Additional sources to peruse if interested: Read “Taking the Gamble as Vascular Surgeons” on Page 3 by Dr. Zeltzer. 332 votes, 166 comments. How do you feel about the 0+5 programs? Even vascular surgery, often insulated from resource scarcity due to its status as an urgent specialty, has limited capacity due to the pandemic. Cases start at 0800 - usually two rooms running. Haimovici’s Vascular Surgery, now in its 6th edition, has been extensively updated to provide you with: Expert perspectives on how the vascular surgery field has evolved so you continue to stay on the leading edge of this dynamic field Hope this helps. Followed by some sort of dialysis access work be it fistulgram or creation or de-clot. I am a 20 year old man. Background Type 2 diabetes mellitus is a risk factor for lower extremity arterial disease. Buy Surgery journals, books & electronic media online at Springer. Edit: Follow-up question - how do you feel about the 0+5 programs? That all vascular surgeons are grumpy and hate their lives. And where? My call as a fellow will be q3 for the next two years, but the above written was in regards to what my attendings in residency are doing. With rapidly evolving new technology available, it is important that alternatives be chosen that are effective in the long-term care of patients with vascular disease. Breakfast. By using our Services or clicking I agree, you agree to our use of cookies. My father was diagnosed with stage IV prostate cancer while I was a first year medical student. Anyone know any good books or good anki deck? Reasons why to do vascular surgery:  Full disclosure I just posted a similar answer on SDN recently and so I’m just gonna copy and paste what I wrote not too long ago. Approach with extreme caution, pick a good program with staff who have an honorable work ethic and motivated, you don’t want to work 90 hours a week for assholes. You will either become enamored with it or you won’t. The Integrated Vascular Surgery Residency Program at the University of Washington was recently granted approval by the ACGME. Cookies help us deliver our Services. I mean is there any fellowships or advanced training in specific procedures? The problem is, they eventually find their way to our service because they're local and often don't want to be transferred somewhere else. - It's fairly common and although it goes in waves, we crank out 1-2 CEAs a week between all the surgeons combined. The hardest part of being a vascular surgeon is keeping your clinic patients apart. A large chunk of our consults are intraoperative from other services that get into trouble and call for help or iatrogenic injuries in the ICU during catheter placement. What possible reason could there be for the report to conclude that everything is fine? So what does that make me then? You are the “mop man.”  Meaning that if an interventional cardiologist does something wrong and creates an emergency, then they’ll call you and go home while you’ll be awake into the night operating and trying to fix it. My program does not have a vascular surgery fellowship, which was great from a resident standpoint because nobody would be able to out-chief me for open AAAs, aorto-bifems, and other awesome stuff. Background The novel Coronavirus Disease 2019 (COVID-19) pandemic is having a profound impact on global healthcare. We are a not-for-profit professional medical society, composed primarily of vascular surgeons, that seeks to advance excellence and innovation in vascular health through education, advocacy, research, and public awareness. There will be concessions made in your personal life due to unplanned emergencies. I was in vascular surgery, i was unhappy and seriously thinking of suicide, I was honestly expecting the text in this post to be, "Don't.". I'm applying to integrated vascular residency this coming season. We have 2 hybrid ORs and 3 vascular surgeons. Here’s a quick snapshot of what a vascular surgeon can do: Endovascular repair of abdominal aortic aneurysms, Open repair of abdominal aortic aneurysms, Endovascular repair of thoracic aortic aneurysms, thoracic aortic dissections and thoracoabdominal aneurysms, including hybrid aortic procedures, Open surgical reconstructions and balloon angioplasty and stenting in all vascular areas, Endovascular intervention, such as angioplasty and stenting, Bypass surgery and endovascular therapy for peripheral artery disease and gangrene of the limbs, Carotid endarterectomy and carotid artery stenting, Treatment for Carotid Body Tumors and other vascular tumors, Endovascular intervention and open bypass surgery for mesenteric and renal arteries, Endovenous laser therapy and open surgical intervention for varicose veins and venous ulcers, Endovascular and open surgical reconstruction for deep vein occlusions, Retroperitoneal exposure for spine surgery. [clinical] vascular surgery elective resources for m3? To paraphrase Dr. John Eidt, “We are cobblers in vascular surgery, we aren’t Nike. 69% Upvoted. If the vascular surgery needs to be performed within a month of CABG, data such as ours may apply and the risk of such vascular surgery may be considered prohibitive. This isn’t a field for those who want to fix a problem and then never see it again. I was in vascular surgery, i was unhappy and seriously thinking of suicide, I