Outcomes of the Early Specialization Program in Vascular Operation

J Am Coll Surg. 2022 Sep 1;235(3):550-558. doi: 10.1097/XCS.0000000000000297. Epub 2022 Aug 10.


Background: The Early Specialization Program (ESP) in vascular surgery (VS) began as a "pilot program" in 2003. There is only one published report on ESP outcomes.

Study design: The general surgery (GS) and VS programs of all institutions using the ESP were contacted. Data gathered included demographics of ESP enrollees, participants' case logs (CLs), and CLs of participants' residency graduating classmates. National CLs, program and institutional data, and participants' certification status were publicly available.

Results: Nine institutions have enrolled 34 participants. Four withdrew, and four are in the GS component. Of 26 who have completed ESP, residency CLs were available for 20. Participants' percentile rankings among national contemporaries were lower than 13th for surgeon-junior cases (SJCs), higher than 73rd for surgeon-chief cases (SCCs), and 49th for total major cases (TMCs). They were lower than the 40th percentile in all domains except operative trauma (52; SD 23.8) and vascular (84.7; SD 22.1). As a percentage of the mean (% mean) for their own graduating classes, participants performed 91.8% (SD 16.5) as many SJCs, 143.7% (SD 45.1) as many SCCs, and 105% (SD 11.4) as many TMCs. Participants performed more than 79 % mean in every domain, including 213.4% (SD 82.4) as many vascular cases. As fellows, they ranked higher than the 50th percentile nationally in all but two categories. Twenty-four of 26 certified in GS. GS certification has lapsed for 5, 17 remain initially certified, and 2 have re-certified. All have current VS certification.

Conclusion: Although infrequently employed, ESP remains an effective option for those who seek both GS and VS certification.

MeSH terms

  • Certification
  • Clinical Competence
  • Education, Medical, Graduate
  • General Surgery* / education
  • Humans
  • Internship and Residency*
  • Specialization
  • Specialties, Surgical* / education
  • Vascular Surgical Procedures / education