. But nothing is definite, especially 5 years out.

I think general surg sub specialties weren’t projected to increase (aside from trauma and critical care).

 

[Per5everance]

Yeah, what I thought.

I suppose there is only so much exhausting, painful, depressing and futile work needed. Or as my gensurg internship mentors summarized the subspecialty: "fem-pop, re-op, chop-chop, hop-hop." Portsmouth was a nest of dark hilarity at times.

At least speaking non-military (or post military career), because there is a projected shortage of vascular surgeons (pretty much majority of surgical fields) in the near future. To add to that, our society diet decisions are only making CAD/PAD more prevalent. Also, a good proportion of practice is aneurysms, carotids, access which doesn't really fall in into the choppity-hoppity pathway.

 

[Jolie South]

Yeah, what I thought.

I suppose there is only so much exhausting, painful, depressing and futile work needed. Or as my gensurg internship mentors summarized the subspecialty: "fem-pop, re-op, chop-chop, hop-hop." Portsmouth was a nest of dark hilarity at times.

I actually find taking care of super sick patients with bad problems satisfying. And not all disease that I deal with is lifestyle induced (though a fair amount is).

Endovascular technologies are advancing at a rapid rate and require thoughtful pre case planning. 75% of what I do is endovascular. I can do a big aortic surgery in an hour and half through less incisions than an appy and my patient will go home in less than 24 hours. Peripheral interventions go home same day. Most endovascular interventions do not even require anesthesia so I am not beholden to the OR and the whims of anesthesia.

There is also a wide case mix from small outpatient cases to the most invasive surgeries. We operate on all parts of the body.

I will always be in demand everywhere as we are facing a huge shortage in the coming years. And once I separate, average starting salary is $500k.

In short, it is more than “cutting smokers legs off”.

 

[narcusprince]

Vascular surgery can be quite challenging in the military. Big system level difficulties and highly reliant on blood bank,icu, purchasing of equipment, remote locations, high turnover of staffing every 3 years and deployment tempo it definitely has its challenges. If its your calling I definitely salute you.

 

[Jolie South]

Vascular surgery can be quite challenging in the military. Big system level difficulties and highly reliant on blood bank,icu, purchasing of equipment, remote locations, high turnover of staffing every 3 years and deployment tempo it definitely has its challenges. If its your calling I definitely salute you.

I am lucky in that I have an ideal hybrid room, a supportive command, and the ability to get the supplies I need without push back. All our endovascular techs are contractors so that helps. OR techs are totally untrained so that sucks.

Deployments in AF are minimal for vascular.