A vascular surgery fellowship program was established at Rush University Medical Center over 20 years ago with the goal of preparing individuals who have successfully completed a general surgery residency to become proficient vascular surgeons in either a private or academic practice setting. The objective of the program is for trainees to become independently capable surgeons who are able to manage and treat all surgical and medical aspects of vascular disease. Fellows are given ample opportunity to build and enhance their skills as they relate to vascular surgery, with the anticipation that they will progress to become leaders and innovators within the field.
The two-year vascular surgery fellowship at Rush University Medical Center begins with an initial year dedicated to acquiring the skills necessary to become proficient in duplex ultrasonography, percutaneous intervention and clinical investigation. Approximately three months are spent in the noninvasive vascular laboratory learning how to perform, record and interpret exams. The fellow will become adept at performing ultrasound examination of the venous system of the lower extremity and the extracranial carotid arterial system. Fellows also obtain significant exposure to performing surveillance scans of lower extremity bypass grafts, preoperative upper extremity evaluation for hemodialysis access, and ultrasound evaluation of the abdominal aorta and its branches. The fellow is expected to not only become proficient at performing the exams, but in reading and interpreting them as well. At the completion of this rotation, the trainee will have acquired the knowledge and experience necessary to take the Registered Vascular Technologist (RVT) exam.
Approximately six months of the first year are spent acquiring basic and advanced catheter skills for percutaneous interventions in the arterial and venous systems. The fellow performs interventional procedures with interventional radiologists as well as with vascular surgeons in the fellowship training program. Fellows work with vascular surgery faculty performing angiographic procedures during the first year at the Stroger Hospital of Cook County, which is adjacent to Rush University Medical Center. The fellow is exposed to standard diagnostic arteriography for abdominal aortic, lower extremity, upper extremity and cerebrovascular disease, as well as interventions in these areas. There is also a wide range of exposure to the diagnostic and therapeutic percutaneous interventions available to treat patients with difficult hemodialysis access.
Three months of the first year of the fellowship are allowed for conducting ongoing clinical research and preparing manuscripts for presentation at the local, national or international level. Throughout the year, the first-year fellow is responsible for supporting the clinical service in the operating room and on the wards when needed, and provides on-call coverage from home as well.
The second year of the fellowship training program is devoted to concentration in the vascular surgery clinical arena, with time spent in the operating room, on the surgical wards and in the outpatient office. The fellow runs a busy surgical service and is responsible for coordinating the inpatient care of all vascular patients and consults. The fellow will be exposed to and become proficient in a wide variety of surgical approaches to vascular disease including open and endovascular repair of abdominal and thoracic aortic aneurysms, open and endovascular management of carotid disease, bypass for lower extremity disease, thoracoabdominal aneurysm repair, mesenteric and renal reconstruction and surgical and/or endoveous intervention for venous insufficiency.
At the completion of this training program, the fellow will be well-prepared to enter any busy vascular practice. The fellow will have obtained the necessary skills in ultrasound, angiography and surgical technique to provide excellent and comprehensive care for the vascular patient. With a cohesive and well-rounded approach to the management of vascular disease, this fellowship provides the training necessary to not only succeed in today's world of vascular surgery but to thrive in the future as the field continues to evolve.
Policy on Selection Criteria
The selection process is based on the match system. All applications are prescreened and approximately fifteen of the candidates are invited to interview. Unfortunately, not all applicants can be interviewed due to time constraints.
Policy on Work Environment
Vascular fellows have office space within the departmental offices with our department senior residency coordinator. A computer, desk space and mailbox are assigned specifically for the vascular fellow. A vascular fellow call room is adjacent to the Surgical Intensive Care Unit and has bathroom and shower facilities. In the vascular lab, the fellow has access to several computers and a private office for work and study.
Policy on Duty Hours
Vascular fellows in both the first and second year of training are restricted to 80 hours of work in the hospital per week. In addition, fellows are required to have 24 hours of continuous time off for every seven day work period. Both fellows participate in providing on-call coverage for the vascular service. Call is taken from home with in-house support from general surgery residents.
Policy on Supervision
Vascular fellows are directly supervised by the individual surgical attendings. All new consults are evaluated and reported to the surgical attending. In the operating room, the surgical attending is always present for the critical portion of the procedure. Attending staff is always available and accessible for discussion with the fellow.