BOSTON MEDICAL CENTER
FELLOWSHIP IN VASCULAR SURGERY
EDUCATIONAL GOALS AND OBJECTIVES
At the completion of the fellowship in vascular surgery, the vascular fellow should have a
comprehensive understanding of congenital and acquired diseases of the vascular system,
the pathophysiology of vascular disease, and the methods of management of patients with
vascular disease. In addition the fellow should be able to demonstrate the following:
1. knowledge of human arterial and venous anatomy
2. knowledge of basic arterial and venous hemodynamics
3. understands the initial manifestations of vascular disorders, including congenital
vascular disease and diseases of the venous and lymphatic systems
4. ability to assess the vascular system by appropriate skills in history taking and in
clinical examination
5. understands the pathogenesis and management of atherosclerosis and related illness,
such as diabetes mellitus, hypertension, renal failure, and congestive heart failure
6. recognizes the diagnostic tools available for assessing vascular disease, including
angiography, CT scanning, MRI, and the relative importance of each
7. understands the basic principles of Doppler ultrasound and non-invasive lab
diagnosis, and can perform bedside arterial and venous Doppler testing
8. recognizes life-threatening signs of vascular disease and when immediate
intervention is required
9. understands the principles of care for ischemic limbs
10. understands the principles of care for non-healing arterial and venous ulcers of the
extremities
11. understands the natural history, hemodynamics, and pathophysiology of lower
extremity claudication, TIA, stroke, mesenteric angina, angina pectoris,
renovascular hypertension, and AV fistula
12. ability to manage shock in critically ill patients
13. performs preoperative assessment and postoperative care of patients undergoing
major vascular surgical procedures
14. knowledge of the fundamental elements of nonoperative care, including the role of
risk management and preventative measures
15. knowledge of the concept of critical arterial stenosis
16. ability to differentiate an acute arterial occlusion from an acute deep venous
occlusion
17. knows the indications for angiography, and complications of angiography, including
contrast-induced renal failure
18. knows the principles and techniques of angiography, including intra-operative and
emergency room angiography
19. knows the principles and technique of MRA
20. knows the principles, indications, and contraindications of anticoagulation and
thrombolytic therapy
21. knows the interaction of the vasoactive prostaglandins and their manipulation by
various medications
22. knows the surgically correctable causes of hypertension and ways to diagnose and
correct them
23. familiarity with the diagnostic and therapeutic pharmacologic interventions for
vascular disease, including vasospastic disorders
24. familiarity with the general principles of surgical technique, including vascular
control, suturing techniques, anastomotic techniques, and the principles of
endarterectomy, angioplasty, and bypass grafting.
25. familiarity with the principles, indications, and contraindications of endovascular
surgery
26. familiarity with the adjunctive measures for management of vascular disease such as
antibiotics, anticoagulants, thrombolytic agents, and antiplatelet agents
27. familiarity with the physiologic end-organ manifestations of vascular disease, such
as renovascular hypertension, portal hypertension, and renal failure
28. ability to dissect out and isolate major vessels from surrounding tissues
29. knowledge of the indications for surgery for claudication, abdominal aortic
aneurysm, carotid stenosis, and amputation along with risks and complications
30. knows the indications and contraindications for balloon angioplasty, along with risks
and complications
31. knows the different types of amputations and potential complications
32. knows the pathogenesis and complications of aneurysmal disease
33. knows the etiology, microbiology, and treatment of diabetic foot infection and also
the principles of diabetic foot care
34. understands nonoperative care of vascular disease
35. familiarity with the role and limitations of the non-invasive vascular laboratory
36. become a registered vascular technician
37. familiarity with the clinical manifestations of failing vascular grafts
38. familiarity with the pathophysiology and repair of pseudoaneurysmal disease
39. familiarity with the principles of reoperative vascular surgery
40. familiarity with the handling of vascular surgical emergencies, such has
management of patients with acute tissue ischemia or major hemorrhage (trauma or
ruptured aneurysm)
41. familiarity with the principles of vascular trauma management
42. recognizes options for treatment of patients with chronic venous insufficiency and
venous ulceration
43. familiarity with proper surgical techniques for vascular disorders, including
knowledge and application of advanced surgical techniques
44. knowledge of the indications and complications of vascular access (venous
interposition, AV fistula)
45. knowledge of the complications of central venous access
46. ability to deal with prosthetic graft infections, including understanding the principles
of diagnosis and management, alternate routes for re-vascularization, and materials
to be used for grafts
47. knowledge of the different types of prosthetic grafts and their indications for usage
48. ability to deal with complications of common major vascular procedures such as
carotid endarterectomy, aortic reconstruction, and lower extremity reconstruction.
49. understands the pathophysiology of aortic dissection
50. understands the complexity of vascular diseases and decision-making processes for
cerebrovascular problems, mesenteric vascular disease, renovascular disease,
aneurysmal disease, lower extremity arterial occlusion, and venous disease
51. knowledge of the general competencies of resident education including but not
limited to patient care, professionalism, interpersonal communication, medical
knowledge, practice-based learning, systems-based practice (see Educational Goals
and Objectives for Education in the Competencies)
DATE ACCEPTED______________________