Vascular Surgery Fellowship

The Vascular Surgery Fellowship Program at the University of Florida consists of a 24 month training period, focusing entirely on the evaluation, treatment and surgery of peripheral vascular disease.

The Vascular Surgery Fellowship at the University of Florida is a participant in the Electronic Residency Application Service (ERAS) provided by the Association of American Medical Colleges (AAMC). Applications and all associated materials to our fellowship are accepted through the ERAS Program only. Applications for the 2021 Match will be accepted beginning in December 2020. Applications can be accepted up until January 30th. Applications will be reviewed after February 1st and a decision made as to whom to invite for an interview. Because of the large number of well-qualified applicants and expense involved, we do not interview all applicants.

If you have any further questions regarding our program, please call our office at (352) 265-0916. I appreciate your interest in our program and look forward to hearing from you.

Sincerely,

Salvatore Scali, MD
Program Director
Vascular Surgery Fellowship Program

Introduction

The Fellowship program at the University of Florida Division of Vascular Surgery is a fully accredited two-year training program in vascular surgery matching two fellows per year. All fellows are matched through the NRMP.  The Division provides all the vascular services for the University of Florida-Shands Hospital and the Malcom Randall VA Medical Center.  The Fellow’s clinical experience is obtained at Shands Hospital and the Malcom Randall VA Medical Center.

Professional attitudes highly valued by this program include complete dedication to life-long learning, an ability to work well with others to become part of a team, and the capacity for hard work with a positive attitude. The fellows in this program are expected to teach and share knowledge with colleagues, students and other health care providers. Critical thinking based on a thorough reading of the available peer reviewed literature, as well as respect for the cultural, religious, and individual preferences of the patient and family will be the basis for decisions made that impact the lives of patients. The well-trained vascular surgeon must be aware of the cost and societal implications of decisions and be able to adapt to the evolving health care delivery system in this country.

Vascular Fellowship Overview

Additional information regarding our faculty, case volumes, clinical research, and other aspects of our fellowship program can be found in our Vascular Fellowship Overview.

Educational Mission Statement

Our mission is to produce a modern vascular surgeon with the necessary technical skills in open vascular surgery and endovascular therapies in order to independently handle the entire gamut of vascular pathologies.  These technical skills are backed by a broad knowledge base of the fundamentals of vascular literature through a structured program of didactic and interactive case conferences.  The Fellowship program has been designed to accommodate applicants with future interests in either academic vascular surgery or private practice and past graduates have been successful in both arenas.  

Educational Program

The Fellowship program is predominantly clinical in nature; however, exposure to both basic and translational science research is offered. Additionally, there is a strong expectation of clinical research productivity, culminating in publication. The two year program is divided into sixteen 5-week blocks. For each 5-week block, the fellow rotates as either the Open Vascular Surgical Fellow at UF Health Shands Hospital, the Endovascular Fellow at UF Health Shands Hospital, the Hybrid Fellow at UF Health Shands Hospital, or the VA Fellow at the Malcolm Randall VAMC. In essence, the trainee performs dedicated blocks of endovascular and open surgical cases, although this delineation is not as distinct in modern clinical practice so fellows frequently negotiate amongst themselves the case coverage based upon experience level and interest. Call is shared evenly between the four fellows and the General Surgery 4^th year resident who is assigned at the VAMC for a 1 in 5 call schedule.

Endovascular Fellow

The Endovascular Fellow is expected to participate in every diagnostic and therapeutic endovascular procedure performed at UF Health Shands Hospital.  The caseload at UF Health Shands Hospital is rich with both aortic as well as diagnostic and therapeutic peripheral endovascular work  (in the last 12 months, the division has performed over 500 diagnostic and therapeutic procedures, including over 200 endovascular repairs of abdominal and thoracic aortic aneurysms).  We anticipate this volume to grow 10% per year over the next several years. Furthermore, all procedures at UF Health Shands Hospital are completed in one of two dedicated OR-compatible, hybrid fixed imaging endovascular suites with access to a third hybrid operating room upon request. All fellows will be given personalized, custom-fitted lead aprons and glasses at the start of their fellowship. Additionally, fellows are given their own personal hand-held Doppler probe to use during the two years of training and to be taken from the institution upon completion of training.

