First Year
The major focus of the first year is to gain expertise in endovascular surgery. As the direction of vascular surgery, in general, is trending toward the endovascular management of patients, it is becoming increasingly important to train vascular surgeons to be comfortable with catheters and wires. In the first year of training, the resident actively participates in diagnostic angiography, as well as peripheral vascular interventions, including carotid, renal, mesenteric, iliac, femoral, and tibial angioplasty and/or stenting. All of this training is through the vascular surgery faculty, and the first year trainee spends about three full days a week in the cath lab or angio suite. Four out of six faculty members are involved in this training. The trainee will finish the program with more than twice the endovascular cases required for certification.

The first year vascular trainee spends a limited amount of time at the New England Baptist Hospital, under the supervision of Dr. Frank Pomposelli, caring for vascular patients in a community hospital setting. They also provide vascular care for patients who are undergoing spine surgery in the New England Baptist Bone & Joint Institute, the region's foremost resource for musculoskeletal treatment, education and research, established by the Hospital in 1995. This experience provides an opportunity for the trainee to gain significant experience in retroperitoneal dissections as well as standard arterial reconstruction. However, operative surgery is not a major component of the first year and this component typically averages one case per week.

We have a large, prospective database encompassing over 1,000 procedures each year. This has formed the basis for many studies on the outcomes of surgical management including lower extremity bypass, carotid surgery, and cost/benefit studies. These ongoing projects provide numerous opportunities for involvement of the trainee in a productive effort. All trainees participate in a clinical research project. Our goal is not necessarily for a trainee to conduct independent research but rather to have an educational experience that will lead to the ability to collect, interpret and critically analyze data, with the subsequent presentation of at least one paper at a regional or national meeting. All of our recent trainees have presented papers at regional or national meetings and have published papers in major peer-reviewed journals.

As the non-invasive vascular laboratory is critical to the understanding of vascular disease, our program integrates this experience in the first year of fellowship. The resident is involved in the interpretation of vascular laboratory studies under the supervision of the vascular surgery staff. One of the goals of this program is to allow the resident to become qualified to read studies in an ICAVL-accredited laboratory.

Second Year
During the second year of training, the resident can expect to perform between 250 and 350 procedures as the operating surgeon. This includes an exposure to the complete spectrum of arterial reconstructive procedures from carotid disease to aneurysms to lower extremity bypass grafting. In addition, the resident will gain expertise with angioscopy. The resident also participates in a significant number of aortic stent-graft procedures and hybrid open/endovascular operations done in the operating room, as well as a number of endovascular cases done in the cath lab.

The residents are responsible for the weekly vascular conference and for presentation at the weekly morbidity and mortality conference. It is our goal that the vascular surgery resident will be expertly trained in clinical vascular and endovascular surgery and capable of organizing and completing a clinical research project. This will provide a foundation for a career in vascular surgery with an academic affiliation or in high-quality, independent practice.