Integrated Residency in Vascular Surgery at Lenox Hill Hospital
Health care is changing. The vascular surgery residency program at Lenox Hill Hospital helps prepare our trainees for the significant changes in the delivery of healthcare. The program helps trainees develop and sharpen skills that are vital for success and better patient-outcomes by providing a diverse and thorough education: structured lectures on health care policy, hands-on training in surgical suites and non-invasive laboratories, practice management training and mentorship.
The residency program consists of five residents and five vascular surgery attendings who supervise the residents and medical students on the service. The R5 of the program functions as the chief of the service. There is a midlevel resident on the service who is either a general surgery or vascular surgery resident. There is an R2 on the service that initially receives and reviews consults, and there is an R1 as the intern on the service.
- During the first year, residents spend five months on the general surgery service. They spend two months in the ICU, two months on interventional radiology, one month in the vascular lab and two months on vascular surgery.
- Second year resident spend five months on general surgery, two months on interventional radiology, one month in the ICU, one month on night float, one month in the vascular lab, and two months on vascular surgery.
- In the third year of training, residents spend six months on general surgery, three months on vascular surgery, one month in the vascular lab, and two months on interventional radiology.
- The fourth year residents spend two months on general surgery, two months on cardiothoracic surgery, two months on interventional radiology, and six months on vascular surgery.
- The fifth year of the program is spent entirely on vascular surgery as the vascular surgery chief. Overall, 24 months are dedicated to learning the basics of general and cardiothoracic surgery and 36 months are dedicated to vascular surgery and interventional radiology with a vascular focus.
Mondays – Basic Science Lectures
This lecture series, developed from the Vascular Surgery Program Directors Curriculum, covers most of the basic and clinical sciences fundamental to the practice of vascular surgery over a two-year span. It includes a monthly review of recent literature, in the format of Journal Club. Articles are chosen that pertain to the module under review.
Tuesdays – Quality and Assurance Conference
This conference allows review of all the cases and consults seen and intervened upon by the general surgery and vascular surgery services.
Wednesdays – Department of Surgery Morbidity & Mortality/Grand Rounds
Morbidity and Mortality Conferences are held on Wednesdays for the entire surgery department. Vascular cases are included on a regular basis in this conference. All vascular residents are required to attend these sessions. Every third week is dedicated to Vascular Morbidity and Mortality Conferences with an eye to presenting cases which usually are not discussed at the surgery department’s M&M Conference.
Friday – Case Conference Presentations
The vascular residents are responsible for presenting the major cases they performed the week prior, addressing questions from the audience regarding clinical course and management. Although most of the presentations are based on surgical or interventional cases, occasionally vascular lab or other non-operative cases will be presented.
The Physicians' Vascular Interpretation Examination must be taken prior to graduation. The Vascular Surgery In-Training Examination (VSITE) is required every year and residents are required to score higher than 70 percent to pass.
Medical student rotations
The vascular surgery medical student rotation consists of participation in the delivery of care to vascular surgery patients both in the inpatient and outpatient setting. Students have the opportunity to scrub in the operating room and in the endosuite to learn basic surgical technique. They participate in rounds and inpatient care including dressing changes and bedside procedures. They learn basic concepts of non-invasive vascular testing and duplex ultrasound.
Medical students function as an integral team member. They are responsible for attending conference, rounds and participating in the operating room, as well as presenting at least one case in conference. Other responsibilities include:
- Presenting at least one H and P of a new consult to the attending on service.
- Helping with dressing changes on daily rounds, as well as
- Basic follow up and information gathering on patients.
The schedule for the students will consist of a 12-hour work day from 6 a.m. to 6 p.m. and a Saturday or Sunday daytime shift call, similar to the intern schedule in order to emulate a surgical residency experience. Students are assessed on the delivery of a case presentation at conference, presentation of an H and P of a consult, fund of knowledge and preparation for OR cases, understanding of the operative plan, and basic interactions with other members of the team including ancillary staff. The overall assessment of the student and grade will be determined by the core faculty with input from the chief resident.
The goals of the experience are to enhance the understanding and knowledge of complex vascular surgery and to give students exposure to the full spectrum of duties as vascular residents and attendings. The rotation is aimed to identify students interested in a career in academic vascular surgery and to give a realistic experience of what the training experience is like. The objectives of the rotation are to expose the student to vascular surgery training experience, to broaden the student’s knowledge of vascular disease, and to aid the student in career development.
Current Hofstra Medical students interested in rotating should contact their ACE (Advance Clinical Experience) directors to arrange a rotation at Lenox Hill Hospital. Visiting students can apply via VSAS.
Schneider P. Endovascular skills: Guidewire and catheter skills for endovascular surgery. Third Edition
Chaikof E, Cambria R. Atlas of Vascular Surgery and Endovascular therapy: Anatomy and Technique.