Training of vascular surgeons: The two-class system

Abstract

I am pleased to have been asked to participate in today's Critical Issues Forum that addresses the training of vascular surgeons. The original title for my presentation was Training of the Practicing Surgeon. The intent was for me to discuss the freestanding programs usually referred to as nonapproved programs, a misnomer because none have ever even been inspected for approval. I mention this to simply point out that we tend to lump practicing community vascular surgeons without certification on one side of the equation and academic vascular surgeons with certification on the other side. In fact, this is exactly what is happening: we are fostering a two-class training system and creating a two-class surgical system. My talk today follows on the heels of Gene Bernstein's 1 presentation to this body in 1988 in which he argued the case for recognizing freeo, tanding programs. He concluded that the freestanding programs provided a means to increase the number of available positions for advanced training in vascular surgery. Furthermore, their graduates should have the opportunity to become certified. Today's second look, as tided in the program, is timely for reviewing the events and results following the establishment of regulations for accrediting vascular surgical training programs. We need to be critical and, where necessary, express dissatisfaction. For some, the level of dissatisfaction is low, and today's review is more for polish than revision. For others, dissatisfaction is intense and reflects a commitment to effect change and establish parity for all of our vascular trainees.