Integrated vascular surgery residency
Vascular surgery rotations at David Grant USAF Medical Center
David Grant USAF Medical Center/ Joint Northern California Federal Vascular and Endovascular Surgery Service
During the vascular surgery rotations, the DGMC site accentuates the program’s vision of “Total Vascular Care” to provide residents a complete, yet subtly unique, educational experience.
Timothy Williams, M.D., David Grant Medical Center
The first axis remains clinical competence. Initial diagnosis to include history taking, physical examination, pertinent laboratory evaluation, imaging selection and awareness of proper indications constitute foundation for decision making in excellent peripheral vascular health care. Assessment of treatment options including selection, temporally appropriate decision-making, technical excellence, sound peri-procedural care, and a sensible grasp of surveillance methods are critical to quality in vascular and endovascular surgery. This important axis constitutes clinical judgment and technical skill.
The second axis of collaborative, multispecialty and inter-professional care exists in purpose at the DGMC Heart, Lung and Vascular Center.
Third, the continuum of care is evident at DGMC. Within the DoD and VA environment, patients require an astute recognition of psychosocial situations, and individual needs. Residents work in a multidisciplinary team providing ongoing vascular care.
Residents will work directly with program primary faculty and focus on topics that are specifically relevant to competency in the practice of vascular and endovascular surgery. Additional learning activities will be preferentially scheduled, including hands-on vascular ultrasound training, vascular and endovascular skills training in the Clinical Investigations Facility, exposures to cardiac catheterization, pharmacologic risk-factor modification, and administration and management of open and endovascular clinical practice.
Goals and competencies at each level of training serve as the foundation for subsequent levels of training. Residents at more senior level of training will have the same goals and objective as those at a junior level, but the senior residents are expected to demonstrate a greater sophistication in their understanding and more refined techniques. Those procedures and tasks, for which the resident has demonstrated competency, may be delegated to others, with the resident taking on a teaching role.
In addition to providing a site for general, thoracic, and vascular surgery experiences, David Grant USAF Medical Center (DGMC) provides clinical experiences that offer specialized training that are uniquely valuable.
The DGMC Department of Radiology Department provides inpatient and outpatient imaging services in all modalities. The imaging rotation provides residents experience interpreting radiographs, ultrasound, CT, and MRI. The department also provides teleradiology services for outside bases, including Coast Guard and Army facilities. Many staff have been in independent practice for more than four years, and several staff are co-faculty with UC Davis and the VA in Sacramento.
Hyperbaric Medicine/Wound Care
The DGMC Hyperbaric Medicine Department specializes in hyperbaric medicine and wound care. The staff consists of board certified undersea and hyperbaric physicians, technicians, and nurses. The center provides consultation in hyperbaric medicine and wound care to the medical facility and tenant units, as well as conducting research, education, and medical practice in operational and clinical arenas during conflict or peace.
The Hyperbaric Medicine Facility operates 24/7 worldwide consultative telephone service in support of military operational requirements. It provides state-of-the-art hyperbaric oxygen therapy to patients with a variety of complex problems, including diabetes, vascular disease and limb ulcers, and it conducts medical research and clinical investigations to establish optimal treatment protocols.