Residency Level:
Residency Level: PGY 3
Surgical Rotation: Vascular Surgery
Length of Rotation: Two Months
Goals and Objectives
Patient care:
• Evaluation and preoperative assessment, postoperative care and nonoperative care of the vascular surgery patient
• Management skills required to independently evaluate the vascular surgery patient, develop your own plan for the patient and communication of the plan to the appropriate level of supervision
• Take ownership in care of the patient
• Mechanisms and criteria for endovascular surgical interventions
• Diagnostic evaluation of arterial disease, including the role of duplex scanning, angiography, CT Scanning and MRI
• Care of the patient with venous disease and venous stasis disease
• Clear and timely documentation of daily progress notes
• Develop a strong work ethic
• Develop appropriate safe hand offs
• Develop the ability to care for vascular surgery emergencies in the role as the surgical resident on call
Technical skill:
• Become proficient in correct basic vascular surgical techniques such as suturing, knot-tying and dissection
• Assist at Major Vascular Reconstructive Procedures
• Vascular Access Procedures, Procedures for Venous Disease
• Vascular Anastomoses.
• Doppler Evaluation for Arterial and Venous Disease
• After a period of learning and appropriate supervision, perform procedures for venous access, etc.
Medical knowledge:
• Pathophysiology of arterial occlusive and aneurysm disease and venous insufficiency
• Demonstrate evidence of continued increase in vascular surgery core knowledge from basic surgical texts, additional readings and the SCORE curriculum as noted below
• Anatomy, physiology, hemodynamics of the arterial and venous systems
• Obtain a broad knowledge base of vascular surgery and other surgical specialties
• Study and prepare for the ABSITE
• Anatomy and physiology of the arterial and venous systems
Practice-based learning and improvement:
• Participate actively in M and M conferences, daily chief conferences and journal clubs
• Understand and when possible participate in SCOAP projects
• Learn to critically read the literature
• Master the IT resources available to you to develop a commitment to lifelong learning and education
• You are encouraged to pursue a clinical research project in an area that interests you
Interpersonal and communication skills:
• Develop the appropriate skills to provide efficient, concise, patient presentations
• Master text paging, emailing, etc.
• Develop strong doctor patient relationships using counseling and education of patients and their families
• Learn to master EPIC to provide proper documentation in the electronic medical record
• Learn to properly consult other specialty services in a professional manner
Professionalism:
• Respect every patient regardless of social or other circumstances
• Log cases appropriately
• Log your duty hours using My Evaluations appropriately and in a timely fashion
• Complete all required clinical and residency documents in a timely fashion
• Demonstrate sensitivity to age, gender and culture of patients and other members of the health care delivery team
• Learn to be punctual
• Always exemplify professional attire, appropriate grooming and hygiene
• Demonstrate honesty, integrity and leadership skills
Systems-based practice:
• Demonstrate the effective communication with referring physicians throughout the Swedish health care system
• Keep patients’ safety foremost while discharging patients in a timely fashion
• Demonstrate time management and organizational skills while adhering to work hour regulations
• Gain an understanding of the importance of discharge planning and the writing of timely discharge orders to the overall throughput of patients in our system
|SCORE CURRICULUM CATEGORY 18: VASCULAR − ARTERIAL DISEASE |
|Diseases/Conditions |Operations/Procedures |
|BROAD |ESSENTIAL − UNCOMMON |
|• Acute limb ischemia |• Embolectomy/thrombectomy artery |
|• Peripheral arterial emboli |• Above knee amputation |
|• Acute arterial thrombosis |• Below knee amputation |
|• Compartment syndromes |• Toe amputation |
|• Diabetic foot infections |COMPLEX |
|FOCUSED |• Aorto-iliac/femoral bypass |
|• Cerebrovascular occlusive disease |• Ilio-iliac/femoral bypass |
|• Aortoiliac occlusive disease |• Femoral-popliteal bypass |
|• Chronic visceral occlusive disease |• Profunda endarterectomy |
|• Renal artery occlusive disease |• Infrapopliteal bypass |
|• Femoropopliteal occlusive disease |• Other endarterectomy |
|• Infrapopliteal occlusive disease |• Composite leg bypass graft |
|• Upper extremity occlusive disease |• Revise/re-do lower extremity bypass |
|• Buerger disease |• Arm bypass, endarterectomy, repair |
|• Fibromuscular dysplasia |• Celiac/SMA endarterectomy/bypass |
|• Cystic medial necrosis |• Renal endarterectomy/bypass |
|• Behcet disease |• Femoral-femoral bypass |
|• Aortic aneurysms |• Axillo-femoral bypass |
|•Visceral arterial aneurysms |• Axillo-popliteal-tibial bypass |
|• Peripheral arterial aneurysms |• Transmetatarsal amputation |
|• Aortic dissection |• Upper extremity amputation |
|• Claudication |• Disarticulation |
|• Hypercoagulable syndromes |• Elective repair infrarenal aortoiliac aneurysm |
|• Carotid body tumors |• Repair femoral aneurysm |
|•Vascular graft infections |• Repair popliteal aneurysm |
|• Aortic thrombosis |• Repair suprarenal abdominal aortic aneurysm |
|• Thoracic outlet syndrome |• Repair thoracoabdominal aortic aneurysm |
| |• Repair thoracic aorticaneurysm |
| |• Carotid endarterectomy |
| |• Reoperative carotid surgery |
| |• Excise carotid body tumor |
| |• Direct repair aortic arch branches for CNS symptoms |
| |•Vertebral artery operation |
| |•Vascular ultrasound |
| |• Angioscopy |
| |• Balloon angioplasty |
| |• Transcatheter stent |
| |• Other endovascular graft |
| |• Endovascular repair aortic aneurysm |
| |• Endovascular repair other aneurysm |
| |• Endovascular thrombolysis |
| |• Pseudoaneurysm repair/injection |
| |• Explore post-op bleed, thrombosis, infection |
| |• Graft thrombectomy/revision |
| |• Excise infected vascular graft |
| |• Repair graft-enteric fistula |
| |• Sympathectomy |
| |• Harvest arm vein |
| |• Thoracic outlet decompression |
| |• Repair ruptured aortic aneurysm |
|SCORE CURRICULUM CATEGORY 19: VASCULAR − VENOUS |
|Diseases/Conditions |Operations/Procedures |
|BROAD |ESSENTIAL − COMMON |
|•Venous thrombosis/embolism |•Venous insufficiency and operation for |
|• Thrombophlebitis, including suppurative |varicose veins |
|•Venous stasis and chronic venous insufficiency |• Sclerotherapy, peripheral vein |
|•Varicose veins |• Insertion vena caval filter |
| |COMPLEX |
| |•Venous embolectomy/thrombectomy |
| |•Venous reconstruction |
| |• Non-reconstructive venous ulcer operation |
| |• Repair arteriovenous malformation |
|SCORE CURRICULUM CATEGORY 20: VASCULAR − ACCESS |
|Diseases/Conditions |Operations/Procedures |
|BROAD |ESSENTIAL − COMMON |
|• Percutaneous vascular access for dialysis |• Percutaneous vascular access |
| |• Arteriovenous graft/fistula |
| |• Revision arteriovenous access |
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