Future of 5+2 vascular surgery fellowships?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

ae2017

New Member
5+ Year Member
Joined
Feb 17, 2017
Messages
1
Reaction score
0
Hi folks,

I am currently an MS3 trying to determine whether to go into gen surg and seek a vascular surgery fellowship afterwards or apply directly into vascular surgery. I have been getting mixed advising from my institution, which I have been able to balance by reading up on some details and commonly asked questions on the forum. One question that has come up when speaking to my advisor is the possibility that by the time I would finish a gen surg program (gonna take a research year + 4th year + 7 years gen surg = 9 years from now) would desirable 5+2 vascular surgery fellowships still be around? My advisor had mentioned that in both CT and vascular surgery a lot of the better academic programs in the country are moving away from the 5+2 fellowship and focusing on integrated training pathways.

Anyone have any thoughts or info on what the likely status of 5+2 vascular surgery fellowships could be like in ~10 years? Will there still be many programs around? Will the better academic vascular training programs no longer be taking fellows? Are the best academic programs currently aggressively shutting down their fellowships to focus on integrated residencies?

Thanks ahead of time!

Members don't see this ad.
 
Last edited:
None of the programs I interviewed at gave the impression that they are looking to end 5+2 in favor of strictly integrated spots. As the first integrated residents are just now getting into the post-training phase of their careers, the jury is still out on the quality of 5+2 experience vs integrated. Many think that integrated will have an earlier edge endovascularly, but that evens out after a couple years in practice. But 5+2 are going to be far more comfortable initially with open procedures given their general experience. But no one really knows yet. It will take more time for all that to come out in the wash but suspect few will move to a purely integrated model in the next 9 years.

Most of your questions no one can answer definitively because you are asking about what the world will look like 10 years from now and we're not clairvoyant. But I can at least tell you that no one I know of is "aggressively shutting down" their 5+2 program.


Hi folks,

I am currently an MS3 trying to determine whether to go into gen surg and seek a vascular surgery fellowship afterwards or apply directly into vascular surgery. I have been getting mixed advising from my institution, which I have been able to balance by reading up on some details and commonly asked questions on the forum. One question that has come up when speaking to my advisor is the possibility that by the time I would finish a gen surg program (gonna take a research year + 4th year + 7 years gen surg = 9 years from now) would desirable 5+2 vascular surgery fellowships still be around? My advisor had mentioned that in both CT and vascular surgery a lot of the better academic programs in the country are moving away from the 5+2 fellowship and focusing on integrated training pathways.

Anyone have any thoughts or info on what the likely status of 5+2 vascular surgery fellowships could be like in ~10 years? Will there still be many programs around? Will the better academic vascular training programs no longer be taking fellows? Are the best academic programs currently aggressively shutting down their fellowships to focus on integrated residencies?

Thanks ahead of time!
 
I'm also an MS-3 seriously considering vascular surgery and I was wondering the same thing. I've heard of some programs closing down their 5+2 pathways and was wondering if we should expect the same from more programs in the years to come since a lot can change in 5 years time...
 
Members don't see this ad :)
This is the same question asked by the OP and answered above. I have just been through the interview process and no programs had plans to scale back or shut down their 5+2 programs. This was asked and answered regularly at interviews.

I'm also an MS-3 seriously considering vascular surgery and I was wondering the same thing. I've heard of some programs closing down their 5+2 pathways and was wondering if we should expect the same from more programs in the years to come since a lot can change in 5 years time...
 
  • Like
Reactions: 1 user
I know of several programs that closed down or are closing down their fellowships. Certainly not the majority, but there are many training sites that can't justify doubling their number of upper level trainees based on their case volumes. There are others, like mine, that intend on keeping our fellowship alongside the residency a) because we have plenty of volume and b) we think that it benefits both types of trainees to be around one another. It is always nice to have a freshly board certified general surgeon around and it is always nice to have a bunch of residents who have been doing hundreds if not thousands of endo and small open cases before they hit their 4th/5th years.
 
