Program Overview

Program Curriculum

Loyola Medicine's Vascular Surgery Fellowship program started in 1978 making one of the oldest training programs in the country.

We offer the complete spectrum of endovascular training that includes diagnostic arteriography, balloon angioplasty of peripheral and visceral arteries (renal and mesenteric), carotid angioplasty and stenting and complex endograft repair of thoracoabdominal, thoracic, abdominal aortic and iliac aneurysms.

The endovascular program that has been developed to complement and mirror our rich history in open vascular. We perform both routine and complex procedures (aortic aneurysm and occlusive disease, lower extremity bypass, carotid endarterectomy, mesenteric and renal artery bypass, venous surgery, and arteriovenous access).

Loyola University Medical Center is a level 1 trauma center and we perform both open and endovascular interventions.

Program Description

Fellows alternate two-month rotations between Loyola University Medical Center and Edward Hines, Jr. VA Hospital over the two-year fellowship period.

At both hospitals, the fellow functions as the leader of the service, helping the attending surgeons care for the patients in both the outpatient and inpatient settings.

In the outpatient setting, the fellow is required to attend at least one half day of clinic per week. In addition, they participate in outpatient surgical procedures.

Inpatient care consists of active involvement in providing pre and post-operative care as well as the management of inpatient consults. Fellows are expected to actively participate in the majority of inpatient surgical and interventional procedures.

To broaden the clinical experience, the fellows currently are approved to assist with surgeries at our two community based hospitals (Gottlieb Memorial Hospital and MacNeal Hospital). The goal is for fellows to participate in open complex procedures, particularly aortic and mesenteric procedures. Once our integrated vascular program matures, we will have dedicated rotations at these institutions.

The fellow works with a first and fourth year general surgery resident while rotating at Loyola University Medical Center and with a first and second year general surgery resident while at Hines VA Hospital.

One or two third-year medical students rotate on the Loyola service for two week periods. In addition, a fourth year medical student may be on the Loyola service for one-month rotations. A podiatry resident may rotate on the service at Hines VA Hospital.

The fellow is responsible for aiding attending surgeons in the teaching of these colleagues and directing them in the care of patients at both institutions.

While rotating at Loyola, the fellow will have dedicated time in the vascular ultrasound lab. This experience will consist of two separate one-week blocks per year for a total of four weeks during the fellowship.

It is expected that this experience will complement the didactic teaching gained through the lectures which the junior fellow present to the division on a bimonthly basis.

While in the vascular ultrasound lab, the fellow is expected to observe, perform and interpret various arterial exams to include interrogation of the carotid, aortic, extremity, renal and mesenteric circulations. In addition, the fellow is expected to observe, perform and interpret venous duplex exams.

While rotating at Hines VA, the fellow can review, with the attending, all ultrasound studies performed within the vascular lab. Although the attendings' signature is required for finalization, the studies are available for review by the fellow so that he or she may sit for the Registered Physician in Vascular Interpretation (RPVI) exam.

Finally, it is expected that both fellows actively participate in all conferences offered by the Division of Vascular Surgery and Endovascular Therapy and the Department of Surgery.

Specifically, these include vascular case presentation conference, vascular topics conference, vascular lab conference, and morbidity and mortality conferences, for the department and division.

The first-year fellow is responsible for weekly vascular ultrasound lab conference including presenting on assigned topics and arranging demonstrations of specific vascular ultrasound techniques and studies.

The second-year fellow is responsible for running weekly vascular case conference and weekly vascular topics conference, which follows the VSCORE curriculum. This includes presenting on vascular topics and organizing monthly morbidity and mortality conferences within the division.

The second-year fellow is also expected to take responsibility for organizing the call schedule which is split between both fellows and the PGY-4 surgery resident.

Fellowship Objectives

Inpatient and outpatient care of the patient with arterial and venous diseases
Identification and management of co-morbidities prior to planning intervention
Performance, interpretation and application of non-invasive vascular laboratory techniques to the diagnosis and management of vascular disease
The ability to provide the best treatment options, including medical management of atherosclerotic disease, as well as open and endovascular techniques
Open vascular surgery – routine and complex procedures, including aortic aneurysm and occlusive disease, lower extremity bypass, carotid endarterectomy, mesenteric and renal artery bypass, venous surgery and arteriovenous access
Endovascular intervention – diagnostic arteriography, balloon angioplasty and stenting of peripheral and visceral atherosclerotic lesions, carotid angioplasty and stenting, endograft repair of thoracic, abdominal, iliac and extremity aneurysms, arteriovenous access interventions, endovenous laser ablation, mechanic al and medical thrombolysis (arterial and venous)
Designing and conducting vascular clinical outcomes studies

Evaluation Process

At the conclusion of each two-month rotation, the fellow's performance is evaluated by all faculty members. Faculty members evaluate each fellow in the six core competencies in addition to technical skills.

The fellow is provided an opportunity to evaluate the merits of the rotation and the faculty. The fellows are encouraged to attend vascular meetings with simulation and mock oral board examination. Feedback from these courses will be used to guide our trainees.

On a semiannual basis, the program director meets with the fellow to review their progress in the training program. The program director conducts a summative review and evaluation at the conclusion of the fellowship.