Sorry, been on trauma call the last several night and have been getting killed, meant to respond earlier. This is the PM I just sent you, but for others curious in the future, figure I'd drop it here for those stumbling on this thread in the future:
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The biggest issue for you is going to be, "Why vascular?" Your Step 1 score will get your application looked at, but the problem is that there are plenty of people with good scores applying to vascular surgery and with the relatively high attrition rate of surgery and the small size of vascular surgery programs, it is imperative that programs select residents that have a higher chance of staying in vascular and really know what they are getting into. It isn't enough to really enjoy a rotation or love carotid endarterectomies or whatever short exposure reason. You have to have an understanding about vascular surgery as a field and be able to demonstrate to faculty that you know what you are getting into. Vascular surgeons have the worst hours of any specialty. They have incredibly unpredictable schedules and it is not uncommon to have emergencies in many practices almost daily. There are many operations that can not be delayed until morning. The patients are the sickest you will find and the pathology chronic.
You have to understand all of those things and still be interested in the field. There are a multitude of reasons to love vascular surgery, but having realistic expectations of your life going forward is paramount. Most people want you to demonstrate this, not just say it. The first step is exposure. This means home institution rotations and away rotations. It is not atypical for people applying to vascular to do 2-3 away rotations. It is not atypical for people to spend 2-3 months in their late 3rd year or early 4th year on the vascular service at their home hospital. Many will create electives in vascular lab or clinic to get extra time with vascular faculty. It is expected that you have 3-5 letters of rec from vascular surgeons. For our program, we call the letter writers of all of our top candidates to get more information. They need to know who you are and not just say that you are 'nice'. Another way of showing/demonstrating interest is vascular specific research. All research is valuable on your application, but a lack of vascular research is concerning, especially if someone has done a reasonable amount of other research. For example, we routinely don't interview people with 3-4 ortho, urology or plastics publications with 240+ step 1 scores who are clearly applying to vascular as a 'backup' or for other unknowable reasons. They tend to also lack vascular specific letters.
Lastly, get to the SVS annual meeting. There is a scholarship that you will get if you apply early:
SVS General Surgery Resident/Medical Student Vascular Annual Meeting Travel Scholarship | Society for Vascular Surgery
There is a ballroom dedicated to vascular programs and ~90% of program directors are there, along with hundreds of vascular residents. Overall, you are far from behind and have a good chance at matching vascular if you are really interested. But, you need to really focus on answering the question of "why vascular" not just for PDs, but also for yourself.
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