Open Vascular Surgical Fellow

During the Open Vascular Surgical Fellow rotation at UF Health Shands Hospital, the designated fellow will be responsible for all open surgical cases. Because there is only a single vascular service and no other competing senior general surgery residents, the fellow in this role is free to select the cases they wish to perform, although typically the fellow in this role participates in the more complex open surgical reconstruction procedures. In the recent past, each Fellow had performed over 400 Category I (index) major vascular reconstructions.  The RRC has consistently placed the Vascular Surgery residency at the University of Florida in the 90%-ile for aortic aneurysms (including suprarenal), mesenteric/renal revascularization, aortofemoral reconstruction, and complex lower extremity bypass.

VAMC Fellow

The VAMC fellow will be responsible for all the endovascular and hybrid procedures performed at the Malcolm Randall VAMC. The fellow will also serve as a resource for the 4^th year general surgery resident who is in charge of running the daily activities of the clinical service and participating in the open procedures. If the 4^th year resident is away on vacation or traveling, the VAMC fellow is expected to run the service and fulfill the chief resident’s responsibility until they return. The VAMC has a state of the art, fixed imaging hybrid endovascular operating suite. During the VAMC rotation, the fellow will have more non-clinical time available to them and as such will be expected to work on vascular ultrasound reading interpretation, supervising conference preparation, and pursuing clinical research projects. Vascular ultrasound interpretation skills learned with dedicated mentored interpretation during this rotation will be supplemented by formal curriculum in the fundamentals of vascular ultrasound interpretation.  At completion of the fellowship, graduates are expected to achieve the Registered Physician in Vascular Ultrasound Interpretation credential.

UF Consult Fellow

The 5 week rotation as the consult fellow provides the unique opportunity for the trainee to support the consult service in coordination with the general surgery residents already assigned to the UF/Health Shands vascular clinical service. The fellow takes primary responsibility for ensuring consult patients are seen daily and that plans of care are generated. In collaboration with the ‘attending of the week’, the fellow rounds on selected consult patients to ensure longitudinal faculty engagement and facilitates clinical mentorship. Moreover, consult patients that are identified to need in-hospital endovascular or open vascular operations are managed by the consult fellow so that timely high-quality care provision occurs.  The consult fellow attends clinic each Wednesday and participates in the fellow on-call schedule, which includes a q5 frequency.

UF Flex Fellow

The UF ‘Flex’ fellow is a 5th clinical rotation that is predominantly based at the University hospital. The fellow engages in a focused apprentice model designed to train in advanced endoluminal aortic therapies including physician modified endograft planning and performance. The fellow will be exposed to advanced image planning and increasingly assumes a larger intraoperative role as the trainee accumulates experience in the program and demonstrates appropriate technical expertise. In addition to these roles, the fellow is exposed to dedicated training in both routine and advanced clinical venous disease management. The rotation has a Thursday ‘vein’ clinic assignment and the fellow participates in the call schedule (q5 frequency).

Sample Block Diagram: Rotations are below (10-12 weeks on each)

• Open Vascular Surgery
• VA Vascular Surgery
• Endovascular Surgery
• UF Consults
• UF Flex

Conference Schedules

Fellows are required to attend all conferences. The only exception is when the fellow is out of town. The conference program is designed to provide a didactic and interactive forum to augment the fellow’s reading and clinical experience.  Failure to attend conferences limits the fellow’s ability to be exposed to the wide breadth of problems seen in vascular surgical practice.  Fellows must be on time for conferences and it is requested that fellows turn down the volume on their beepers or put them on vibrator mode if possible so that there is the least disruption to the speaker when the fellow is paged.  Fellows will be called upon to present at conferences regularly and should spend the necessary time to be well prepared.

Departmental Conferences

Morbidity and Mortality Conference – Friday morning at 6:45 AM.  All residents are required to attend.  The format is case presentations by chief residents on the general surgery services, plastic surgery and vascular surgery and includes special presentations of interesting cases. The yearly schedule is available on the Department of Surgery website.

