Impact of New Vascular Fellowship Programs on Vascular Surgery Operative Volume of Residents in Associated General Surgery Programs

Abstract

General surgery (GS) resident vascular surgery (VS) operations have declined significantly in the last 15 years. We hypothesized that initiation of VS fellowship programs (VSFPs) contributes to that decline. This study examined the effect of establishing new VSFPs on VS case volumes of residents in associated GS programs. General surgery programs were reviewed if associated with VSFPs accredited since July 1, 2002 that had 1 or more matriculants (GS case logs only available since 2002 to 2003). Total VS cases by residents in those programs was analyzed before and after matriculation of first fellow into the associated VSFP. Twenty-two programs were available for analysis. General surgery case-log data were available variably from 0 to 14 years before and 0 to 14 years after first fellows in the associated VSFPs. In 12 programs with 4 years of data before and after matriculation of associated VSFPs' first fellows, VS cases increased from 109.6 ± 32.4 cases to 143.65 ± 78.15 cases in 4 years before matriculation (p= 0.008) of VS fellows and then declined from 143.65 to 114.04 ± 46.97 in 4 years after (p=0.0134). In all 16 programs with 4 years of data after matriculation of the associated VSFP's first fellow, VS cases declined from 123.37 ± 71.42 to 103.23 ± 44.35 (p= 0.0232). New VSFPs diminished peak VS operative volume of residents in associated GS programs, thereby contributing to declining national average number of VS cases done by GS residents. Nevertheless, resident VS case volumes remained robust in most GS programs associated with new VSFPs. Additional study is required to determine both resident perception and overallimpact of VSFPs on associated GS training.