Curriculum

The Henry Ford vascular surgery fellowship program is a 2-year clinical experience with emphasis on the deliverance of patient care, expansion of knowledge base concerning clinical and basic science data, research related to vascular surgery, and the acquisition of endovascular and operative skills. An actual research rotation is not allocated; however, research opportunities are available, encouraged, and are a vital aspect of the maturation of the resident physician. The vascular surgery service is easily identified as a separate unit with a service-specific vascular surgery clinic, hospital-based service, operating room, and dialysis access areas. During the two years the resident physician is expected to learn and become proficient in the following areas:

1. Experience in non-invasive vascular laboratory diagnosis and interpretation culminating in the studying for and passing the Physicians’ Vascular Interpretation (PVI) Examination provided thorough the Alliance for Physician Certification & Advancement (APCA).
2. Experience in the vascular surgery clinic to learn the mechanics of organizing and operating an efficient yet comprehensive vascular surgery clinic in the assessment of patients and deliverance of appropriate patient care.
3. Experience in the medical specialty devoted to the care and maintenance of patients who are on dialysis access. This includes but is not limited to preoperative evaluation, performance of temporary dialysis access catheters and devices, performance of permanent dialysis access grafts and or surgically constructed fistulas, management of complications of dialysis access including thrombosis, infections, and venous outflow obstruction.
4. Organization and participation in an in-patient vascular surgical service including post-operative care, in-hospital consultations, emergency room consultations, and intensive care unit patient care issues.
5. Development of competence in the performance of generalized angiographic diagnostic studies including aspects related to radiation safety, arterial and venous access, appropriate and safe use of fluoroscopic equipment, either mobile or fixed, and management of complications related to angiography.
6. Development of competence of endovascular interventions including the appropriate application of techniques such as angioplasty, stent placement, stent-graft placement, atherectomy, and mechanical and pharmacologic thrombolysis.
7. Development of competence in the preoperative planning, operative positioning, and the use of appropriate technical skill set and operative judgment necessary to perform safe and optimal vascular surgical arterial and venous reconstructions.

Patient care responsibilities for first-year fellow:

1. Provide senior leadership on the resident team rendering care to an inpatient vascular surgery service including all vascular surgery consultations.
2. Attendance with patient evaluation in the vascular surgery clinic ½ day weekly.
3. Attendance with patient evaluation along with the performance of procedures in the vascular access center averaged out to ½ day weekly.
4. Participation in call schedule (home call) with coverage responsibilities for patient evaluation initial management for impatient care, consultations, and transfers.
5. Performance, participation and exposure to the principles of endovascular care performed in the I-basement dialysis access center, the cardiac Cath lab angiogram suite (K2), the hybrid operating room (OR 30), and the regular operating room with mobile fluoroscopic equipment.
6. Participation and performance with progressive responsibilities commensurate with resident abilities and level of training for the all open operative cases
7. Notification and updated information provided to the vascular attendings staff of all changes in patient status or information.
8. Record keeping and dictations on their patients as deemed appropriate on all outpatient clinic appointments, preoperative notes and evaluation, emergency room or inpatient consultations, operative notes, procedural notes, and when necessary, discharge summaries (most discharge summaries are performed by the vascular surgical nurse practitioner).
9. Maintenance of communications and ongoing relationship with family members, patients, residents, students, and support staff in the progress, outcome, prognosis and ultimate plan being rendered in patient care.

Patient care responsibilities for second-year fellow:

1. Supervision, oversight and delegation of the day-to-day workings of the vascular surgery service.
2. Rounding and participation in the care of all patients who had an operation or procedure performed by the fellow with communication of patient care activities to the rounding team members.
3. Attendance with patient evaluation in the vascular surgery clinic ½-day weekly
4. Attendance with patient evaluation along with the performance of procedures in the vascular access center averaged out to ½ day weekly.
5. Participation in call schedule (home call) with coverage responsibilities for patient evaluation initial management for impatient care, consultations, and transfers.
6. Performance, participation and exposure to the principles of endovascular care performed in the I-basement dialysis access center, the cardiac Cath lab angiogram suite (K2), the hybrid operating room (OR 30), and the regular operating room with mobile fluoroscopic equipment.
7. Participation and performance with progressive responsibilities commensurate with resident abilities and level of training for the all open operative cases especially those involving less common or complex reconstructive procedures.
8. Notification and updated information provided to the vascular attending staff of all changes in patient status or information.
9. Record keeping and dictations on their patients as deemed appropriate on all outpatient clinic appointments, preoperative notes and evaluations, emergency room or inpatient consultations, operative notes, procedural notes, and when necessary, discharge summaries (most discharge summaries are performed by the vascular surgical nurse practitioner).
10. Maintenance of communications and ongoing relationship with family members, patients, residents, students, and support staff in the progress, outcome, prognosis and ultimate plan being rendered in patient care.

Vascular Surgery Fellowship Conferences

• Vascular Conference -- A biweekly conference involving a structured series of lectures covering basic and clinical sciences fundamental to vascular surgery. Lectures are assigned to residents rotating on the vascular surgery by the senior fellow.
• Divisional Morbidity and Mortality Conference -- A monthly conference in which all patients on vascular surgery service who developed complications and/or deaths are discussed in an open forum with faculty and trainees from the division. The PGY7 fellow is responsible for organizing the conference and presenting cases.
• Multidisciplinary Aortic Conference -- A monthly conference focusing on cases involving aortic disease of all types. The conference is attended by faculty and trainees from vascular surgery, cardiothoracic surgery, cardiology, and vascular medicine services.
• Departmental Morbidity and Mortality Conference -- A weekly conference in which cases involving morbidity and/or mortality are discussed in an open forum, with an emphasis on systems-based causes. Cases are presented by the trainee who served as primary surgeon, with commentary and discussion by the associated attending.
• Departmental Grand Rounds -- A weekly conference involving a series of lectures representing all surgical disciplines, including vascular surgery. One Grand Rounds each year is devoted to the Szilagyi Lecture, given by the invited visiting professor in vascular surgery.
  Journal Club -- A weekly conference at which papers from the recent literature that are of interest to vascular surgeons are discussed in detail.

ACGME Vascular Surgery Program Data Report