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Vascular surgery training in general surgery residency programs: the Canadian experience.

R S Sidhu1, M Ko, L Rotstein

  • 1Division of Vascular Surgery, University of Torornto, Ontario, Canada. raviparv@hotmail.com

Journal of Vascular Surgery
|November 7, 2003
PubMed
Summary

General surgery residents in Canada receive insufficient vascular surgery training. Most residents do not intend to perform vascular procedures, and experts agree more specialized training is needed for competence.

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Area of Science:

  • Surgical Education
  • Vascular Surgery Training
  • Residency Programs

Background:

  • Vascular surgery is traditionally part of general surgery training.
  • Evidence suggests improved patient outcomes with surgeon volume and vascular certification.
  • Current training requirements for vascular surgery within general surgery are controversial.

Purpose of the Study:

  • To assess the experience and perceived competence in common vascular surgery procedures among general surgery residents in Canada.
  • To evaluate the alignment of training with the perceived needs for performing vascular procedures.

Main Methods:

  • A web-based survey was conducted from January to June 2002.
  • Participants included general surgery program directors (GSPDs), vascular surgeons (VSs), and senior general surgery residents (SRs) from 13 Canadian English-speaking programs.

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  • Survey questions focused on appropriate procedures for general surgeons, training received by SRs, and intended future practice.

    • Main Results:

    • 49% of SRs did not intend to perform vascular procedures post-training.
    • Agreement existed that SRs should be trained in varicose vein surgery, leg amputation, and femoral embolectomy.
    • Disagreement on training for complex procedures like infrainguinal bypass, carotid endarterectomy, and AAA repair, with SRs more inclined than VSs.
    • 76% of VSs believed SRs receive inadequate vascular training.

    Conclusions:

    • General surgery residency programs in Canada show consensus regarding vascular surgery training content.
    • Current general surgery training is insufficient for competence in managing common vascular surgery procedures.
    • Additional rotations or fellowship training is necessary; competence in vascular surgery may not be an appropriate objective for general surgery training.