The Vascular Surgery Fellowship is purely a clinical program. During the first year, you spend time in the outpatient clinic, noninvasive vascular laboratory, duplex ultrasound area and CT core laboratory, in addition to hospital clinical services. Basic endovascular and open operative skills are acquired through rotations with the vascular staff surgeons. The total time spent in each rotation ranges between six and 12 weeks.
In the second year, you are assigned to a staff vascular surgeon for either a six- or 12-week rotation. Advanced endovascular training is acquired through additional time spent with the interventional vascular radiologists and with the staff vascular surgeons in the endovascular operating room suite. Fellows will be a chief resident for three months during the second year, based on their ability and performance.
Basic endovascular skills are acquired during the first year. Endovascular training is performed at Mayo Clinic Hospital, Saint Marys Campus, and in an endovascular suite in the operating room area. The goal is for you to double the minimum endovascular requirements set forth by the Association of Program Directors in Vascular Surgery and the American Heart Association.
The Division of Vascular and Endovascular Surgery has a large aortic aneurysm practice — 250 to 300 cases a year — of which 50 to 60 percent of repairs are done with endovascular-stent devices in the thoracic or abdominal aorta, including the use of branched or fenestrated grafts.
The division participates in many clinical trials, including:
- Two IDE protocols for complex fenestrated abdominal aneurysms and fenestrated/branched thoracoabdominal aneurysms
- Zenith low-profile, iliac branch, and p-Branch for juxtarenal and pararenal aneurysms
- Gore iliac and thoracic trials
- Treovance infrarenal stent graft trial
Since January 2006, each fellow spends 12 weeks on an off-campus endovascular rotation in Sioux Falls, South Dakota, which is about 240 miles from Rochester, Minnesota. Fellows perform between 80 and 150 endovascular procedures during a six-week rotation, including carotid artery stents. Although the endovascular volume within Mayo Clinic's Division of Vascular and Endovascular Surgery is high, this rotation is highly popular among the fellows because of the clinical volume of cases and the quality of teaching provided.
|Off-campus rotation (Sioux Falls, S.D.)
|Vascular medicine and duplex ultrasound
|Off-campus rotation (Sioux Falls, S.D.)
There are formal basic science, clinical and endovascular curricula that conform to those outlined by the Association of Program Directors in Vascular Surgery. The curriculum has been designed to correspond with Multidisciplinary Simulation Center activities and journal club readings. Additional seminars and lectures in general and cardiovascular surgery and the allied medical fields are available for attendance as well.
Education is enhanced by selected lectures given by consultants at Mayo Clinic and through the visiting faculty member program. The division invites several prominent surgeons to Mayo Clinic each year.
Clinical research is expected of all fellows. You will submit at least two clinical or basic science research studies to major regional and national vascular surgery society meetings and for publication in peer-reviewed journals.
The division has close affiliations with M.D. and Ph.D. researchers in the Department of Physiology and Biomedical Engineering and the Division of Cardiovascular Diseases. Depending on the interests of the fellow, many basic science research opportunities are available, including spinal cord blood flow as it relates to thoracoabdominal aortic aneurysm repairs, neointimal hyperplasia, endothelial function and pathogenesis of inflammatory abdominal aortic aneurysms. The division will consider other areas of investigation if it relates to the fellow's interests.
Fellows take call once every five to six days depending on the off-site rotation schedule and absences.
There are several multidisciplinary and vascular surgery conferences each week, including a bimonthly morbidity and mortality conference, bimonthly case conference, and weekly multidisciplinary Vascular Grand Rounds. An endovascular case management conference meets once a month.
Moonlighting is not permitted during the fellowship.
To ensure you gain proficiency and develop the corresponding technical skills, your performance is monitored throughout the Vascular Surgery Fellowship. You are formally evaluated by your supervising faculty member after completing each clinical rotation, and you then meet with the program director to review these evaluations. In addition, you regularly evaluate the faculty to ensure your educational goals are being met.