Program Description

Vascular surgery is dedicated to the care of patients with disorders of the circulatory system. The vascular patient is challenging because the disease process involves multiple body systems. Complete care of the patient with peripheral vascular disease requires a multidisciplinary team, often comprised of a surgeon, radiologist and vascular internal medicine specialist.

Over the past decade, there have been numerous advances in the treatment of patients with vascular disease. Diagnostic methods have evolved from arteriography toward duplex ultrasonography, and magnetic resonance and computerized tomographic angiography.

Endovascular treatment and minimally invasive surgical techniques have increased the options available for treating patients. Such techniques include endovascular repair of abdominal and thoracic aortic aneurysms; minimal incision aortic reconstructions; and carotid, renal and peripheral artery angioplasty. The Peripheral Vascular Surgery Fellowship at Mayo Clinic in Rochester encompasses all of these areas, which makes the fellowship challenging and rewarding.

The fellowship provides 24 months of intense and broad-based training, which allows you to acquire the skills necessary for diagnosis and treatment of patients with diseases of the arterial, venous, and lymphatic systems. Diseases intrinsic to the heart, ascending aorta and intracranial vessels are not included in this training program.

You will participate in, and perform, a large volume of open vascular surgery operations. The fellow will also perform endovascular procedures and gain comprehensive training in our non-invasive vascular laboratory and ultrasound areas.

Program Highlights
Two tracks are offered in the Peripheral Vascular Surgery Fellowship program. One is a purely clinical track. The other combines one year of basic science and clinical research, followed by a clinical training year. The first year for both tracks is primarily outpatient based; the second year is hospital-based.

During the first year, you will spend time in the outpatient clinic, the noninvasive vascular laboratory, and the duplex ultrasound area. Basic endovascular skills will be acquired through rotations with the vascular staff surgeons and the interventional vascular radiologists. The total length of time spent in each of these areas will be approximately three months.

The research fellow will also gain experience in these areas during the first year of training. The first-year fellows will take emergency call and provide coverage of the hospital services whenever the second year fellows are away or the operative case volume is high. Thus, clinical and operative skills can be maintained.

During the second year, you will participate in, and perform, a large volume of vascular surgery operations and endovascular procedures. You will work under the direction of a staff vascular surgeon, being given graded levels of responsibility based on your abilities.

There are more than 1,600 open vascular operations performed each year at the Mayo Clinic. We anticipate that each fellow will scrub over 300-400 cases and will perform approximately 250-300 major vascular reconstructions as the primary surgeon. The Division of Vascular Surgery expects fellows to operate independently in the latter portion of the training program.

Faculty

Advisors & Mentors
You will be assigned a staff mentor. The staff surgeon is expected to review the fellow's progress and to assist in meeting the fellow's career goals. The program director also meets with the fellows periodically during both years of the fellowship program to ensure that educational needs are met.

Visiting Professors
Mayo Clinic's Division of Vascular Surgery has an active visiting faculty member program and invites several prominent vascular surgeons from other medical institutions to visit Mayo Clinic each year. You will have access to these individuals throughout the training program.

Curriculum

Clinical Training
The first year you will be assigned to a staff vascular surgeon's outpatient clinic. You will spend time in the non-invasive vascular laboratory and ultrasound area, and be exposed to the wound care, thrombophilia and vein clinics. During this time, basic endovascular skills will be acquired.

The second year, you will be assigned to a staff vascular surgeon for quarter-long rotations. Advanced endovascular training will be acquired by additional time spent with the interventional vascular radiologists and with the staff vascular surgeons in the endovascular operating room suite.

Endovascular Training
Basic endovascular skills will be acquired during the first year. This training will be done in conjunction with the vascular staff surgeon and/or the interventional vascular radiologist. Endovascular training is performed at Saint Marys Hospital 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 for Program Directors in Vascular Surgery and the American Heart Association.

