Vascular training and endovascular practice in Europe

Eur J Vasc Endovasc Surg. 2009 Jan;37(1):109-15. doi: 10.1016/j.ejvs.2008.09.015. Epub 2008 Nov 5.

Abstract

Objective: To evaluate the influence of the status of vascular surgery (VS) training paradigms on the actual practice of endovascular therapy among the European countries.

Methods: An email-based survey concerning vascular surgery training models and endovascular practices of different clinical specialties was distributed to a VS educator within 14 European countries. European Vascular and Endovascular Monitor (EVEM) data also were processed to correlate endovascular practice with training models.

Results: Fourteen questionnaires were gathered. Vascular training in Europe appears in 3 models: 1. Mono-specialty (independence): 7 countries, 2. Subspecialty: 5 countries, 3. An existing specialty within general surgery: 2 countries. Independent compared to non-independent certification shortens overall training length (5.9 vs 7.9 years, p=0.006), while increasing overall training devoted specifically to VS (3.9 vs 2.7 years, p=0.008). Among countries with independent certification an average of 76% of aortic and 50% of peripheral endovascular procedures are performed by vascular surgeons, while the corresponding values, for countries with a non-independent certification, are 69% and 36% respectively. Countries with independent vascular certification, despite their lower average endovascular index (procedures per 100,000 population), reported a higher growth rate of aortic endovascular procedures (VS independent 132% vs VS non-independent 87%), within a four-year period (2003-2007). Peripheral endovascular procedures, though, have similar growth rates in both country groups (VS independent 62% vs VS non-independent 60%).

Conclusions: In European countries with VS as an independent specialty, vascular surgeons have a shorter total training period but spend more time in VS training, although they may not undertake a greater proportion of the endovascular procedures their countries appear to have adopted endovascular technologies more rapidly compared to the ones with non-independent VS curricula. Whether such differences influence patient outcomes requires investigation in future studies.

MeSH terms

  • Angioplasty / education
  • Angioplasty / statistics & numerical data*
  • Certification
  • Data Collection
  • Education, Medical, Graduate
  • Europe
  • Fellowships and Scholarships
  • Humans
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Specialties, Surgical* / education
  • Vascular Diseases / surgery*
  • Vascular Surgical Procedures / education*
  • Vascular Surgical Procedures / statistics & numerical data