The Department of Surgery Division of Vascular Surgery is proud to announce the inaugural year of our Vascular Surgery Fellowship here at Charleston Area Medical Center.  Our Vascular Center of Excellence, for many years, has participated in the teaching of young trainees in all areas of vascular and endovascular medicine and recently has continued this tradition with the advent of a Vascular Surgery Fellowship. 

This is a 2 year program fully accredited by the ACGME.  Our primary goal of this fellowship is to produce well rounded vascular surgeons, who are both clinically and academically sound.  We have 4 full time vascular surgeons, 3 endovascular interventionalists, and 1 preventative medicine specialist, all of whom are dedicated to the teaching of young surgeons. 

The 2 year experience offers a wonderful opportunity for graduating residents to learn the art of vascular and endovascular surgery.  The environment provided includes a wide variety of routine and complex vascular cases allowing for a complete understanding of vascular disease.

The Vascular Center of Excellence has been a tertiary vascular center in the community and state of West Virginia for many years.  It is widely heralded as a prominent institution committed to the needs of vascular patients, offering only the best care for everyone we see.  Along with state of the art facilities, CAMC has a truly wonderful faculty and staff that not only allows for an excellent opportunity to become a fully trained vascular surgeon in every aspect but also gives you the tools needed to practice in any setting.

Open and Endovascular Experience
Our institution is an extremely high volume center with a myriad of different cases.  Our open surgical volume between 4 vascular surgeons exceeds 1,000 cases annually.  Fellows will perform more than 50 major cases monthly.  These cases consist of both routine operative interventions as well as complex cases that require the most intricate detail.  Comparatively we offer an important combination of both which will allow for an extremely well trained surgeon capable of practicing in either an academic or community setting.  Currently, our faculty performs more than the following procedures annually in the operating room.

            150 Carotid Endarterectomies
            50 Aortic and Complex Intraabdominal Reconstructions
            10 Renal/Mesenteric Bypass Procedures
            150 Dialysis Access Constructions
            150 Infrainguinal Bypass Procedures

We are also proud to acknowledge our Circulatory Diagnostics Lab that is solely dedicated to peripheral intervention.  Rotations here will give the training fellow completely restricted time learning how to approach and treat patients with transcatheter therapy.  Under the guidance of Dr. Mark Bates, the laboratories at both hospitals have become facilities available to all hospital teams with only the newest technological advancements.  Our staff performs annually over 1,000 interventional cases including the following
           
             40 Carotid Stenting Procedures
            100 Renal Artery Interventions
             25 Mesenteric Interventions
             60 Endovascular Abdominal Aortic Aneurysm Repairs
             50 Thrombolysis Cases (both arterial and venous)
             25 Coil Embolizations (Including All Trauma at both institutions)
            175 Iliac Interventions
            100 Superficial Femoral Artery Interventions
             50 Infrapopliteal Interventions

Rotational Schedule
The Fellowship will be primarily based out of CAMC Hospitals, the Memorial and General Divisions.  Most of the 2 years will be spent at Memorial hospital; in particular the endovascular rotations as well as most complex open aortic interventions.  All faculty do work out of both institutions, however, and a fair portion of time will be spent at the General Division as well.  When on call, all consultation requests as well as patient care will involve both institutions.  Both hospitals have full time operating rooms as well as CDL facilities.

Each of the fellows will have dedicated months on both open and endovascular services.  Each year, the fellow will spend 6 months on the open service and 5 months in the endovascular suite, with 1 month spent each of the two years on a rotation completely dedicated to the vascular lab.  We have 2 services with regards to the open surgical rotations.  The fellow doing his/her open surgical rotation will be in charge of one service with a senior general surgery resident in charge of the other. Both the fellow and senior resident will each have a junior general surgery resident with them for the month.  The fellow is expected to run that service with the junior resident, and will work with the attending staff accordingly.  Along with doing the cases of the attending surgeons on that particular service, any and all complex open cases (i.e. aortic interventions) will be performed by that fellow, usually with the help of the senior resident on the rotation at that time. 
The other fellow will be completely devoted to the endovascular lab.  On this rotation, all endovascular cases each week will be available to the fellow.  The primary teaching on this rotation will be at the Memorial Division with weekly lectures from Drs Campbell and Nanjundappa, however any complex cases done at the general division will be covered as well.  The goal is to have one fellow on the open surgical rotation while the other is on the endovascular months.  The fellow on that rotation will thus cover all complex open interventions and the same coverage applies for the endovascular cases.  The only exception will be July of each year, in which both fellows will be on the open rotation each covering one of the services.  Finally, the month that the fellow is on his vascular lab rotation, he will be available to cover any and all complex endovascular cases.

Vascular Lab
One month out of each year the fellow will spend time in the vascular laboratory in the Center.  The month will be devoted to learning how noninvasive testing is performed and read.  Each fellow will meet weekly with faculty for a didactic session, emphasizing all the principles involved in Non Invasive Imaging.  The goal is to have a complete mastery of reading ultrasounds, and each fellow is expected to take and complete the RPVI and RVT.   This will allow for the ability to read at any vascular center in the future.  Also, during the second year, the fellow will begin having assigned studies to be read each week outside of his rotation.

Academic Curriculum
On Wednesday of each week is protected time for our weekly lectures.  Fellows, surgical residents, and attending staff will all participate in presentations to the entire group each morning.  The academic curriculum set forth by the APDVS is the circuit that will be followed.  In addition to this, the last week of each month is reserved for discussion of complex cases that have come to the service that month.  The senior fellow will be in charge of a monthly journal club, which is a session sponsored by industry where all faculty and resident ream can discuss articles hand selected regarding the educational topic that month.

Research
During both years, research is welcomed and required.  A goal of at least one publication per year is required for completion of the fellowship.  However, this is by no means a minimum.  All fellows are encouraged to help participate in any and all topics that are of interest throughout the entire two years.

Call Schedule
Call is split between each fellow evenly each month.  A fellow will cover each day of the month.  The second year fellow will be in charge of the call schedule and will organize it each month.  Call is from home with all consultation requests as well as patient care responsibilities coming to the fellow on call.  The general surgery residents have at least one resident in house who is available to work with the fellow for whatever is needed.  Approximately 1/3 of the nights on call will involve returning to the hospital.  Each fellow, when on, will be the first call along with an attending faculty member for both endovascular intervention as well as one for surgical intervention.  All consultation requests will be primarily handled by the fellow on call along with whichever attending staff member is with him.  In addition, all consultation requests and admissions will be dispersed between the surgical resident team and the physician assistant team, with the resident team handling most open surgical issues, and the PA team handling all endovascular interventions.

Additional Training
In addition to the didactic lecture circuit, each fellow will be offered several opportunities to attend outside conferences and training sessions.  Most are sponsored by industry and include IVC filter, AV access, and endovascular stent graft courses.  Also, one fellow per year will be allowed to attend the Wesley Moore Conference in  California which is open to all fellows.  Encouragement and support is also given to each fellow to find added training, which will be reviewed by the staff and allowed if it is a beneficial opportunity.

Application Process
The application process for the fellowship coincides with the NRMP match.  All residents should apply through ERAS and all interviews and the subsequent match will take place in the latter half of each year.