The Division of Vascular Surgery also has a large abdominal aortic aneurysm practice (250-300 cases per year), of which 30-35% of repairs are repaired with endovascular-stent devices. The division is active with several endovascular research clinical trials, including the use of the Gore Excluder and Medtronic Talent Devices, and the CREST Carotid Stent Trial. There also is an active carotid artery stent program at Mayo Clinic.

Didactic Training
There are several multidisciplinary and vascular surgery conferences each week. An endovascular case management conference meets once per month. There are formal basic science, clinical, and endovascular curricula which conform to that outlined by the Association for Program Directors in Vascular Surgery. 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 the Mayo Clinic and through the Visiting Faculty Member program. The division invites several prominent surgeons to Mayo Clinic each year.

Research Training
Clinical research is expected of all fellows. You will submit your clinical or basic science research studies to the major regional and national vascular surgery society meetings. Publication of research in peer-reviewed journals is encouraged.

The Division has an active basic science research laboratory and an affiliation with a Ph.D. researcher in the Department of Physiology. Basic science research topics include:

• Spinal cord blood flow as it relates to thoracoabdominal aortic aneurysm repairs
• Neointimal hyperplasia
• Endothelial function
• Pathogenesis of inflammatory abdominal aortic aneurysms

However, the division considers other areas of investigation if it relates to your interests.

Moonlighting Policy
Moonlighting is not permitted during this fellowship.

Evaluation
Your performance will be monitored closely to ensure that clinical knowledge, judgment, and technical skills meet the expectations of the Division. You will be evaluated formally by the supervising faculty member after each clinical rotation.

You also will evaluate the faculty to ensure that your educational needs are being met. The Division incorporates 360-degree reviews from the surgical, critical care, and radiology staff; the physician extenders; and the paramedical personnel in the outpatient clinics and in the operating rooms. One fellow is chosen from each year to be a division educational representative.

Admissions

Qualifications
To apply to the Vascular Surgery Fellowship Program, you must have successfully completed an accredited general surgery training program and be American Board of Surgery eligible.

You are allowed to take the American Board of Surgery qualifying and certifying examinations during the fellowship.

Application Process

Positions
Three positions are offered on a competitive basis each year in the Vascular Surgery Fellowship Program at Mayo Clinic in Rochester.

Apply

• Step1: You first must submit an electronic application via the Electronic Residency Application Service (ERAS). Your application must be submitted by February 1 of the year preceding the appointment date. The academic year begins in July.
  
  To apply see: Electronic Residency Application Service (ERAS)

  The application requires the following information:

- Official medical school transcripts

- Official test transcripts for all applicable examinations (USMLE, LMCC, COMLEX, NBOME, FMGEMS, FLEX or NBME)

- A dean's letter and at least two other letters of recommendation

- A curriculum vitae

- A personal statement

- A valid ECFMG certificate (if you graduated from medical school outside of the United States)

- A copy of your medical school diploma (if you have graduated from medical school)

Step 2: Appointments are made through the Vascular Surgery Matching Program, sponsored by the National Resident Matching Program Specialty Matching Services. All candidates must register through the SMS.

To register see: National Resident Matching Program's (NRMP) Specialty Matching Services

• Applicants considered for an appointment will be invited to visit Mayo Clinic for a personal interview with the program director and selected faculty. Interviews are conducted during March and April each year.

Program Contacts

For an application form or more information, please contact:

Thomas C. Bower, M.D, Peripheral Vascular Surgery Fellowship Program Director
(507) 284-2644

Julie Griffin, Peripheral Vascular Surgery Fellowship Education Coordinator
(507) 255-7062

For more information about Mayo Clinic residencies and fellowships, please contact:

Mayo Clinic College of Medicine
Mayo School of Graduate Medical Education
200 First Street S.W.
Rochester, MN 55905
(507) 284-2220

Upon request, we can also provide you with a list of our previous and current vascular surgery fellows, which includes the site of their previous general surgery training and their current practice location.