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

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.
• 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.