A vascular surgeon is a physician specializing in diagnosing and treating vascular diseases in all parts of the body except the brain and heart. Vascular surgeons treat vascular conditions surgically and non-surgically. In recent years, vascular surgery has evolved to include open surgical procedures as well as newer endovascular procedures.
Surgeries and Management
Vascular surgeons perform a variety of procedures, including carotid endarterectomy, carotid stenting, abdominal aortic aneurysm repair, phlebectomy, angioplasty, peripheral bypass surgery, aortic dissection repair, thrombectomy and varicose vein surgery. They also place hemodialysis access grafts to enable patients to receive hemodialysis. Vascular surgeons are responsible for providing inpatient post-operative care to their patients. After surgery, many patients follow up with the surgeon in an office setting for disease management.
General Surgery Residency
After completing four years of medical or osteopath school, a physician interested in vascular surgery traditionally completes a five-year general surgery residency program. The residency may be extended two additional years if the physician wants to dedicate time to vascular research. The general surgery residency trains physicians in general surgery as well as in sub-specialties such as vascular surgery, colorectal surgery, trauma surgery, cardiothoracic surgery, plastic surgery and burn surgery. A physician may elect to receive training in other areas if time permits.
Vascular Surgery Fellowship
After completing a general surgery residency, the surgeon traditionally completes fellowship training in vascular surgery, in order to specialize in that area. These fellowships are usually one or two years in length, depending on the amount of time the program requires be dedicated to research. When choosing a program, surgeons should carefully review program curricula to ensure they will receive adequate training in more traditional open vascular surgeries as well as the newer endovascular procedures. Not all vascular fellowships provide significant training in endovascular surgery.
Integrated Vascular Surgery Residency
In recent years, some programs have developed integrated vascular surgery residencies, which replace the five-year general surgery residency and the one to two-year vascular surgery fellowship. These programs are usually five years.
Licensing and Certification
A vascular surgeon must be licensed by her state medical board to practice medicine and must also be board-certified to practice vascular surgery. If the surgeon completed a general surgery residency and a vascular surgery fellowship, she must pass the general surgery board examination (after completing the residency) and the vascular surgery board examination (after completing the fellowship). If the surgeon completed the integrated vascular surgery fellowship, she must only pass the vascular surgery board examination. She will not be eligible to take the board examination in general surgery and cannot practice general surgery. These board examinations are administered by the American Board of Surgery.
Vascular surgeons commonly work in academic medical centers, smaller hospitals or private practice. Vascular surgeons are usually required to “take call” and cover overnight hours in hospitals, and they may occasionally perform emergency surgeries in at off-peak hours. The lifestyle depends largely on the type of employer and the specific requirements of the employment contract.