am happy that I quit to a better speciality. Not overweight, non smoker, low blood pressure. What vascular surgery do you consider to be urgent? Would you say that's representative of the type of surgery that you do on a daily basis? Vascular surgery has a unique set of characteristics in the medical landscape that some practitioners will find appealing and others abhorrent. There’s very little middle ground and I don’t think this specialty was ever meant to be any other way. My attendings are averaging probably around 65 hours a week, but this can vary from as short as 40 some weeks to 80-90 other weeks. My home institution is offering a stipend while I’m in fellowship and guaranteed $500K salary for two years if I signed right now. I have really enjoyed spending time with our IR guys because they're so eager to teach and just all around fun guys to be around. 15 Surveyed residents and medical students are concerned about the lifestyle associated with vascular surgery. The specialty evolved from general and cardiac surgery, and includes treatment of the body's other major and essential veins and arteries. Introduction Reduced antiplatelet activity of aspirin (ALR) or clopidogrel (CLR) is associated with an increased risk of thromboembolic events. New comments cannot be posted and votes cannot be cast. Small profile on Dr. Conte at UCSF explaining his outlook on being a vascular surgeon. Having gone through GS and now staring down the barrel of two more years of grueling training. Typical day from a general surgery resident standpoint:  The usual census ranges anywhere from 6-25. Cheers. Do you think the surgeons they produce are as competent as those who do 5+2? Thanks for the great write-up! I have had interactions with those in the 0+5 model and found them to be quite competent and I think it all evens out in the end. Can I get these veins treated and what is the likelihood they will get worse or come back? Attending Call: q3 - giving a rough approximation I’d say that 1 in about every 3-4 calls they have to come in for something in the middle of the night. 7 In this exhaustive report, the institution of Hub hospitals for urgent and emergency patients, supported by satellite Spoke hospitals, was detailed described. Vascular surgery has a unique set of characteristics in the medical landscape that some practitioners will find appealing and others abhorrent. Manageable MS only health problem. I’ve decided not to because I don’t want to get locked into something that is 2 years away and lot can happen in that time. Maybe 80/20 at most one day from an overall caseload standpoint. Program lengths vary from 5-7 years, depending on research requirements. Go home anywhere between 1700 on a good day to 2100 on a bad day, see what cases are coming up in the week, read up on them, dinner, play with my kid, play with my wife, go to bed (not in any particular order). A good vascular surgeon will also be hard-working, for anyone who has rotated on this service knows how demanding of one’s time this field can be. I have amazing mentors who throughout my residency never complained and just did work in front of them. I go through labs, I/Os and various notes from the overnight team. Being a vascular surgeon, you are going to be very good-looking (because this field attracts such beautiful people) and thus many of the staff will not leave you alone. https://www.mdedge.com/sites/default/files/Document/April-2018/webvas18_1_digital.pdf. This thread is archived. - On a daily basis, the most common procedure is a lower extremity angiogram with or without some sort of intervention. But someone has to do it, might as well be us vascular surgeons... Stupid sexy ortho can't always take the credit. If the hours were better I would have gone into vascular 100%... do not go into this field unless you want work to dominate your life. I’ve had weeks where I was home by 1700 every night and one week where the earliest I got home was 2100 and even 0100 that one night. I'm sure there are things I have forgotten. save hide report. New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community. Background: Just finished a traditional 5-year general surgery residency and about to begin fellowship. Clinical. I’m a 46 year old female. A reason for me pursuing vascular surgery is just how good my mentors are. I have stopped pinching them more than three months ago. We develop long-term longitudinal relationships with our patients similar to surgical oncologists and they will come back with other issues. Was planning on doing vascular as I absolutely LOVE everything about it...it has a large variety of procedures, it’s very technical and it’s just straight up baller honestly. We are having a problem at my hospital in that the vascular surgeons are flooding our emergency list with their 'urgent cases'. Do you think the surgeons they produce are as competent as those who do 5+2? Choose from a large range of academic titles in the Medicine category. Trained at a level-one trauma, tertiary “privademic” center. It's true. Fellowships: https://vascular.org/career-tools-training/vascular-training-programs. Many Americans over the course of their lives will experience some form of vascular-related symptoms. With general surgery training, research time and my vascular fellowship combined, I