Factors associated with general surgery residents’ perceptions of vascular surgery

Abstract

Objectives

Shortages of vascular surgeons are projected through 2050, and vascular surgery fellowships (VSFs) remain a critical pathway for training vascular surgeons. We sought to identify general surgery (GS) residents' perceptions of/attitudes toward VS.

Methods

Anonymous, electronic questionnaires were sent to GS residents. Questions assessed demographics, fellowship preferences, and exposure to and perceptions of VS. Univariate and multivariate analyses were performed.

Results

Of 152 respondents (15% response rate), 20 (13.2%) will apply for VSF, 64 (42.1%) are interested in VS (IVS), 62 (40.8%) are not interested in VS (NIVS), and 6 (3.9%) remain undecided. Overall, among respondents encompassing all postgraduate years, 106 (69.7%) felt comfortable with medical management of vascular disease, 52 (34.2%) felt comfortable with open surgical management, and 14 (9.2%) felt comfortable with endovascular management. Compared with residents NIVS, trainees planning on applying for VSF or IVS reported greater familiarity with diseases treated (97.6%; P = .003) and procedures performed (88.1%; P = .013) by vascular surgeons. Those applying for VSFs were more likely to perceive they were essential members of the vascular team (P = .003), and their time in the operating room was productive (P = .001). Fifty-five (36.2%) respondents believed their exposure to VS in residency was inadequate for a surgeon not pursuing a VSF. More trainees NIVS reported disrespectful treatment by VS attendings, residents, and fellows (P = .043). Stratified by gender, 25 female residents (29.4%) cited male dominant (P < .001) as a reason for not choosing VS. When asked how vascular training programs impacted exposure while on VS rotations, 45 residents (70.3%) at institutions with both a VSF and integrated VS residency indicated diminished experiences owing to the presence of vascular trainees (P = .014), and 25 (39.1%) expressed lower satisfaction with their rotation (P = .012).

Conclusions

Exposure to VS during GS residency may be inadequate for a general surgeon entering practice. Reasons for not pursuing a VSF included disrespectful interactions from VS residents, fellows, and attendings, as well as a male-dominant field. Residents at institutions with vascular training programs expressed lower satisfaction and experiences gained. Improving these factors may increase interest in VSFs.