PGY6 - HUP Vascular Surgery
On a more specific note pertaining to the clinical months, the education will begin with basic angiographic skills. Initially, the fellows will learn percutaneous and open arterial and venous puncture and cannulation, basic wire and catheter manipulation, and adequate knowledge of all anatomy. As the year progresses, they will learn basic understanding and familiarization of angioplasty balloon, stents and other devices, familiarization of fixed and mobile angiography units and the ability to perform iliac and lower extremity arteriogram and intervention. In terms of open procedures, they will learn fundamental vascular anatomy and exposure. For example, dissecting and exposing carotid arteries, lower extremity vessels and the aorta will be stressed. As they have already completed a general surgery residency, basic surgical skills are already understood. Finer more refined technique will be taught such as suturing anastomoses with small sutures. Understanding and learning how to perform operative procedures and the conduct of the operation will be stressed. Fellows will learn the importance of ischemic timing, anticoagulation regimens and the conduct of the overall operation from start to finish. Careful teaching of clinical judgment will be important. For instance, they will learn when intervention for carotid stenosis is indicated and whether carotid endarterectomy or carotid stenting is best. Fellows will also be expected to understand preoperative, perioperative and postoperative management by participating in outpatient and inpatient care. This will be supervised by daily rounds and time spent in office hours. Overall, the clinical rotations will not be different from month to month. However, each month will offer a large variety of cases and patients which can be tailored to the specific fellow’s abilities and needs.
In terms of research months, fellows may participate in a university-offered statistics course in their first assigned research month. Fellows will be instructed on management of and participation in clinical trials. They will also participate in clinical studies within the institution. They will be taught about obtaining Instituitional Review Board approval, formulating hypotheses, accruing and gathering data, processing the data to prove or disprove the hypothesis and other aspects of clinical research. Ultimately, these projects will lead to publications in peer-reviewed journals as well as presentations at local, regional and national meetings. Faculty mentorship at all levels will be provided. This educational process will continue throughout the research rotations of both years. During the research months, fellows will also spend time in the noninvasive vascular laboratory. Initially, they will observe studies and then begin to perform and interpret them as time progresses.