  • Like
Reactions: 1 users
This is the same question asked by the OP and answered above. I have just been through the interview process and no programs had plans to scale back or shut down their 5+2 programs. This was asked and answered regularly at interviews.

That's utter nonsense. You can't double the number of trainees with a fixed number of patients (cases). Thus, many smaller programs will definitely shut down fellowships.
 
That's utter nonsense. You can't double the number of trainees with a fixed number of patients (cases). Thus, many smaller programs will definitely shut down fellowships.

I don't know that it is nonsense. Clearly mimelim has knowledge of some programs that I do not. But I spoke truthfully when I said none of the programs I interviewed at gave any indication that they were closing down their fellowships. Some had expanded their size by adding 1 or more 0+5 spots instead of adding 5+2 spots like they might have in the era before integrated was a thing. In addition there are still plenty of places out there that don't have a 0+5 and no current plans to start one. Beyond that, the OP and the second poster both wanted to know if 5+2 were disappearing. If you review the full collection of my posts in this thread I clearly stated while none of us could read the future, based on my personal experience during the most recent cycle suggested that there would still be plenty of 5+2 spots available by the time these MS3s would be applying. I don't see what is nonsense about that.
 
  • Like
Reactions: 1 user
I don't know that it is nonsense. Clearly mimelim has knowledge of some programs that I do not. But I spoke truthfully when I said none of the programs I interviewed at gave any indication that they were closing down their fellowships. Some had expanded their size by adding 1 or more 0+5 spots instead of adding 5+2 spots like they might have in the era before integrated was a thing. In addition there are still plenty of places out there that don't have a 0+5 and no current plans to start one. Beyond that, the OP and the second poster both wanted to know if 5+2 were disappearing. If you review the full collection of my posts in this thread I clearly stated while none of us could read the future, based on my personal experience during the most recent cycle suggested that there would still be plenty of 5+2 spots available by the time these MS3s would be applying. I don't see what is nonsense about that.

I think the most common thing that I've heard/seen is downsizing. ie. going from 2 fellows/year to 1. Honestly, my biggest concern are the programs that are lying to themselves about their volume and ability to take on more trainees. Junior residents take up cases, not as much as your PGY4/5 IVS residents, but if you have 3 more residents (PGY1-3) around, they are going to need cases. I've heard of a couple of places that intend on keeping their fellowships that irk me a little because their previous graduates were already complaining about lack of certain types of cases.

Personally, I wouldn't worry about fellowship spots not being available. There will be ample for the number of applicants. Maybe will shift more/less competitive, but that is going to happen regardless.
 
  • Like
Reactions: 1 user
I think there will always be a role for the 5+2 model going forward. The training of a general surgeon into a vascular surgeon is a tried and true method since we are coming in with a whole skill set. There will always be those like myself who didn't even know that vascular surgery as a field existed until residency started and right away fell in love with it.

Looking into my murky crystal ball, I would imagine that many programs will look to adopt an integrated model and possibly phase out the independent. It's just crazy to me to decide on vascular surgery as a medical student without proper exposure. There are categorical residents in my program now who applied and didn't match into integrated spots and now that they're routinely pounded with vascular patients while on call and their unique and seemingly never-ending complications, they don't want anything to do with it.

I've also seen the other end, where integrated residents are graduating and doing really solid vascular work. Knowing what I know now, I would have definitely opted for the integrated route. The idea of suffering through another bariatric bypass, doing an ex lap for sigmoid volvulus or total colectomy for toxic megacolon is just torture for me now. And don't even get me started on the ass stuff that comes into the ED...
 
  • Like
Reactions: 1 user
From the programs I interviewed at, I didn't get the impression that 5+2 is going away any time soon. As said above, it is hard for students to know that they are interested in vascular and even I didn't really like vascular until I was a 4th year and able to do the more complex open cases. Unlike CT, I think there is more crossover and doing a general surgery residency trains you to be able to enter the abdomen with no fear. Coming into a fellowship, you also have a better gestalt about patients and just learn primarily the procedural aspects. For me personally, I think it's advantageous because we are also well equipped for trauma call as well so you are more diversified in what you can do after fellowship.
 
Top