The effect of vascular fellowships on general surgical residency training.

To answer the controversial question of whether or not vascular fellowships detract from general surgical training, questionnaires were sent to directors of 41 approved vascular fellowship programs, 41 residency directors in the same institutions, and 40 residency directors in university programs without approved fellowships. Overall response rate was 74% (93% of vascular fellowship directors, 63% of same-institution residency directors, and 65% of residency directors without vascular fellowships). Thirty-four per cent of fellowship directors and 38% of same-institution residency directors indicated that the fellowship has reduced the vascular surgery case load of residents. In institutions with fellowships, general surgery residents performed an average of 71 major vascular procedures and first assisted on 44, whereas residents performed 65 major vascular procedures and assisted on 47 in institutions without fellowships. Overall, 79% of fellowship directors and 62% of same-institution general surgical directors indicated that the fellowship improved the quality of vascular surgical training. Only 15% of same-institution residency directors and 3% of fellowship directors felt that the fellowship detracted from the general surgical experience. Fifteen per cent of institutions without approved fellowships have now initiated vascular fellowship programs, and an additional 23% plan to begin such fellowships. No fellowship directors plan to abolish their programs, although 8% plan to decrease the number of fellows in order to increase general surgery resident participation. Among the majority of institutions studied, vascular fellowships have not adversely affected general surgical training, and often enhanced it.