Vascular Surgery – Integrated Residency

The Division of Vascular Surgery at UM offers both an Integrated Residency and a Fellowship training program. The Integrated Residency Program’s curriculum (5+0) consists of two years of core general surgery training, with strong emphasis in vascular surgery during the third year of training. The last two years of residency are fully dedicated to endovascular and open vascular surgery education, which parallels our traditional two-year Fellowship Program (5+2). Our trainees divide their time and rotate between the University of Miami Hospital, Jackson Memorial Hospital and Miami VA Medical Center. These institutions are located within one block of each other. Rotating at a referral center provides trainees with exposure to a broad spectrum of both open vascular and endovascular cases, offering hands-on experience in treating diverse vascular pathologies. The division supports our nationally renowned Level 1 Ryder Trauma Center, The Sylvester Cancer Center, and The Miami Transplant Institute, where trainees are exposed to a variety of vascular reconstructions, as well as vascular trauma including many traumatic aortic injuries. There is absolutely no doubt that future generations of vascular surgery trainees will be the beneficiaries of South Florida’s first vascular surgery training program at UM/JMH.

At three rotating sites – University of Miami Hospital, Jackson Memorial Hospital, and Miami VA Medical Center – trainees work with a team of junior general surgery residents, physician assistants, nurse practitioners, and medical students. The rotating vascular surgery trainee attends a weekly outpatient clinic and participates in the pre-operative and post-operative care of patients under the supervision of the vascular surgery faculty. Under faculty supervision, only one vascular fellow or senior vascular resident (PGY4 or PGY5) is present at each site, manages their respective team, and is responsible for the daily function of the service.

Vascular surgery trainees are entrusted with increasing levels of responsibility as they showcase proficiency in surgical procedures, pre- and post-operative patient care, and progress towards autonomous practice throughout their training.
The fellowship and residency programs aim to cultivate expert vascular surgeons who can become leaders in clinical practice and academic research. We achieve this by providing a comprehensive learning and training environment that equips trainees with the necessary tools and skills.

The training ensures that upon completion of the full program, the fellows and residents will have all the clinical education and experience needed to prepare them for certification by the American Board of Surgery. They will have the clinical exposure necessary to obtain competence in vascular surgery and lay a foundation for safe and compassionate patient care. The trainee will be eligible for certification as an RVPI (Registered Physician in Vascular Interpretation) and eligible for certification in Vascular Surgery by the American Board of Surgery. It is expected that the trainee will be a competitive candidate for the professional position of their choice, whether private practice, academic, or a combination of the two. Additionally, it is a goal of the program to graduate physicians competent in all aspects of vascular care, including diagnosis, medical management, endovascular and open management. They will attain competence in both endovascular and open vascular procedures, including appropriate pre-procedural evaluation, procedural conduct, and post-procedural care and follow-up of the patients. This includes the judgment and skill needed to discern the best course of care for each patient, including non-operative therapy.

Upcoming vascular surgery cases on the campus are presented by the vascular surgery fellow, or senior integrated resident, in our daily case presentation conference (7:00 AM-7:45 AM) in the presence of their team and faculty. Endovascular, hybrid, and open procedures are performed from Monday to Friday in the dedicated hybrid rooms and operating rooms.

The rotating senior trainee (fellow or PGY4 & PGY5) acts as a consultant for junior general surgery residents and participates in the pre- and post-operative care of vascular surgery patients. Vascular surgery fellows and senior integrated residents will take home call at the three sites, covering acute and chronic care of vascular patients.

Our program fosters a culture of lifelong learning and research, ensuring fellows and residents stay current with the latest advancements in vascular surgery. We achieve this through a variety of structured educational activities:

• Daily Morning Case Presentations: Fellows and senior residents present upcoming vascular surgery cases to their team under faculty supervision. These discussions delve into the intricacies of each case, explore optimal treatment options, and prepare trainees for future oral board exams.
• Weekly Didactic Vascular Topic Presentations: Dedicated protected time allows trainees, faculty, or guest experts to present serial topics from the Rutherford Textbook on PowerPoint, fostering in-depth learning.
• Monthly Morbidity & Mortality Conferences: Trainees present vascular surgery complications and mortalities to the entire faculty and team for open discussion and learning. Additionally, they present challenging cases at Departmental General Surgery Morbidity & Mortality conferences every a few weeks.
• Skills Workshops: The program offers frequent on-campus and off-site workshops across the US. Junior residents (PGY1 & PGY2) participate in a dedicated vascular anastomosis workshop with faculty every Tuesday. Additionally, organized workshops with the vascular industry provide simulator training on Tuesday afternoons.

Our program provides comprehensive training in all aspects of clinical research, equipping fellows and residents with the skills to design, conduct, analyze, and report impactful studies. This includes:

• Participation in data-driven research projects within the division
• Access to national vascular surgery registries
• Opportunities to present research findings at national vascular surgery meetings
• Regular vascular-oriented oral presentations to the local medical community, including students, general surgery residents, and medical practitioners
• Participation in prospective clinical trials, including both investigator-initiated and industry-sponsored studies
• Additionally, the division boasts an integrated basic science research laboratory led by Drs. Omaida Velazquez and Roberto Vazquez-Padron, offering further research opportunities.

The program will also ensure that all trainees have the appropriate tools to practice the art of vascular surgery. Purchase of magnifying loops, protective lead attire, as well as tools to develop their surgical knowledge, including educational and learning software programs, and textbooks, are all covered by the program.

During the first two years of training, integrated vascular surgery residents are part of the general surgery rotating pool, acquiring necessary core general surgical knowledge, and learning surgical patient management. The junior vascular residents (PGY1 & PGY2) participate in a dedicated vascular anastomosis workshop every Tuesday.

Residents in their 3rd year dedicate a designated month to achieving proficiency in interpretation and performance of vascular lab studies, as well as developing expertise in dialysis access creation and management. The 3rd year of residency transitions to a more dedicated vascular surgery curriculum.

When vascular surgery residents reach their senior years (PGY4 & PGY5), they will be responsible for open and endovascular cases performed in the operating rooms and the hybrid rooms. In that capacity, they become the team leader at their respective site and share the same responsibilities and role as the junior and senior fellows. The senior vascular resident is responsible for open and endovascular cases performed in the hybrid rooms and operating rooms at their rotation site. In this capacity, the vascular surgery resident preoperatively evaluates the patient, develops a therapeutic plan in consultation and with the input of the faculty. Fellows perform the endovascular/open procedures with the attending surgeon, and then follow up the patient in hospital and clinic setting.