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Evaluating The Venous Experience In Vascular Surgery Training
MICHAEL SIAH1, STEVEN ABRAMOWITZ1, Edward Woo1, PAUL HASER2, JOHN RICOTTA3, Robyn Macsata4.
1MEDSTAR WASHINGTON HOSPITAL CENTER/GEORGETOWN UNIVERSITY, Washington, DC, USA, 2MONCTON CITY HOPSITAL, Washington, DC, USA, 3GEORGE WASHINGTON UNIVERSITY, RESIDENCY REVIEW COMMITTEE, Washington, DC, USA, 4VAMC, MEDSTAR WASHINGTON HOSPITAL CENTER/GEORGETOWN UNIVERSITY, Washington, DC, USA.

Objective:
There is an increasing recognition and treatment of venous disease in the United States; results of the Society for Vascular Surgery (SVS) 2014 membership survey showed venous disease compromises 18.8% of a vascular surgeon’s current practice. Despite this, there are no operative objectives or case requirements specific to venous disease for vascular surgery (VS) trainees. The objective of this study was to examine the current venous surgical training experience of graduating VS trainees.
Methods:
Following Institutional Review Board (IRB) waiver and Association of Program Directors in Vascular Surgery (APDVS) and Residency Review Committee (RRC) approval, results of the 2014 APDVS educational needs assessment survey pertinent to venous training as well as the vascular surgery in-training examination (VSITE) venous scores were summarized. Using the RRC case log database, venous case logs of 0/5 resident and 5/2 fellow VS graduates from 2012-2015 differentiated by CPT code were summarized. Venous case logs of 0/5 VS residents were compared to 5/2 fellows using a student t-test with results considered statistically significant at a p<0.05.
Results:
15% of recent VS graduates felt they encountered training gaps in venous procedures; 54% felt this was due to a gap in VS training while 43% felt this was due to evolution in technology. Venous VSITE scores were similar between 0/5 residents and 5/2 fellows (69% vs. 76% correct answers, respectively) as well as overall VSITE scores (70% vs. 74% correct answers, respectively). Venous case logs are summarized in table 1. 0/5 residents averaged statistically significantly more cases than 5/2 fellows (p<0.01). 0/5 residents completed between 11 and 264 cases and 5/2 fellows completed between 1 and 188 cases during their training. 0/5 residents venous cases were 8.1% of overall cases and 5/2 fellows cases were 4.3% of overall cases during their training.
Conclusion:
Current VS trainee experience is highly variable and not consistent with future VS clinical practice. VS trainee fund of knowledge does not appear affected. Program directors should consider developing a better defined venous curriculum which includes venous case minimums in defined categories.

2012-2015 Venous Case Logs
Case Description
(# graduates)
Resident
(58)
Fellow
(497)
Total
(555)
Cases/ResidentCases/FellowCases/Resident & Fellow
Open Thrombectomy454524970.780.910.90
Reconstruction IVC576156720.981.241.21
Vein Bypass151862010.260.370.36
Sclerotherapy2296859143.951.381.65
Venous Ablation12677274854121.8414.6415.39
Percutaneous Thrombectomy255163718924.403.293.41
Venous Angioplasty482212690.830.440.48
IVC Interruption11305572670212.0811.2112.08
Ligation/Phlebectomy
Total:
917
3963
2856
19498
3773
23461
15.81
68.33
5.75
39.23
6.80
42.27


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