Vascular Surgery Residency

Residency Training Program - Curriculum

Curriculum Overview | Preliminary Year | Clinical Year

Clinical Year

The clinical year is divided between rotations at the University Hospital and the Mercy Hospital. These two institutions have dedicated Vascular Surgery teaching services. On both services the vascular resident is the senior trainee on a service that is supported by junior-level general surgical residents.

University and Mercy have independent clinical activities, but all major clinical conferences are held jointly. Instruction at both hospitals is provided by the full-time academic teaching faculty.

The clinical curriculum includes:

Performance of all forms of non-cardiac vascular surgical, vascular trauma, and endovascular procedures.
Refinement of inpatient management skills for pre- and post-operative patients on the Vascular Surgery Service
Outpatient evaluation of patients with known or suspected vascular disorders.
Didactic conference and lecture programs
Teaching general surgical residents and medical students
Instruction in techniques of preparation of graphic materials for conferences, presentations and publications
Clinical research
Expansion of skills in the field of noninvasive vascular testing including clinical applications and understanding of technological and physiological limitations and interpretations.
Instruction on the development of evidenced-based treatments, quality outcomes assessments, practice guidelines, and other practice management skills, as a part of the University of Maryland, Division of Vascular Surgery quality improvement team.

Surgical Procedures

The vascular resident performs all categories of major non-cardiac vascular surgical procedures under the direct supervision of the attending staff.

University of Maryland Hospital is an urban academic medical. The Division of Vascular Surgery treats complex patients from our local West Baltimore community and also receives referral of complex vascular cases from practitioners throughout the state of Maryland and the surrounding geographic region. The DVS also participates in the specialty care of vascular trauma cases seen at the Maryland Shock-Trauma Center, the nation's busiest trauma unit.
Mercy Medical Center is an inner-city, community based, comprehensive acute-care hospital. The Mercy Vascular Center has a large clinical vascular surgery service with significant experience in endovascular procedures.

Vascular residents in our program have generally performed 250-275 major open surgical procedures during their clinical year. Surgical case totals are generally balanced with regard to case mix (e.g. carotid, aortic, extremities), but our cases tend to be at the high end of complexity. A typical clinical year would be expected to include:

50 carotid endarterectomies
15 repairs of suprarenal and thoracoabdominal aortic aneurysms
15-20 visceral artery reconstructions
40 aortic reconstructions for occlusive or aneurysmal disease
60 infrainguinal vascular reconstructions

Dialysis access procedures are obtained during the Mercy Hospital rotation.

Endovascular procedures

During the clinical year the vascular resident performs diagnostic angiography, as well as peripheral and visceral angioplasty and stenting. The operating room is fully equipped with the latest imaging technology and endovascular equipment.
During the clinical year the vascular resident performs a substantial number of aortic endograft procedures in the operating room. Aortic and peripheral stent graft procedures are performed routinely at all of our training sites. The Baltimore VA Medical Center is enrolled in the multi-institutional endograft trial (OVER). Trainees have experience with all approved endograft and stent graft devices available. The Division will also be involved in future clinical trials involving endograft treatments in both the infrarenal and thoracic aorta.
Members of the teaching faculty are qualified to perform carotid interventions and the Division is approved for participation in the CREST trial.
Upon completion of the training program, the vascular resident will have both the skills and experience to qualify for independent performance of all approved percutaneous interventions and aortic endografting based upon all current established credentialing guidelines.

Inpatient Management

The vascular resident serves as a supervisory resident in the clinical management of all inpatients on the teaching Vascular Surgery service at all institutions. The vascular resident is assisted by a second and/or first year general surgical resident on both services (UMH, Mercy). Daily work/teaching rounds are made with the attending staff to plan diagnostic and therapeutic strategies for all patients. It is anticipated that throughout the year, the vascular resident will assume an increasing degree of responsibility for perioperative patient management decisions.

Outpatient Experience

The vascular resident will attend the weekly outpatient Vascular Surgery Clinic at UMMS and the Mercy Vascular Center during the period of his/her rotation at each institution. The resident will directly examine and evaluate patients and confer with the attending staff to plan further diagnostic evaluation and treatment. During the clinical rotation at UMMS the vascular resident may also attend daily outpatient sessions held on a rotating basis by each staff member to see referral patients.

Conference Experience

The conference schedule can be reviewed on a separate site. There is a monthly clinical curriculum didactic lecture and quarterly talks by visiting experts. The clinical resident is responsible for choosing case presentations for the weekly main Vascular Conference, and coordinating preparation of educational materials for discussion. The clinical resident also has primary responsibility for the weekly Preoperative Conference, where each patient scheduled for surgery is reviewed in detail. The preliminary resident is responsible for planning the bi-weekly Vascular Lab Conference and the monthly Journal Club.

Academic Environment

All fellows have office space in the Division of Vascular Surgery academic suite with full computer support for access to electronic patient records, the radiology PACS system, web-based literature research, and internet services. There is a Division of Vascular Surgery library with books, journals, and there are extensive reprint files of past and current literature.

Support for Academic and Scholarly Activities

The Division supports travel and expenses for residents to present scholarly material to meetings of all major vascular societies. The clinical resident is routinely allowed to attend board review courses that are offered annually.

Work Environment

On call responsibilities are shared among the fellows and conform to current ACGME guidelines. Long-range pagers are provided and call may be taken from home. Call-room facilities are provided if necessary. The DVS office has a fully equipped kitchen. Residents have a total of 2 weeks of vacation time each year.

This page was last updated on: August 23, 2007.

For patient inquiries, call 410-328-5840 or 1-800-492-5538 and e-mail us at: MarylandVascularCenter@smail.umaryland.edu