A Proposal for a National Vascular Surgery Curriculum for ... APDVS MS Curriculum 033… · •...
Transcript of A Proposal for a National Vascular Surgery Curriculum for ... APDVS MS Curriculum 033… · •...
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A Proposal for a National Vascular Surgery
Curriculum for Medical Students
Mark A. Mattos, MD FACS
Associate Program Director, Vascular Fellowship
Michigan Vascular Center-Michigan State University
Flint, Michigan
Presented at the 2017 APDVS Spring Meeting, March 31, 2017 Rosemont, Illinois
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Disclosures
• None
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Introduction
• Consistent numbers of medical students
have applied for a residency position in the
0+5 Integrated Vascular Surgery Residency
Training Programs
• Multi-year vascular surgery-specific
cognitive and skills training curricula in
medical school appears to be nonexistent
or deficient at best
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Examples of Educational Voids
• Wayne State University– MS1: No exposure
– MS2: No exposure
– MS3: 1 week elective rotation during 2-month surgical clerkship
– MS4: No available option for subinternship on vascular surgery
• Michigan State University– MS1: No exposure
– MS2: No exposure
– MS3: 1 week elective rotation on 6-week surgical clerkship
– MS3: Single 2-hr lecture on basics of vascular surgery
– MS4: 1 month elective available on vascular surgery
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Introduction
• SVS / APDVS – Lack of clear vision as to how to improve medical
students exposure to vascular surgery more than once a year at VAM?
– Lack a plan of action to implement vascular education for our potential future vascular surgeons?
• If SVS / APDVS…… – is to continue to recruit and acquire the highest level
medical students available, than a……
– a formal vascular surgical educational curriculum for all 4 years of medical school should be considered
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Curricular Content and Aim
Introduce a brief basic preliminary proposal for a vascular curriculum based on the following 5-part program
1.Vascular Education
2.Vascular-specific Skills Training
3.Vascular Research
4. Professional Mentorships and Relationships
5.Vascular Society Relationships
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Year 1
• Primary cognitive goal is to introduce the specialty of vascular
surgery as a career choice to students.
• Coordinated introductory lectures about vascular surgery and
basic surgical skills training
– Use content from VAM and MVSS Student Programs
• Provides a vehicle for 1st year students to meet other students
with similar interests
• Provide opportunity for introduction to vascular surgeons
• Provide a pathway for mentorship to begin
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Year 1
• Begin conversations about research opportunities
• Participation in national or regional vascular meetings is
encouraged
– ei. VAM, MWVSS
• Interactions should occur on at least a quarterly basis
• Interactions should be focused, casual and fun
– Remember that at this point vascular surgery is not a top priority of
student!
– Remember to always bring food and drink
– Remember to bring ‘something’ they can leave with
– Bring vascular residents or fellows
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2nd Annual
2016 MVSS Medical Student
Education & Participation Program
“Introducing Vascular Surgery as a Career
Choice”
Mark A. Mattos, MD for the
2016 MWVSS Education Committee
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Program Overview
• 2 yr Program
• Didactic Lectures, Career Choice
Discussions, Expert Demonstrations
• Basic Vascular Surgery Skills Training
• 4 Hands-on Skill Stations
– Knot Tying, Forceps Handling/Needle Driving,
Needle Accuracy Placement, Vascular Repair,
• 77 Medical Students, 23 Institutions
• 25 Vascular Surgery Faculty Proctors
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Program Goals
• Introduce vascular surgery simulation
and skills training/curricula as means
to enhance medical school educational
experience
• Provide basic vascular skills
experience
• Answer questions about vascular
surgery
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Program Objectives
• Introduce Vascular Surgery as a Career
Choice
• Provide opportunity to meet members
and leaders of MVSS
• Discuss opportunity for mentorship
locally, regionally and through the
MVSS
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2015 Lectures
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Year 2
• Primary cognitive goal is provide organ system-based
lectures and associated vascular procedures
• Increase fund of knowledge of vascular physiology, pathology
and pathophysiology
• Technical skills goals are to include knowledge of basic
general and vascular surgical instrumentation
• Technical skills training should now include basic vascular
techniques
• Participation in regional and national vascular meetings is
now strongly recommended and expected.
