Residency/Fellowship Training (5+ years) – There are multiple training pathways within Graduate Medical Education (GME) to become a vascular surgeon. These are Integrated Vascular Surgery Residency (known as 0+5), General Surgery Residency followed by Vascular Surgery Fellowship (known as 5+2), and in certain select cases a Fast-track General/Vascular Surgery Joint Training Program (known as 4+2). Each of these has unique advantages and disadvantages and the decision about which pathway to pursue is amongst the most important that any applicant will have to make.
Integrated Vascular Surgery Residency (0+5) – The 0+5 paradigm provides the fastest path to board eligibility in vascular surgery, requiring 5 clinical years and a program-specific period of academic development time. The first 0+5 program was approved in 2007 and the number of available integrated vascular positions has increased from 19 positions in 2009 to 100 positions in 2024. https://www.nrmp.org/match-data-analytics/residency-data-reports/
– Residency Structure: The specific structure of training can vary significantly between programs. In general the first-year (PGY-1) residents, also known as interns, are responsible for the day-to-day management of patients on the floor. Residents in their PGY-2 and PG-3 years typically are responsible for critical care and evaluation of consults while senior residents in their PGY-4 and PGY-5 years are fully immersed in the nuances of operative conduct. Vascular surgery training has an obligatory minimum ofat least 18 months of Core Surgical Rotations, which usually include rotations in General surgery, Cardiac surgery, Intensive care, and Transplant surgery. You should try to gain unique perspectives and tricks from these other specialties, which could help you to shine during your Vascular surgery training.
– Research during Integrated Vascular Surgery Residency: One of the exciting things about vascular surgery is that there is interesting research being done in not only basic sciences but educational initiatives, outcomes, and clinical trials. Some Vascular Surgery residency programs have a mandatory research component (1-2 years), while others provide non-obligatory research time (ranging from a few months up to several years), based on your career goals. It’s crucial to discuss your career interests with your Program Director early in your residency training, so you will be able to get the necessary funding and dedicated time. Though some programs may not have resources to provide you dedicated research time many residents are still very productive in conducting research during their training. If you don’t have a research mentor in your institution, resources like the VESS Mentorship program (https://vesurgery.org/resources/find-a-mentor/ ) can help to connect mentors and mentees from different programs in the USA.
– National Meetings – There are several annual meetings that are valuable career opportunities – remember that this is not only an opportunity to present research but a chance to identify mentors and develop connections that an be helpful throughout your career! A list of meetings can be found at https://vascular.org/trainees-students/resources/meetings. Don’t forget to apply for travel scholarships that are available for most meetings!
General Surgery Residency and Vascular Surgery Fellowship (5+2) – The 5+2 paradigm, also known as the “Traditional Fellowship” entails completing a general surgery residency (5 clinical years with a program-specific period of academic development time) followed by a vascular surgery fellowship (2 clinical years). Fellowship does not have to be completed at the same institution as residency and does not have to be completed immediately after residency. Graduates of these pathways are board-eligible in both General and Vascular Surgery.
– Junior Residency (PGY-1, PGY-2) – Junior residency is intended to provide a broad exposure to surgical specialties while learning how to manage patients and developing fundamental operative skills. The amount of time that residents spend on vascular surgery, as well as their role on the service, will depend on the specific institution. You should use these early experiences to learn the perioperative management of vascular patients, gain familiarity with the operative conduct of basic procedures, and develop relationships with faculty.
– Vascular Surgery Research During Residency – As mentioned before, research projects are a valuable opportunity to work closely with faculty to better understand the field. As with intergrated residencies, some general surgery programs include one or more years of built-in academic development time however residents should seek out opportunities before, during, and after their dedicated academic time.
– National Meetings – Like students and integrated residents, general surgery residents are welcome at national meetings (https://vascular.org/trainees-students/resources/meetings). Remember, almost all meetings have travel scholarships available to cover some or all of the cost of attendance for residents and for students and many residencies will help pay for conferences at which a resident is presenting. These are valuable opportunities for professional networking and to learn more about the future directions of the field.
– Senior Residency (PGY-3 – PGY-5) – Senior residency is designed to teach the nuances of patient management and operative conduct in a variety of surgical specialties. This is when you will be immersed in the operative experience of vascular surgery. The specific rotation structures will vary depending on the institution. Use this time to make a final decision about pursuing a career in vascular surgery and to develop meaningful relationships with faculty members.