Grand Rounds – Friday at 7:15 AM.  All residents are required to attend Surgery Grand Rounds.  Format includes lectures, case presentations and visiting professors. The yearly schedule is available on the Department of Surgery website.

Vascular Surgery Service Conferences

The Divisional conferences are held throughout the week at 7:00 AM. Attendance is mandatory and punctuality is expected.  Assigned readings and conference topic schedules are distributed well in advance.  All residents – both at the VA and at UF Health Shands Hospital are expected to attend.

Rutherford/Journal Club – This conference is held weekly and chapters from Rutherford are provided.  Topic-based articles are selected and assigned for review by the faculty based in part on the Clinical and Basic Science curricula, developed by the Association of Program Directors in Vascular Surgery.  The major topics in this curriculum are covered over a 24-month period.

Rutherford/Journal Club – This conference is held weekly and chapters from Rutherford are provided.  Topic-based articles are selected and assigned for review by the faculty based in part on the Clinical and Basic Science curricula, developed by the Association of Program Directors in Vascular Surgery.  The major topics in this curriculum are covered over a 24-month period.

 Morbidity and Mortality Conference – This conference occurs the 4th Wednesday of every month.  The format is a discussion amongst faculty, staff, vascular surgery fellows, and residents, and is designed to identify areas where patient care could be improved.  It is our practice to review the list of all complications and discuss a select few. Both the VAMC and UF Health Shands Hospital services participate.

Vascular Pre-op Conference – This conference normally occurs every Wednesday at 7 AM, except the 4th Wednesday of every month, when the conference block is used for the Morbidity and Mortality conference.  This interactive preoperative conference provides the chief resident on the VA Vascular service (PGY-IV) and vascular surgery fellows on both the UF Health Shands Hospital and VAMC services a chance to present upcoming cases and discuss the surgical management options.  The faculty then question the presenters in an interactive, oral board format with a strong emphasis on evidence-based decisions.

Research Conference – This conference meets at least quarterly to update the faculty and vascular surgery residents of ongoing research endeavors within the division, both of a basic science nature as well as clinical research.  Additionally, the vascular surgery fellows and residents who are looking for projects in which to participate are encouraged to bring ideas and potential study designs for presentation to the group at large.  Lastly, residents and vascular surgery fellows slated to give talks at upcoming meetings are expected to give their presentation to the division for critique.

VQI Conference –This is a monthly roundtable discussion of the quality initiatives that are ongoing within the Division of Vascular Surgery, most notably the Southeastern Vascular Quality Initiative.  This discussion is integrated with the morbidity and mortality conference.

Vascular Lab Conference- This was designed as a reflection of a perceived area of opportunity to strengthen the fellowship. This is on an 11 month cycle with the 12^th month being for a practice exam. The conference consists of a set curriculum of core vascular lab topics as well as interesting and current cases using vascular ultrasound. At the conclusion of the 12 month cycle, each fellow will be able to successfully take and pass the RPVI examination.  A textbook is provided to each fellow.

JVS Conference-This conference goes over selected articles from the current month’s Journal of Vascular Surgery. The articles will be distributed well in advance. Each fellow is provided a complimentary subscription to JVS.”

Living in Gainesville

Gainesville offers all the benefits of a small, college town, including great college sports, low cost housing within minutes of the hospital, no rush-hour traffic, ethnic diversity, University-sponsored cultural activities, good schools and a safe environment for families with children. Gainesville is ideally situated within 1-1½ hours to the Gulf and the Atlantic Ocean, and 2 hours to Jacksonville, Orlando, and Tampa. The weather is almost perfect for nearly 9 months of the year, with 2 months of hot and 1 month of cool temperatures. Outdoor activities are popular and opportunities are plentiful for cycling, mountain biking, swimming, hiking, and canoeing, just to name a few.

We hope you have found this brief overview of our Fellowship program helpful and informative.  You undoubtedly still have many questions and we hope that we will have the opportunity to meet and answer them in person.