did nine years training post-med school. What is the split of open versus endovascular procedures and do you see endovascular becoming more popular/taking up a greater percentage of cases? Major non‐cardiac surgery within 40 days of coronary angioplasty with stenting has high cardiac complication rates. Depending on my familiarity with patients, I will then go by the ICU and then see the new ones on the service. There are mid-levels to otherwise staff a full day of clinic everyday on their own for postop evals, surveillance, etc. This is a great place to start. And I want to be really really good. Press question mark to learn the rest of the keyboard shortcuts. However, they do feel a little bit harder when touching them from the outside (I can't remember if they were as hard before). In the end I switched to radiology because the hours on vascular were just miserable and radiology gives me the possibility of going into IR. VASCULAR SURGERY From the Society for Vascular Surgery A look at the future of vascular surgery Frank J. Veith, MD, New York, NY; and Cleveland, Ohio I would first like to thank Dr Perler and the Society for Vascular Surgery (SVS) for the singular honor of giving the Eleventh John Homans Lecture. Thanks! Not for me, but cheers. Although everything is moving towards more endo, I don't envision a scenario where it's all endo for there will always be a need for (and the practitioners to provide) good open surgery. This is all I have for now. I appreciate how their mindset, preparation and training has brought them to a point where they are just really really good. They will be more slick with wires and catheters and those of us coming from GS will be more comfortable navigating around the abdomen, but I think at the end of our training and definitely within 3 years of practice, we're all probably the same. We see each patient, get to know them and develop a relationship, and then tailor an operation for their specific needs and goals.”. Vascular injury during laparoscopy is associated with significant morbidity and up to 23% mortality. During my residency, nothing was worse than the ER calling me with a cold leg. - It varies week to week but I'd say it's probably a 70/30 split endo versus open. Hey, great write up. This post will be cataloged on the wiki for posterity. It’s ridiculous. The operations can be difficult, made more challenging by the fact that you are not operating on healthy veins and arteries but rather very diseased ones. Cold limb, rupture, dissection, trauma, etc. I went to the doctor a couple days ago though about my hand and they referred me to a vascular surgeon and I’m getting a scan in the new year. - I have no issues with the 0+5 model and actually almost re-entered the match as a PGY-2 to try and obtain one of those slots. What did you end up going into? Although there have been landmark strides made in the field over the last 30 years, it still today remains  an incredibly challenging and dynamic field from a patient care and research standpoint. Reddit; Summary. But you really have to take this with a grain of salt because geographics will play a large role in how you’re compensated as well as how your contract is structured, your wRVUs, etc. Anyone who is attracted to surgery will innately have a desire to not only fix a problem (because all of medicine seeks to do that) but to do so tangibly with their hands. Holy shit I just watched the video of the carotid endarterectomy and wow... is that a common procedure? Is Vascular Surgery destined for outpatient venous work, amputations, and the less common (but still relatively high-volume) EVARs, CEAs, bypasses, and high-end emergency hospital case? Can I just ask what type of residency you switched to? Inpatient vs Outpatient: Each attending does one full day of clinic a week and half day of veins. Being the chief of the service, I usually wake up around 0500 and get to the hospital around 0530. Training in endovascular surgery has therefore become an important part of the vascular surgery curriculum.1 Current and projected numbers In 2014, a survey by the Vascular Society of Great Britain and Ireland of 2352 vascular surgery consultants across 95 NHS trusts established current work practices and highlighted projections for future service and training needs. For almost half a year, due to my health anxiety, I have been pinching my abdominal wall veins pretty hard, resulting in possibly damaging them (or the nerves above them). We're starting to really ramp up the TCARs that we're doing and also do stents occasionally. I was his cheerleader and coach as he fought against the illness that eventually took his life, and learned that healing becomes the most important when a cure is out of reach. From what I've researched about arterial tortuosity it doesn't seem to be normal at all, at least not in the non-elderly. Vascular Graft Market 2019 Global Analyses – by New Development, Business Opportunities, Share Overview, Demand, Regional Demand and Growth Insight to … Each resident depending on their interests will graduate with around 6-10 months on the vascular service over the course of 5 years. Vascular Surgery Residency. When you finish, you have more control over your schedule. As specific questions come up, I’d be more than happy to try and answer those. Abstract