The Vascular Service is composed of a PG5, PG3 and two PG-1 residents or a PG1 and PG2. Below are objectives for the PG-1 level.

Administrative

You are commencing your surgical education and will be exposed to a very busy and demanding service. Your administrative responsibility is to organize patient care in a coherent manner, to have lab data when on rounds, and to work with the vascular nurse to prepare patients for surgery and discharge. You will perform admission histories and physical exams during the a.m. EMA time set aside for the service. You may be asked to present patients during Friday a.m. rounds.

Reading

You are expected to read in the realm of vascular disease from your standard textbook of surgery. Additional materials are available if you have specific questions or interests. You should be cognizant of the physiology and pathology of vascular disease. You should note the problems of treating patients with severe generalized atherosclerosis and the un-repaired heart. You should be aware of the diagnosis of stroke. You should read about problems from chronic venous disease.

Technical

You will have experience with simple procedures, such as venous access for hemodialysis, vena cava filter placement, amputations and will assist some other complext procedures. You will begin to work with fine suture materials and may choose to practice using Castroviejo needle holders with PTFE (Goretex) graft. Depending on your skills, you may be allowed to perform some vascular anastomoses. You should read about the standard vascular exposures, including the retroperitoneum and the neck. You should practice stable knot tying, particularly two-handed ties.

Diagnostic

You should learn what the indications are for vascular surgery and how vascular patients are prepared for surgery. It is important to study the risk factors for vascular surgery and the management of common complications for the vascular procedures. You should study the assessment of the circulation by physical examination and with the vascular laboratory, as well as with the use of angiography.