The Johns Hopkins Fellowship in Vascular Surgery and Endovascular Therapy is a two-year clinical tract that provides a comprehensive experience in the diagnosis and management of the broad spectrum of circulatory disorders, including arterial, venous and lymphatic disease. Known for our breadth of both open and endovascular experience, the first year was traditionally inpatient heavy with the second year being dedicated more to research, presentation at meetings and independent surgical experience.
With our ever-increasing volume and service lines, as well as the Registered Physician in Vascular Interpretation (RPVI) requirement, our fellowship offers a balanced program over both years. The service is divided into two teams, with a single fellow responsible for each. Fellows rotate between services every three months, with the goal of having a complete inpatient and outpatient experience at the completion of the two years. The call is approximately every third night, and is split with the PGY-3 on the service.
Beginning with the 2024–26 academic year, we will alternate between two trainees and one trainee, for a total of three fellows. This will result in more dedicated time in the outpatient clinical setting, as well as time for meaningful research experiences and preparing for the RPVI in the Noninvasive Vascular Laboratory. It also allows fellows to dedicate more time to preoperative planning of complex endovascular cases, begin a new vascular medicine rotation, increase academic productivity and decrease the frequency of home call to approximately every fourth night.
The inpatient service is run by the fellows. This includes morning rounds along with the PGY-3, PGY-1 and physician assistants. Our service is staffed by seven full-time advanced practice staff members and two wound nurses, all of whom are integral members of our team, assisting the attendings, fellows and residents with a wide spectrum of inpatient and outpatient clinical and administrative duties.
The second-year fellow frequently operates independently, serving as a teaching assistant to the residents in both open and endovascular cases. The second-year fellow is also expected to run Thursday morning conference. Ample time is set aside for presentations at national meetings, board examinations and job interviews.
Fellows are assigned to an outpatient clinic every week, where they participate in the preoperative evaluation and postoperative follow-up of patients with the attending surgeons. Over the two years, fellows rotate through each outpatient clinic to gain a comprehensive understanding of the outpatient management of vascular disease.
On Thursday mornings, there is a dedicated and protected educational conference. The fellows meet with the program directors to participate in a didactic educational session using the VSCORE curriculum. During this session, fellows prepare for oral boards by reviewing recent cases linked to VSCORE topics. This is followed by vascular morbidity and mortality and an expert lecture series. Lecture topics vary weekly to match the VSCORE topics and range from aortic measurement to journal club and vascular lab interpretation. Approximately once a month, a lecture on a specific vascular surgical or vascular medicine subject is given by a Johns Hopkins expert attending.
The Division of Vascular Surgery & Endovascular Therapy is committed to supporting the well-being of our fellows. Over the past three years, both the institution and the fellowship have made strides to improve resources for trainees. Please visit our GME website for more information on the wellness programs available to all trainees.
In 2014, the ACGME revised the requirement for the RPVI: Board eligibility in vascular surgery now necessitates that candidates obtain the RPVI credential of the American Registry for Diagnostic Medical Sonography. In line with this new requirement, fellows spend approximately one half day a week in our Vascular Laboratory learning noninvasive techniques, as well as interpretation of the diagnostic studies. Throughout the year, there are lectures targeted at all aspects of noninvasive vascular lab diagnosis. The Vascular Laboratory is fully accredited with the Intersocietal Accreditation Commission in extracranial cerebrovascular, peripheral arterial and venous and visceral vascular testing.
Clinical research is an integral part of the fellowship experience. Fellows are expected to participate in multiple projects throughout their training. The Johns Hopkins Surgery Center for Outcomes Research (JSCOR) within the Department of Surgery provides the division with expert statistical assistance, and is an invaluable resource. Our goal is that fellows will be able to start their independent careers with a sound understanding of IRB protocols and reviews, statistical methodologies, and seeing a project through its inception, presentation and publication.
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