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 2025 Match will be accepted beginning in December 2024. 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 the 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
University of Florida Vascular Surgery Fellowship

Introduction

The Fellowship program at the University of Florida Division of Vascular Surgery and Endovascular Therapy is a fully accredited two-year clinical training program in vascular surgery that alternates between two and three fellows every year (e.g., a total of 5 clinical fellows matriculating in the program at any one time). All fellows are matched through the NRMP.  The Division provides all of the vascular services for the University of Florida Health-Shands Hospital and the Malcom Randall Veterans Affairs Medical Center (VAMC), which is located across the street from the University Hospital. The Fellow’s clinical experience is primarily obtained at UF/Health-Shands Hospital and the Malcolm Randall VAMC. Notably,  fellows also have a single ‘transition to independent practice’ rotation block (e.g., 5 weeks/fellow) each academic year at UF/Health-Halifax in Daytona Beach, Florida.

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 healthcare 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 healthcare 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 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 Consult Fellow at UF Health Shands Hospital, the Pre-op/Hybrid Fellow at UF Health Shands Hospital, the ‘PMEG’ Fellow at UF Health Shands Hospital, or the VA Fellow at the Malcolm Randall VAMC. Fellows also rotate through UF Halifax once every year.  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 five fellows and the General Surgery 4^th year resident who is assigned at the VAMC for a 1 in 5 call schedule.

Research

The Division has a strong track record of NIH-, industry-, and investigator-sponsored research.  Faculty serve as principal investigators or co-investigators in more than 10 NIH-funded studies and as site principal investigators in more than 10 industry-sponsored device studies.  Research studies span the full spectrum of content from basic biology to health services research.  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.  Faculty are available to help mentor fellows in projects designed to be completed during fellowship.  Fellows with an interest in dedicated research as part of their career will benefit from exposure to faculty with diverse research training and interests. For more information on research within the Division, click here.

Pre-Operative/Hybrid Fellow

The Preop/Hybrid Fellow is expected to facilitate patient check-in and preoperative evaluations for patients on the daily elective schedule. The fellow has the opportunity to participate in a multitude of diagnostic and therapeutic endovascular, open, and hybrid procedures 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  (e.g., 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 ~5-10% 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 [Artis-Zeego Siemens systems] 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 inpatient 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. However, this decision is a shared negotiation among the other clinical fellows and faculty members are flexible to accommodate any and all fellow trainees during cases. In the recent past, each Fellow had performed over 500 Category I (index) major vascular reconstructions.  The RRC has consistently placed the Vascular Surgery fellowship at the University of Florida in the 90^th percentile for aortic aneurysms (including suprarenal), mesenteric/renal revascularization, aortic-femoral 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 Gainesville VAMC has a state of the art, fixed imaging hybrid endovascular operating suite [Azurion Philips] which differentiates it from many other VA health systems since < 50% of vascular divisions in the Veterans Health Administration have access to these rooms. 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 a 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 facilitate clinical mentorship. Moreover, consult patients who 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 PMEG Fellow

The UF ‘PMEG’ 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).

UF Halifax Fellow

Fellows rotate through UF Halifax for 5 weeks each year participating fully in a busy community-based practice.  Beyond clinical/technical skills, fellows are expected to learn about the transition to independent practice elements including practice-building, coding, and billing, as well as strategies for practicing in a high throughput environment.  Local lodging is provided at no cost to fellows. The three dedicated faculty members at UF Halifax in Daytona have extensive experience in curriculum development, teaching, and mentoring especially since the senior partner (Dr. Robert Feezor) is a former program director (201-2015) for the University of Florida vascular fellowship in Gainesville. Moreover, the core faculty members (Drs. Feezor, Cadavid, and Yacoub) have a highly diverse and very busy clinical practice that affords fellow trainees unique opportunities to learn about a different model of care delivery compared to the traditional tertiary academic model. Lastly, Dr. Feezor is a nationally recognized coding expert and has previously instructed courses for the Society for Vascular Surgery so this rotation provides novel exposure to this often underrepresented component of clinical training.

Sample Block Diagram: Rotations are below (~5 weeks on each)

• Open Vascular Surgery
• VA Vascular Surgery
• Pre-op/Hybrid Fellow
• Fellow PMEG
• Fellow
• Halifax Fellow

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 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 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.  The 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.

VSCORE/Rutherford Conference – This conference is held weekly and chapters from Rutherford are provided that align with the VSCORE curriculum topics.  Topic-based articles from the supplemental material recommendations in VSCORE are occasionally selected to supplement conference preparation, which was developed by the Association of Program Directors in Vascular Surgery.  The major topics in this curriculum are covered over a 24-month period. Both the VAMC and UF Health Shands Hospital services participate (additionally, when fellows rotate at Halifax, they have virtual link access).

 Morbidity and Mortality Conference – This conference occurs on 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 presentations to the division for critique.

VQI Conference – This is a quarterly 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. Institution and regional quality reports are reviewed by the faculty VQI ‘champions’ and provide fellows the required exposure to quality improvement initiatives.

Vascular Lab Conference – This was originally designed over 10 years ago as a reflection of a perceived area of opportunity to further strengthen and differentiate the fellowship. The conference supplements the mentored interpretation that occurs throughout the 2 years of training. is the course runs on an 11-month cycle with the 12^th month being designed for a practice exam in an effort to prepare trainees for the Registered Physician in Vascular Interpretation Exam (RPVI) which is required to eventually receive American Board of Surgery certification in Vascular surgery. 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 occurs either the 3^rd or 4^th week of each month and supplants one of the VSCORE/Rutherford conference dates. The goal of the conference is to review selected articles from the current month’s Journal of Vascular Surgery. The articles will be distributed well in advance to each fellow so that they can provide a concise description of the article and provide a critique of the strengths and weaknesses of the study. 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 of 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.