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Rewriting the Future of Transplant and Vascular Surgery: Survey Suggests Vascular Surgery Workforce Available to Increase Retention and Recruitment in Transplant
Tanner P. Jones1, Samuel A. Larkin
2, Dominique R. Betterbed
2, Jorge A. Ortiz
2.
1Albany Medical Center, Albany, NY, USA,
2State University of New York At Buffalo, Buffalo, NY, USA.
OBJECTIVES: Renal and hepatic transplantations have historically been within the purview of vascular surgeons, who continue to assist with transplant surgeries at some centers. The integrated residency training curriculum omits the breadth of transplant education taught traditionally in general surgery. We believe there are many vascular surgeons with an interest in organ transplantation. We surveyed vascular surgery trainees and surgeons to better characterize their interest in formal transplantation training during or after residency. Because of substantial interest in organ transplantation, survey responses suggest a need for a revision in national organ transplantation training to provide education/certification to interested vascular surgeons.
METHODS: A survey was distributed via email to vascular surgery trainees (integrated residents and traditional fellows) and surgeons. Survey results were reviewed cumulatively (N-94) and sorted according to participant demographics. Association analyses were performed with chi-squared testing with secondary power testing using standardized residual values calculated by SAS software. Email addresses of participants were obtained from peer-reviewed vascular surgery journals and online profiles at respective institutions.
RESULTS: Integrated residents have significantly increased interest in organ transplantation than practicing surgeons, 13/16 vs 31/66 respectively (P=0.014). Of the 51 respondents interested in organ transplantation, 32 (63%) were specifically interested in renal transplant only. Trainees supported incorporating renal transplant training into the vascular training curriculum more strongly than surgeons (21/27 vs 31/67; P-value=0.005). There were no significant gender differences with regard to organ transplantation interest. (Female 10/19, Male 36/64, Undisclosed 2/4; P= 0.78 )Of the 43 participants “not personally interested in organ transplantation,”17 later marked to be interested in organ transplantation if it is integrated into the vascular curriculum. In suggesting the “appropriate duration” of a kidney-only fellowship training for vascular surgeons, results favored a shortened duration. The percentages of respondents favoring each category: 6, 12, 18, and 24 months, were 54%, 36%, 3%, 7%, respectively. For combined kidney/liver training, the percentages of respondents were more evenly distributed to the 4 durations: 23%, 36%, 11%, and 30%, respectively.
CONCLUSIONS: There is a robust vascular surgery workforce with an interest in organ transplantation, particularly renal transplant. A revision of the current transplantation training paradigm is necessary to realize the benefit vascular surgeons can offer to transplantation programs in need.
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