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Leadership, Teamwork, And Healthcare-Economics Training In Surgical And Procedural Specialties: Where Does Vascular Surgery Stand?
Dongjin Suh, MD, Zaid Khan, MS, Khaled Alnahhal, MD, Rocky Regulus, MD, Ayan Dasgupta, MD, Ryan Gillies, MD, Samuel Steerman, MD, David Dexter, MD, Hosam El-Sayed, MD.
Eastern Virginia Medical School at Old Dominion University, Norfolk, VA, USA.
OBJECTIVES:While clinical excellence remains foundational to surgical and procedural residency training, competencies in systems-based practice—such as leadership, interprofessional collaboration, and an understanding of healthcare economics—have become essential components of modern surgical education. These competencies are especially relevant in vascular surgery, which involves delivering complex, multidisciplinary care in resource-intensive settings. However, the prevalence of training in these domains across surgical specialties remains poorly characterized. characterized.
METHODS:Residency programs across 11 specialties listed in the American Medical Association’s FREIDA database were reviewed. Data on presence of three specific curricula: health systems leadership skills, interprofessional teamwork, and an economics of healthcare systems curriculum, were collected from individual program profiles. Programs without data on any of the three domains were excluded from analysis.
RESULTS:Data availability varied by specialty, with interventional radiology (52.5%), vascular surgery (46.2%), and obstetrics and gynecology (65.0%) having the highest reporting rates. The average reporting rate across all 11 specialties was 45%, and a total of 810 programs were included for analysis. Vascular surgery had the lowest proportion of programs with formal leadership training at 36.1%, trailing behind interventional radiology (48.1%) and general surgery (54.1%) with obstetrics and gynecology (OBGYN) leading all specialties, significantly higher at 56.4% when compared to vascular surgery (p=0.029, Fisher’s Exact). As for healthcare economics education, vascular surgery reported inclusion in 52.8% of programs—among the lowest, while interventional radiology led all specialties at 80.8%, significantly higher than vascular surgery (p = 0.009, Fisher’s Exact). Vascular surgery ranked 9th out of 11 specialties (55.6%) in interprofessional teamwork curriculum —behind neurosurgery, general surgery, with OBGYN leading all specialties, significantly higher at 73.1% when compared to vascular surgery (p = 0.046, Fisher’s Exact). Only 6 vascular surgery programs (16.7%) offered all three components. By comparison, otolaryngology (32.7%), general surgery (32.4%), and OBGYN (35.5%) had nearly double the exposure to all three domains of system-based competencies.
CONCLUSIONS: Despite the increasing complexity of vascular surgery care, vascular surgery residency programs fall behind in offering key areas of system-based practice training such as leadership, interprofessional teamwork, and healthcare economics. Specialty-wide curricular reform and standardized expectations may be needed to bridge this deficit during residency training.
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