Residency Program Overview

Program Curriculum

The newly formed integrated vascular program follows our rich history and tradition in education and training vascular surgeons' since 1978. We offer the complete spectrum of endovascular training that includes diagnostic arteriography, balloon angioplasty of peripheral and visceral arteries (renal, mesenteric), carotid angioplasty and stenting and complex endograft repair of thoracoabdominal, thoracic, abdominal aortic and iliac aneurysms.

The endovascular program was 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 hospital is a level 1 trauma center and we perform both open and endovascular interventions.

General Description

The integrated vascular residents will rotate at four different hospitals to expose them to academic and community based hospitals as well as the VA hospital. This will broaden their clinical experience during their five years of training. The integrated vascular residents will rotate on general surgery where rotations have been selected to sharpen their clinical skills to complement their vascular training.

In all four hospitals, the integrated vascular residents will assist the attending surgeons and care for the patients in both the outpatient and inpatient settings. In the outpatient setting, the trainee 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.

The integrated vascular residents are expected to actively participate in the majority of inpatient surgical and interventional procedures. The integrated vascular residents will work with a first and fourth year general surgery resident while rotating at Loyola University Medical Center. Additionally, the residents will work with a first and second year general surgery resident while at Hines VA Hospital. We have one or two third year medical students rotate on the Loyola service for a two week period.

In addition, a fourth year medical student may be on the Loyola service for a one-month rotation. A podiatry resident may rotate on the service at Hines VA Hospital. The senior resident 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 any of the hospitals, the trainee 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 their training. It is expected that this experience will complement the didactic teaching gained through the lectures which the junior trainee present to the division on a bimonthly basis.

While in the vascular ultrasound lab, the trainee 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 resident is expected to observe, perform, and interpret venous duplex exams. Although the attendings' signature is required for finalization, the studies are available for review by the residency so that he or she may sit for the Registered Physician in Vascular Interpretation (RPVI) exam.

Finally, it is expected that all the integrated vascular residents on the vascular service to 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. Junior integrated residents are expected to attend the general surgery didactics.

The junior residents are responsible for weekly vascular ultrasound lab conference including speaking on assigned topics and arranging for demonstration of specific vascular ultrasound techniques and studies.

The senior residents are responsible for running weekly vascular case conference and weekly vascular topics conference, which follows the VSCORE curriculum. This includes speaking on vascular topics and organizing monthly morbidity and mortality conferences within the division. They are also expected to take responsibility for organizing the call schedule, which is split between both fellows and the PGY-4 surgery resident.

Integrated Vascular Surgery Residency Objectives

Inpatient and outpatient care of the patient with arterial and venous disease

• Identification and management of acute abdomen, critically-ill patients, and surgical emergencies
• 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 resident's performance is evaluated by all faculty members. Faculty members evaluate each resident in the six core competencies in addition to technical skills. The resident is provided an opportunity to evaluate the merits of the rotation and the faculty.

The residents 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 resident to review their progress in the training program. The Program Director conducts a summative review and evaluation at the conclusion of the residency.