UC Davis School of Medicine offers two new integrated residency programs and a new fellowship program to train physicians for careers in vascular and thoracic surgery and meet the national needs for highly trained surgical specialists who can treat diseases of the blood vessels, heart, espophagus and lungs — leading causes of death and disability in the U.S.
The integrated residency programs merge general and subspecialty surgical training for vascular surgery into a single five-year program and for thoracic surgery into a single six-year program. Traditional post-graduate education in these fields involves completing a general surgery residency followed by a subspecialty fellowship, often at separate institutions and lasting seven to 10 years beyond medical school.
"Medical school graduates who could be excellent vascular surgeons often select other medical specialties as careers due to the length of the training, especially because many need to start repaying medical school debts during their residencies," said David Dawson, professor and director of the vascular surgery residency program with the UC Davis Vascular Center.
"Our goals with the combined program are to attract those qualified candidates and provide them with the advanced, rigorous training they need to begin providing quality vascular care to patients as quickly as possible," Dawson added.
For physicians who have completed general surgery programs, UC Davis also offers a new traditional two-year fellowship in vascular surgery.
Closing gaps in access to surgical care
According to the Association of American Medical Colleges, patient volume outpaces surgeon availability, and a significant shortage of 41,000 general and specialty surgeons is possible by 2025.
Integrated residency options are becoming common alternatives at academic medical centers to encourage interest in surgical specialties and close gaps in access to care. Residency directors like Dawson are pleased that these options are proving to be highly competitive, attracting high-achieving medical school graduates.
"There were 30 superbly qualified applicants for one of the new training positions — an embarrassment of riches," Dawson said.
While most vascular surgery residencies accept one resident each year, the UC Davis program accepts two: one chosen by the U.S. Air Force and one selected through the traditional residency match system. A unique partnership between UC Davis and David Grant Medical Center at Travis Air Force Base provides shared training opportunities for physicians at both institutions.
"A powerful attraction of our physician training is the chance to gain experience in the working environments and practice procedures of all major health care systems in our region, including the military health care system," Dawson said. "The more diverse the training experiences, the more qualified the physicians."
The first two residents in the integrated vascular surgery program are Melissa Loja from the UC Davis School of Medicine's class of 2012, and Jason Nieves, a U.S. Air Force officer, who completes medical school at Ponce School of Medicine in Puerto Rico in June. The first vascular surgery fellow is LeAnn Chavez, a general surgeon at the Alaska Native Medical Center in Anchorage, Alaska. All three begin their UC Davis training in July.
The first integrated thoracic surgery residency program candidate will be selected from graduating medical school classes of 2013.
Exciting and dynamic specialties
Vascular surgeons treat diseases of the blood vessels with the exception of vessels of the heart and brain. Vascular surgery includes endovascular procedures such as angioplasty and the placement of stents to open blocked arteries or veins, a growing need due to the proliferation of peripheral vascular disease related to obesity and diabetes.
Thoracic surgeons perform complex procedures to treat diseases of the heart, aorta, lungs and esophagus. One of the most common procedures is coronary artery bypass graft surgery, where diseased vessels are replaced with vessels from elsewhere in the body to restore healthy blood supply. In recent years, the field has become more complex, with the advent of robotic surgery and advanced devices like mechanical heart pumps, which expand options for those unable to have heart transplants.
"It's an exciting, dynamic field that requires a combination of compassion, engineering, strategic planning, skill and dexterity," said David Cooke, assistant professor and associate director of the thoracic surgery residency program at UC Davis. "Unfortunately, academic medical centers nationwide haven't been successful in recruiting enough physicians to take up the challenges of the field."
Expanding opportunities for women in surgery
National Resident Matching Program data shows that 24 percent of the 102 available postgraduate training positions in thoracic surgery were unfilled in 2011.
"We are hopeful that integrated training options will make the field more competitive, especially for women, who now make up nearly half of all medical school graduates and are typically not attracted to specialties with extended training times," Cooke said. "This is especially important as the population ages and diseases of the heart, blood vessels and lungs become even more common."
Information on the new residency programs is available online at www.ucdmc.ucdavis.edu/surgery/education/vascular_surgery_residency.html and www.ucdmc.ucdavis.edu/surgery/education/cardio.html.
Offering top-quality graduate medical education is integral to UC Davis Health System's goals of assuring a physician workforce that is fully prepared to address the nation's evolving health-care needs and broaden access to quality health-care for all. Residencies or fellowships are offered in nearly 100 specialty and subspecialty fields, from emergency medicine to pathology and from developmental-behavioral pediatrics to ophthalmology. All UC Davis post-medical school training fosters excellence in medical practice and meets the nation's highest standards for graduate medical education. For information, visit www.ucdmc.ucdavis.edu/gme/
More information on the UC Davis School of Medicine is available at medschool.ucdavis.edu.