Educational Resources for Vascular Laboratory Education in Vascular Surgery Residencies and Fellowships
Adam Tanious, MD, MMSc1, James D. Brooks, MD2, Murray L. Shames, MD2, Paul A. Armstrong, DO2, Mark Conrad, MD, MMSc1, David L. Dawson, MD3.
1Massachusetts General Hospital, Boston, MA, USA, 2University of South Florida, Tampa, FL, USA, 3UC Davis, Sacramento, CA, USA.
Objective:
The Registered Physician in Vascular Interpretation (RPVI) is a prerequisite for Vascular Surgery Board of the American Board of Surgery (VSB-ABS) certification. Despite this, vascular surgeons’ pass rates on the Physician Vascular Interpretation (PVI) examination have been gradually declining. Residents and fellows have a lower PVI exam pass rates than practicing vascular surgeons and there is currently no standardized curriculum for the vascular laboratory (VL). The goal of this study was to assess the VL experience of vascular trainees in an effort to identify ways to improve PVI pass rates.
Methods:
Program directors of 117 ACGME-accredited vascular surgery programs (107 fellowships, 53 integrated residency programs) were surveyed using a web-based tool. Responses were submitted anonymously. Data collected included information about the program director (PD), the program, accreditation status of the VL, and the VL curriculum used to meet the PVI prerequisites. Concurrent data (May 2017) on the credentials of all 117 PDs were obtained from the Alliance for Physician Certification and Advancement (APCA).
Results:
Sixty-one program directors agreed to participate (51.7% response rate). Of these, 44 individuals (81% of responders) reported they had the RPVI and/or the Registered Vascular Technologist (RVT) credential. Records from APCA indicated that 51 PDs of accredited vascular surgery residencies and fellowships (44%) had an RPVI/RVT credential, suggesting survey respondents were more likely than their PD counterparts to have a vascular laboratory credential. Ninety-four percent reported that their vascular laboratory was accredited.
Practical vascular laboratory experience was reported to be 20 hours or less for 62% of respondents. Use of a structured curriculum for practical experience was reported by only 15 programs. Programs with fellowships established for > 10 years were more likely to have a structured program for didactic instruction (P = 0.03). Only 23 programs reported a dedicated VL rotation. Didactic instruction provided was 20 hours or less for 75% of the cohort.
Conclusions:
Without a standardized vascular laboratory curriculum, there is variation in the VL instruction provided to trainees. Fellowship programs with longer histories have more structured instruction, but time allocated to VL instruction is substantially less than the 30 hours of didactic and 40 hours of observation recommended by APCA. Programs and learners may benefit from the development of vascular laboratory training guidelines and curriculum resources.
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