Critical issues in vascular surgery: Education in Brazil

Abstract

Vascular surgery practice and education vary widely across the globe. In Brazil, the largest and most populated country of South America, vascular surgery is an independent specialty, with >3000 practicing specialists. Vascular surgery education in Brazil consists of 6 years of medical school, followed by a 4-year residency in vascular surgery. Endovascular surgery training is provided by part-time mini-fellowships after a residency program has been completed. The author of this report, who represents the Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) or Brazilian Society of Angiology and Vascular Surgery, presents the critical issues in vascular surgery education in Brazil. An informal survey was conducted among residency program directors and members of the SBACV National Board to identify the critical issues in vascular surgical education in Brazil. The 25 responders pointed to two issues as the most critical. The first is funding for vascular surgical education. Currently, 73 vascular residency programs are accredited, with 142 first-year positions and 288 residents in training. Vascular surgery residents are paid a meager stipend, but instructors receive no pay. Endovascular fellows have to pay for their training. This has led to endovascular training being financed by the industry, despite the potential conflicts of interest created by this situation. The second critical issue is endovascular surgery training. The vascular surgical community in Brazil faces the huge task of how to offer training in endovascular techniques to the 140 or so young vascular surgeons coming out of residency programs every year, as well as how to teach endovascular techniques to several hundred certified vascular surgeons already in practice. Funding vascular surgery educational programs and training surgeons in the new endovascular techniques are the critical issues faced by vascular surgical educators in Brazil.