Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, Mass.
Division of Vascular and Endovascular Surgery, University of South Florida, Tampa, Fla.
J Vasc Surg. 2019 Jun;69(6):1918-1923. doi: 10.1016/j.jvs.2018.10.070. Epub 2019 Jan 6.
The Registered Physician in Vascular Interpretation (RPVI) credential is a prerequisite for certification by the Vascular Surgery Board of the American Board of Surgery. Of concern, as more current trainees and recent program graduates take the Physician Vascular Interpretation (PVI) examination, vascular surgery trainee pass rates have decreased. Residents and fellows have a lower PVI examination pass rates than practicing vascular surgeons. The purpose of this study was to assess current vascular laboratory (VL) training for vascular surgery residents and fellows and to identify gaps that residency and fellowship programs might address.
Program directors (PDs) of Accreditation Council for Graduate Medical Education-accredited vascular surgery programs (107 fellowships, 53 integrated residency programs) were surveyed using a web-based tool. Responses were submitted anonymously. Data collected included information about the program, the PD, accreditation status of the VL, and the curriculum used to meet the PVI prerequisites. Concurrent data (June 2017) on the credentials of all PDs were obtained from the Alliance for Physician Certification and Advancement (APCA).
Sixty-one of 117 PDs participated in the survey (52% response rate). Of these, 44 individuals (72% of responders) reported they held the RPVI and/or Registered Vascular Technologist credential. Records from APCA indicated that 51 of 117 PDs of accredited vascular surgery residencies and fellowships (44%) had an RPVI/Registered Vascular Technologist credential. Ninety-four percent reported that their VL was accredited. Practical VL experience for trainees was reported to be 20 hours or less by 62% of respondents. The use of a structured curriculum for practical experience was reported by only 15 programs. Programs with fellowships established for more than 10 years were more likely to have a structured program for didactic instruction (P = .03). Only 23 programs reported a dedicated VL rotation. Didactic instruction provided was 20 hours or less for 75% of the cohort.
In the absence of a standardized VL curriculum, there is variation in the VL instruction provided to trainees. Fellowship programs with longer histories have more structured instruction, but time allocated to VL education is substantially less than the 30 hours of didactic and 40 hours of practical experience recommended by the APCA. Programs and learners may benefit from the development of VL training guidelines and curriculum resources.
注册血管影像解读医师（RPVI）资质是美国外科学委员会血管外科学认证的先决条件。值得关注的是，随着越来越多的现任住院医师和最近的项目毕业生参加医师血管影像解读（PVI）考试，血管外科住院医师的通过率有所下降。住院医师和研究员的 PVI 考试通过率低于执业血管外科医生。本研究的目的是评估血管外科住院医师和研究员目前的血管实验室（VL）培训情况，并确定住院医师和研究员项目可能需要解决的差距。
使用网络工具对经研究生医学教育认证委员会（ACGME）认证的血管外科项目的项目主任（PD）（107 个研究员，53 个综合住院医师项目）进行了调查。回应是匿名提交的。收集的数据包括有关计划、PD、VL 的认证状态以及用于满足 PVI 先决条件的课程的信息。同时（2017 年 6 月）从医师认证和提升联盟（APCA）获得了所有 PD 证书的相关信息。
117 名 PD 中有 61 名参加了调查（52%的回应率）。其中，44 人（72%的应答者）报告说他们拥有 RPVI 和/或注册血管技师证书。APCA 的记录显示，117 名经认证的血管外科住院医师和研究员项目的 PD 中有 51 人（44%）拥有 RPVI/注册血管技师证书。94%的人报告说他们的 VL 是经过认证的。62%的应答者报告说，实习医生的实际 VL 经验为 20 小时或更少。只有 15 个项目报告说使用了实用经验的结构化课程。成立超过 10 年的研究员项目更有可能为理论教学制定结构化计划（P =.03）。只有 23 个项目报告了专门的 VL 轮换。75%的项目提供的理论教学时间为 20 小时或更少。
在缺乏标准化 VL 课程的情况下，向学员提供的 VL 教学存在差异。历史较长的研究员项目具有更结构化的教学，但分配给 VL 教育的时间明显少于 APCA 推荐的 30 小时理论教学和 40 小时实践经验。计划和学习者可能受益于 VL 培训指南和课程资源的开发。
