Vascular Surgery Residency
Residency Training Program - Curriculum
Preliminary Year
The first year trainee is involved in four main areas of activity:
- Endovascular Training
- Non-invasive vascular laboratory
- Clinical research
- Basic science research
Endovascular Training
In both the preliminary and clinical years, the vascular resident masters basic
and advanced endovascular skills through the following curriculum:
- The resident will be instructed in all aspects of endovascular management
including basic and advanced catheterization skills, principles of diagnosis,
and therapeutic endovascular procedures including angioplasty, stenting, embolization,
and endografting.
- Endovascular procedures are performed in the operating rooms of all our
affiliated institutions using the most modern portable imaging equipment and
under the direction of our experienced vascular surgical faculty. The University
of Maryland Hospital also has a new operating room equipped with fixed fluoroscopy.
Here, the esident will be exposed to complex cases requiring a combined endovascular
and open surgical approach.
- The preliminary residents have primary responsibility for endovascular procedures
performed on the Vascular Surgery services at Mercy Hospital, Baltimore Washington
Medical Center, and the VA Hospital.
- The preliminary residents have primary responsibility for ultrasound-guided
interventions such as bedside insertion of IVC filters and ultrasound guided
treatment of femoral pseudoaneurysms performed at UMMS.
In both years the fellow is involved in our active program of endograft repair
of aortic aneurysms.
Non-invasive Vascular Laboratory
Goals and Objectives:
- The trainee will acquire knowledge of ultrasound physics as it applies to
current established techniques of vascular diagnosis.
- The trainee will become familiar with all major forms of instrumentation
associated with routine noninvasive vascular diagnosis, including plethysmography,
continuous-wave and pulsed Doppler, and Color-flow duplex ultrasound scan
technology.
- The trainee will learn to perform, supervise, and interpret the results
of noninvasive testing modalities performed for major non-cardiac vascular
disorders.
- The trainee will learn the applications of noninvasive vascular testing
in the development of practice guidelines, surveillance, outcome assessment,
and clinical research in vascular disorders.
- The trainee will learn the administrative skills necessary to serve as a
medical director of a noninvasive vascular laboratory.
- The trainee will be qualified for certification as a Registered Vascular
Technologist (RVT). These goals are achieved through a program of:
- Hands-on experience in the vascular lab
- Didactic training sessions
- Clinical applications in a variety of institutional settings with progressive
experience and instruction in the interpretation of vascular studies.
Clinical Research
This experience includes project selection, literature review, experimental
design, data collection, reduction and analysis, presentation skills and manuscript
preparation.
Some examples of past and current research include:
- Assessment of cerebral ischemia during carotid endarterectomy under regional
anesthesia
- Physiology of mechanical compression devices in prevention of deep venous
thrombosis
- Clinical utility of duplex Doppler surveillance programs in the management
of deep venous thrombosis prophylaxis in high risk neurosurgical and trauma
patients
- Role of defects in fibrinolytic proteins in the clinical status of patients
with peripheral arterial occlusive disease and in post-operative patients.
- Effectiveness of duplex Doppler ultrasound in the selection of patients
for renal artery revascularization
- Application of duplex Ultrasound to the evaluation of ocular ischemic syndromes
and the assessment of results of carotid revascularization.
- Safety and efficacy of bedside, duplex guided deployment of IVC filters
in high risk ICU patients
- Clinical Studies of Aortic Endografts
- Study of Acquired Anticoagulants
- Treatment alternatives for femoropopliteal arterial occlusive disease
Past fellows have had presentations at the annual meetings of the Eastern Vascular
Society, Midwest Vascular Surgery Society, Southern Association for Vascular
Surgery, Chesapeake Vascular Society, Society for Clinical Vascular Surgery,
and the Venous Forum.
Basic Science Research
The goal of this program has been to broaden the residents' understanding of
the physiology and pathophysiology of the vascular system and to increase understanding
of the molecular and cellular mechanisms of vascular disease.
The focus of the research program has been the study of flow mediated remodeling
of collateral arteries in an animal model of hind limb ischemia. Laboratory
techniques have included: chronic animal limb ischemia models, in-vivo blood
flow and hemodynamic measurements, angiography, light histology, in-situ hybridization,
mRNA analysis with Northern Analysis and RT-PCR, zymographic assays of metalloproteinase
(MMP) activity, and ELISA.
Residents learn the principles of experimental design, hemodynamic measurements,
micro-surgery, basic molecular biology, data analysis and publication skills.
This experience has resulted in academic presentations at Vascular Basic Science
meetings including: Research Initiatives in Vascular Surgery, Experimental Biology
(FASEB), Vascular Biology (American Heart Association), and The Surgical Forum
of the American College of Surgeons.
This page was last updated on: August 23, 2007.
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