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Year 2
• Participation in vascular research projects is strongly
encouraged and expected
• Interactions should occur on at least a twice monthly basis
• Faculty mentorships should be acquired
• Discussions regarding career choice should begin
• Encourage candidate membership in regional and national
vascular societies
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Year 3
• Primary cognitive goals are lectures which emphasize
vascular procedural knowledge
• Technical skills training should be advanced to intermediate
vascular skill techniques and procedures
• Offer cadaver-based vascular procedural training
• Cement research participation with expectation of
submission and presentation at meetings
– ei.Medical student research forums, Regional/National Societies
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Year 3
• Participation in national or regional vascular meetings is
encouraged
– ei. VAM, MWVSS
• Interactions should occur as often as necessary
• Faculty mentorships should be solidified
• Discussions should revolve around a definite career in
vascular surgery
• Discuss selection of 4th year rotations, subinternships and
interview opportunities
• Encourage candidate membership in regional and national
vascular societies
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Year 4
• Continue to provide vascular procedure-based lectures
• Begin participation in faculty-based and industry driven
skills/simulation training sessions with surgery residents and
vascular fellows
– Consider self-training skills program
• Recommend participation in medical school Advanced
Surgical Skills Electives/Rotations
• Encourage participation in vascular conferences
• Invite to vascular journal club dinners
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Vascular Surgery
Surgical Skills Curriculum for Residents
Open Surgical Skills Module
Mark A. Mattos, MD - Vascular Surgery Surgical Skills Curriculum
Open Surgical Skills Module: Vascular Anastomosis – End-to-End Anastomosis Interposition Graft
Syllabus
February 27, 2017
Vascular Anastomosis
End-to-End Anastomosis, Interposition Graft
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Program Demographics
• Vascular Surgery Surgical Skills Training Sessions
• Genesys Simulation Center, (2nd Floor)
• Monthly 5:30pm-8:00pm
• Vascular Surgery Faculty and Vascular Surgery Fellows
• General Surgery Residents (PGY-1 to PGY-5)
– Genesys Regional Medical Center, McLaren-Flint
– 1:3 or 1:4 faculty/resident teaching ratio
• Food and Beverages provided
• Voluntary participation
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Program Format
• 5:30pm – 6:00: Introduction/Food
• 5:30pm – 6:00: Prosthetics Lecture Series
• 6:00pm – 6:30pm: Faculty Presentation
– Goals and Objectives
– Expert Demonstration, Video presentation
• 6:30pm - 8:00pm: Hands-on Skills Training
– 10-15 work stations / 2 residents per station
– 2 Procedures (Primary surgeon / 1st assistant)
– Fill out assessment forms (if applicable)
• 8:55pm – 9:00pm: Complete Surveys (if applicable)
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The Vascular Skills Stairway to Success
Transverse Arteriotomy – Primary Closure
Longitudinal Arteriotomy – Primary Closure
Longitudinal Arteriotomy – Patch Closure
End-to-End Anastomosis-Primary Repair
End-to-End Anastomosis-Interposition Graft Repair
End-to-Side Anastomosis (Medium Vessel)
End-to-Side Anastomosis (Small Vessel)
Femoral-Femoral Artery Bypass
Abdomial Aortic Repair – Tube Graft
Aorta-Renal Artery Bypass
Abdominal Aortic Repair – Bifurcated Graft
11 Open Skills Modules
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Year 4
• Interactions should occur as necessary but at least monthly
• Obtain letter of recommendations from vascular mentor
• Seek externships at outside institutions
• Solidify interviews for residency position
• Finalize research projects
• Mentor to provide mock interviews if warranted
• Interview, Match, Residency
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Summary
• Development of a vascular surgery
curriculum for medical students is feasible
• Benefits of such a curriculum seems
reasonable and intuitive
• APDVS should consider this a priority for
recruitment of medical students