Surgical site infections (SSI) substantially increase costs for healthcare providers because of additional treatments and extended patient recovery. Hi fellow applicants - It's that time of year, when 2020's spreadsheets wither and die and the 2021 specialty specific … Carotid endarterectomy (one of my favorite procedures to do): https://www.youtube.com/watch?v=Oa8XV27KNAY. What’s not to like? My veins are not visible from the outside, only a few spider veins. Cheers. Currently you will either go the traditional route (5+2) whereby you do a general surgery residency (5-7 years) and then a standard 2-year fellowship in vascular surgery. Vascular Surgeons are the only vascular specialist able to provide all treatment options available for Peripheral Artery Disease or PAD. Operate all throughout the body and on every vessel outside of the brain and heart. Anyone who is already a practicing attending or fellow would be able to lend more insight. Gives a list of training programs and various paradigms. They also feel uncomfortable and some are slightly painful when I lift my arms, probably because they tighten, or after I touch them for some time. This is just probably the coolest thing I would want to do but after that graph of how much people in vascular work I just can’t bring myself to do so. I’ll do the more complex cases or since I am going into vascular, I’ll even do the angios to get better with my wire skills and get comfortable with the sizes and lengths of various sheaths, catheters, balloons, etc. 6 comments. But I do mean it when I say that this isn’t a field that you talk yourself into. No redness or discoloration is visible. When interviewed about personal interest in vascular surgery, general surgery residents cite concern for loss of vascular patients to other interventionalists as a possible deterrent to pursuing the field. Welcome to /r/MedicalSchool: An international community for medical students. Surgical videos from DICET at Houston Methodist on open aortic procedures. We make one shoe at a time. I only found (Advanced Aortic) any others? Lifestyle: This is highly variable, but vascular surgeons tend to work a fair bit more than other specialties. You pick the job you take, so of course you know the hours and the situation. Income: If I remember correctly the starting median salary for an academic job is $382K/yr and private practice is $442K/yr (I could be completely wrong on these figures). What is the split of open versus endovascular procedures and do you see endovascular becoming more popular/taking up a greater percentage of cases? By using our Services or clicking I agree, you agree to our use of cookies. Shortages in staff, operating theatre space and intensive care beds has led to a significant reduction in the provision of surgical care. share. At my institution it is actually quite cordial, and where I am heading for my fellowship is much the same since everyone is under the same umbrella of a heart and vascular institute. The data were analysed to evaluate the number of inpatient consultations, the reason for the consultation and its outcome. We'll save it in our wiki for future reference! Any suggestions on what I can do while waiting for my appointment? Bottom line - none of us are going to be hurting for money, and we will sure as hell work for it. Contemporary vascular surgery is also heavily technology dependent, and has manifested itself in the ability to perform hybrid procedures whether that is sewing in iliac/subclavian conduits for a complex EVAR or femoral endarterectomies and stenting to create ipsilateral in-line flow to the foot. My colour has never been great but the last several weeks my right hand has been red and swollen with some bruising. Or you can go directly into vascular surgery and match into an integrated program right out of medical school. Press J to jump to the feed. It’s unfortunate because it really is the coolest surgical special out there. Talk to the overnight residents and get updates. Cheers. Cookies help us deliver our Services. https://www.youtube.com/watch?v=o0pJr6BiMjA, https://www.youtube.com/watch?v=Y1xS2TVL-GE. They call if they have questions, but do an awesome job of making sure these patients don’t fall through the cracks and get the follow-up they need. Spoke with my PD and he told me to stay in GS and that I wouldn't regret my training. They are master technical surgeons and are often called to bail others out of trouble. 9400 W. Higgins Rd., Suite 315 Rosemont, Ill. 60018-4975. If everything goes well and we have no add-ons, we’re at signout for the night float team by 1645 or we catch them later on after we’ve wrapped up all the floor issues and done our postop checks. I do not smoke, rarely drink alcohol and drink a lot of water. Consults will come in throughout the day and the intern/junior will go see them and report back to me. Hi - please help. It is dedicated to the science and art of vascular surgery and aims to improve the management of patients with vascular diseases by publishing relevant papers that report important medical advances, test new hypotheses, and address current controversies. The amount of people they have helped, lives and limbs saved, families comforted has been humbling to experience. Hahaha. 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