A. Humayun1, P. Satarasinghe1, J. Chizea1, S. Sajja1, M. Kahn1 1Crozer Chester Medical Center, General Surgery, Chester, PA, USA
Introduction:
Vascular surgery training is a challenging process. With more than 70 percent of surgical residents seeking additional fellowship training, integrated pathways without a general surgery prerequisite have emerged along with independent pathways to satisfy the demand for specialization. Although there have been numerous papers commenting on integrated residency programs supplanting traditional programs due to factors such as decreased interest, standardized curriculum, and desire for a “fast track” method of training, independent general surgery applicant demand remands for a career in vascular surgery. An evaluation of independent vascular surgery applicant data was conducted to appraise the status of traditional vascular surgery education.
Methods:
Match outcome data from the National Resident Matching Program (NRMP) data and applicant data from the Electronic Residency Application Service (ERAS) was analyzed for vascular surgery. The total number of applicants to independent vascular surgery fellowships was obtained for the years 2017 through 2022. The number of applicants per program was then identified. The applicants were then further stratified by type of medical education – international medical graduate (IMG), medical degree (MD), or doctor of osteopathic medicine (DO). The applicant pool was then compared against the available positions.
Results:
The demand for independent vascular surgery positions is at an all-time high, though the number of independent vascular surgery spots has remained essentially the same. In 2022, 193 general surgery residents applied for a vascular surgery fellowship. In 2021, 154 residents applied for fellowship. In 2017, only 130 residents applied for fellowship. In 2022, approximately 101 general surgery residents applied to each vascular surgery program, each typically having one to two fellowship positions. In 2017, only 55 residents applied for each program. Across all educational pathways (IMG, MD, DO), the number of applicants has increased. Overall, there has been a 47% increase in total general surgery applicants to vascular surgery and a 56% increase in average applicants per independent vascular surgery fellowship.
Conclusion:
The future of vascular surgery training rests in both integrated and independent training pathways. However, the rising demand for independent vascular surgery spots over the past few years supports the preservation of the independent pathway and potential expansion of available spots and programs to align demand with interest.