0+5 Integrated Residency Program
We have had a 0+5 vascular residency since July of 2009, while also maintaining a vascular surgery fellowship since 1985. Each year, one position is filled at the PGY-1 level for the vascular residency, and one position is filled at the PGY-6 level for the vascular fellowship . The positions are filled via the NRMP (National Residency Match Program). Interested applicants may apply via the Electronic Residency Application Service (ERAS). Applicants to the vascular surgery residency apply during the fourth year of medical school training for the position starting in July of the following year after graduation. Selected applicants are invited for an interview in January for the position starting in July of the same year for the residency program.
The training program encompasses experiences at the UAMS Medical Center, the Central Arkansas VA hospital and the Baptist Health hospital. The University of Arkansas for Medical Sciences Hospital is the only academic referral center in the state and surrounding region, attracting complex cases from the three surrounding states. The vascular resident is exposed to a variety of complex vascular reconstructions, involving all vascular beds, with cases involving a combined open and endovascular approach. The experience at the VA hospital is not necessarily “typical”. It has a very streamlined and state-of-the-art hybrid operating room that operates 5 days a week, is not only rich in “bread-and-butter” vascular cases, but also index cases, such as renal and visceral bypasses, thoracoabdominal aneurysm repairs, fenestrated endografts and complex re-operative lower extremity reconstructions. Baptist Health is one of the State’s largest community hospital system and the Little Rock hospital is the referral center for this medical system, attracting both straight-forward and very complex cases from around the State. The large hybrid operating room, opened in 2014 allows for advanced vascular surgical imaging and treatment. Access to a community hospital experience helps completes the trainee’s experience in all realms of vascular surgery options when they finish.
The benefit of an integrated vascular surgery residency is to provide graduated, incremental training in both vascular and general surgery during the five-year program. Two of the five years includes “core” surgical curriculum. Our rotation schedule is designed so that it integrates appropriate rotations during the first four years, and provides chief residency experience in vascular surgery during the fifth year. A total of 36 months is spent on vascular surgery, and 24 months on core or general surgery rotations. The schedule has been designed to appropriately interact with current general surgery, intensive care unit, cardiothoracic surgery rotations at the appropriate level to optimize learning and hands-on experiences. It provides five-six months experience as the chief resident on general surgery during the fourth year of training in addition to twelve months chief resident experience during the last year on vascular surgery. During core surgery education, the vascular surgery resident has the opportunity to perform basic open and minimally-invasive surgical procedures. Three of the five years are dedicated specifically to vascular surgery training.
Vascular surgery inpatient training is obtained on our dedicated vascular surgery service. By spending six months on this service during each of the first four years and twelve months in the last year (total 36 months) residents have substantial exposure each year to inpatient management and operative treatment of vascular patients with progressively increasing responsibility. Training in diagnostic catheter-based imaging and endovascular intervention is provided to the vascular resident during all five years in a progressively complex manner. During each rotation, residents spend one day per week in the outpatient clinic, under direct faculty supervision.
Core surgical training occurs primarily on general surgery services that are focused on abdominal, trauma and critical care, but also includes laparoscopic, transplant and oncologic surgery in a ratio that is optimal for vascular surgeons who will not necessarily perform elective GS, but will be caring for vascular patients who often develop general surgical problems, have complex abdominal exposures and require complex critical care. In addition, rotations on cardiac and non-cardiac thoracic surgery increase exposure to techniques of median sternotomy, thoracotomy, and care of cardiothoracic patients. This experience is robust because we do not have a CT fellowship at our institution. We have a busy kidney and liver transplant program, so rotation in this service provides substantial experience in vascular surgery techniques and exposures related to this area. Finally, ICU rotations, both in the standard medical-surgical ICU and in the Cardiac-Coronary care unit supplement the critical care experience associated with care of vascular patients while on the vascular surgery service. Rotations have been scheduled each year at levels that provide the optimal experience on each of the non-VS services, to avoid competition with any current residents on these services.
Vascular chiefs and fellows spend 18-24 months on vascular surgery rotations divided between the three hospitals, always on their own separate service allowing for independent management of patients and working closely with the faulty they are assigned to. Extensive exposure is provided to both open and endovascular techniques. Significant autonomy is provided during this training resulting in a confident and well-rounded vascular surgeon at the end of the training.
The University of Arkansas vascular surgery faculty take didactics very seriously and are very protected educational events; all residents and fellows are supported by the faculty to be present unless actively involved in life-saving activities.Our weekly vascular conferences include an hour of case presentations and discussions as well as an hour devoted to one of the following: service morbidity and mortality (M&M), literature review, chapter from Rutherford’s vascular text, or a “How I Do It (HIDI)”, in which residents present in 10 steps how they would perform a vascular procedure. In addition, there are monthly Journal Clubs, EBM reviews, review of classic publications in vascular surgery and biannual oral board review sessions held on campus in a true, life-like setting at our simulation center.
Both UAMS and the VA Medical Center are involved with multiple clinical trials and have access to prospectively maintained clinical databases, allowing trainees to be involved with new and cutting edge devices and procedures in vascular surgery. Residents and fellows also have the opportunity to be involved with clinical vascular surgery research, or basic science research if they wish. Trainees have presented abstracts and posters at all major Vascular Surgery meetings, and are expected to present and publish annually.
Little Rock is a hidden gem. It is called the Natural State for a reason, as the beautiful rivers and lakes that surround it offer endless opportunities for outdoor activities. The people are very diverse and welcoming throughout. Many people who come to train never leave!
Interested applicants may apply via ERAS. For further information, please contact:
Division of Vascular Surgery
4301 W. Markham St.
Little Rock, AR 72205
501-686-6627 or 501-686-6176