Vascular and Endovascular Surgery Fellowship

Overview

The Division of Vascular and Endovascular Surgery, part of the Fireman Vascular Center at Massachusetts General Hospital, provides comprehensive training in vascular surgery with an emphasis on complex procedures. The Division of Vascular and Endovascular Surgery is one of 12 divisions within the Department of Surgery at Mass General with broad clinical programs for both primary and tertiary care problems.

The Vascular and Endovascular Surgery Fellowship is a combined two-year ACGME-accredited program of research and clinical activities. A dedicated staff presents multiple opportunities for academic development both along clinical and basic lines. The fellowship is designed both for individuals who intend to continue in academic surgery and enter private practice. Virtually all trainees in the program to date have been board-eligible in general surgery by virtue of completing a five-year general surgery residency.

The fellowship collaborates closely with the Interventional Cardiology Fellowship at Mass General, with a joint conference and collaborative protocols for a variety of endovascular interventions, including carotid stenting.

Curriculum

First Year

The first year of the fellowship is devoted to basic research, clinical research and developing endovascular skills. The fellow also gains experience in the Noninvasive Vascular Laboratory at Mass General, which sees a high volume of patients each year and has expertise in cerebral and peripheral vascular diagnostic modalities.

Second Year

During the second year, the fellow works on the inpatient service within the Division of Vascular and Endovascular Surgery, where a high volume of open (or combined endovascular) surgical cases are performed yearly. The fellow’s primary responsibility is to be a leader of the patient care team. The second year provides an in-depth and broad exposure to both routine and complex vascular surgical problems. The fellow is included in patient care from initial outpatient evaluation to long-term follow-up. The year is structured to provide training in the appropriate use and integrated interpretation of diagnostic modalities, to develop vascular surgical judgment and to gain technical expertise in the surgical management of a wide range of vascular surgical procedures.

The fellow gains administrative experience through the day-to-day running of activities such as rounds, conferences and schedules. It is expected that during this second year, the fellow will take a strong role in all educational components of the Division of Vascular and Endovascular Surgery.

Clinical Experience

Four fellows participate in the Vascular Service each year. The fellow’s time is divided between two teams of attending surgeons designated as the Linton and Darling Services. Such designation honors the memories of Robert R. Linton, MD, the founder of Vascular Surgery at Mass General, and his protégé, R. Clement Darling, Jr., MD, whose clinical and academic contributions established Mass General as a major academic center for vascular surgery.

The Vascular Service performs about 1,200 open cases per year. Although 100 cases per year are required by the American Board of Surgery to be eligible for certification in vascular surgery, our fellows generally list well over 300 cases as primary surgeon and participate actively in many more cases. The caseload ranges from complex aortic arch, thoracoabdominal, aortorena and mesenteric artery reconstructions to distal tibial/pedal artery bypass procedures. There are also many standard reconstructions performed. Stent graft repair of both abdominal aortic aneurysms (triple A) and thoracic aortic aneurysms are routinely performed. An appropriate balance of emergency reconstructions is also included in the clinical experience. The Vascular Service serves as consultant to the Mass General Trauma Service for treatment of vascular trauma patients.

The patient care responsibilities of the vascular fellow are structured to maximize educational and training opportunities. Strong ancillary services, including service-dedicated physician assistants, as well as the presence of more junior residents, obviate much of the need for junior resident type responsibilities. It is expected that the vascular resident will retain primary responsibility for the patients on whom he or she has operated and attention to administrative detail for these patients is expected. The vascular resident takes no in-house call but is expected to be available for inpatients and urgent transfers during the week and to rotate backup weekend call. In addition to the two vascular residents, there are general surgery residents assigned to the Vascular Service, two in their final (PGY-5) year and four at junior levels. Each service thus comprises an administrative vascular fellow, as well as a senior and junior resident. Vascular Fellows are responsible for assigning case coverage. Vascular fellows and residents perform approximately 80% of cases on the Vascular Service as primary operators.

Research Experience

The Division of Vascular and Endovascular Surgery includes the Vascular Biology Research Laboratory. Principal areas of investigation include ischemic/reperfusion injury and spinal cord protection. There is also an active clinical research program that includes ongoing clinical trials, which are an integral part of the academic program.

Participation in the basic science program is included in the first year of the fellowship. It is primarily designed to teach critical, analytical thinking about fundamental issues in vascular biology as particularly relevant to vascular surgery. One year usually is not enough to achieve full competence in basic research skills, however the broad exposure to research projects will allow the fellow to participate in research programs in their future career, if desired.

How to Apply

Application Documents

Please submit the following documents electronically via ERAS:

• Four letters of reference (one must be the medical school dean’s letter)
• Curriculum vitae
• Photo (preferred, but not required, for identification during interview process)
• Personal statement
• Most recent ABSITE score
• USMLE Step 1, 2 and 3 results or equivalent

Shortly after all applications are received, selected individuals will be invited for a formal interview to be held in March. At that time, current residents and staff will meet with the applicants. Tours will be given by the residents and any questions you have about the program will be answered.

National Residency Match Program (NRMP)

The Vascular and Endovascular Surgery Fellowship participates in the National Resident Matching Program (NRMP). Registration information and dates for the 2019-2020 academic year can be found on their website at nrmp.org.

Fellows in the two-year program are selected via the NRMP. Two positions are available each year. Acceptance into this program means that fellows selected in the matching program automatically proceed to a two-year fellowship.