Does training paradigm matter? A comparison of outcomes of frail patients treated by integrated vascular surgery residency and vascular surgery fellowship-trained surgeons

Am J Surg. 2022 Sep;224(3):881-887. doi: 10.1016/j.amjsurg.2022.04.036. Epub 2022 May 4.


Background: It is unclear whether shortened training of integrated vascular surgery residencies (IVSR) has detrimental effects on graduates' performance. We sought to investigate whether there is a difference in frail patient outcomes based on the training paradigm completed by their surgeon.

Methods: IVSR and vascular surgery fellowship (VSF)-trained surgeons were identified in the American Board of Surgery database and linked to the Vascular Quality Initiative registry (2013-2019) to evaluate provider-specific patient outcomes for frail patients following vascular procedures using mixed-effects logistic regression.

Results: 105 IVSR graduates (31%) and 233 VSF graduates (69%) were included. Composite 1-year outcomes of frail patients were comparable between IVSR and VSF-trained surgeons following carotid endarterectomy (16%-IVSR vs 25%-VSF; p = 0.76), lower extremity revascularization (37%-IVSR vs 36%-VSF; p = 0.83), and aortic aneurysm repair (25%-IVSR vs 23%-VSF; p = 0.89).

Conclusions: The type of training paradigm completed by vascular surgeons was not associated with differences in their post-operative outcomes in frail patients.

Keywords: Integrated vascular surgery residency; Outcomes; Vascular surgery fellowship; education.

MeSH terms

  • Aged
  • Clinical Competence
  • Education, Medical, Graduate
  • Fellowships and Scholarships*
  • Frail Elderly
  • Humans
  • Internship and Residency*
  • United States
  • Vascular Surgical Procedures