1. Vascular Surgery Residency and Fellowship
Residency established with ACGME approval in 2009; fellowship started in 1999.
Designed to produce surgeons who can provide comprehensive care to the vascular patient and be expected to fully participate in the rapid expansion of the field of vascular surgery, both clinically and academically.
First Resident, July 2010
1st graduate: Brigitte Smith, MD, Univ of Wisconsin School of Medicine
Assistant Professor Univ of Utah
2nd graduate: Jessica Secor, MD, Boonshoft School of Medicine at Wright State
Private practice Illinois
PGY-5 Elena Rinehardt, MD, University of Washington School of Medicine
PGY-4 Christopher McAninch, MD, St Louis University
PGY-3 Jason Le, MD Chicago Medical School at Rosalind Franklin University
PGY-2 Shruthi Thiagarajasubramanian, MD, MI State College Of Medicine
PGY-1 Alexander Leung, MD, Boston University School Of Medicine
5+2 Fellowship program: matching 1 fellow annually
PGY-6 Peter Bartline, MD, Univ of Utah - General Surgery
PGY-7 Camila Castello, MD, St Luke’s NYC - General Surgery

2. Jon Matsumura, MD Professor and Chief, Division of Vascular Surgery
Residency, Northwestern University,
Vascular Fellowship, Northwestern University,
President, Midwestern Vascular Surgery Society,
PI or site PI on 18 industry sponsored Grants
PI: WL Gore: "Thoracic Aneurysm Graft Corelab", ( )
National PI: WL Gore: "Phase II Clinical Trial of the Bifurcated
Excluder Endograft for Treatment of Infrarenal Aortic Aneurysms”
International PI: Cook, Inc: “Zenith Thoracic TAA Endovascular Graft”
National Co-PI for Abbott Vascular: “Asymptomatic Carotid stenosis, stenting versus endarterectomy Trial”, present
PI.-Medical Director AortaCore Imaging Lab# 08-01:Evaluation of the GORE Conformable TAG® Thoracic Endoprosthesis for Treatment of Acute Complicated Type B Aortic Dissection ( )
PI. NIH R01 (Terrin, Matsumura, Baxter) Non-Invasive Treatment of Abdominal Aortic Aneurysm Clinical Trial (N-TA3CT)
Author of more than 100-peer reviewed articles, 42 book chapters and editor of 10 books

3. John R. Hoch, MD Professor of Surgery
Program Director, Vascular Residency and Vascular Fellowship
Chief of Vascular Surgery, Madison VA Hospital, 1994 – 2011
Residency, Thomas Jefferson University, Philadelphia, PA,
Fellow, Vascular Surgery, University of Missouri-Columbia,
Research:
PI VA Co-op trial #410 and #498
Industry sponsored clinical trials
Chair, UW Anticoagulation Taskforce
Clinical Interests:
Complex aortic and visceral artery occlusive disease
Endovascular management of arterial occlusive and aneurysmal disease
Systems approach to VTE prevention
Less invasive management of varicose vein disease

4. Girma Tefera, MD Professor of Surgery
Chief of Vascular Surgery, Madison VA Hospital and Vice-Chair Division Vascular Surgery, 2011-Present
Director, UW Limb Salvage Angioplasty and Carotid Stenting
Residency in General Surgery, Howard University Hospital, Washington, D.C.,
Fellowship in Vascular Surgery, University of Wisconsin Hospital
and Clinics, Madison, WI,
Research and Clinical Interests
Carotid stenting, Limb salvage angioplasty
FEVAR and complex TEVAR
Ethiopian Medical Education Initiative ( MEPI) as well as Leader of multiple funded health and nutrition projects.
Ethiopian Emergency Medicine Training Initiative
Co-Founder University Wisconsin Global Health Initiative
Medical Director of ACS Operation Giving Back (OGB). OGB is a comprehensive resource that helps surgeons find volunteer opportunities worldwide that match their expertise and interests.

5. Charles W. Acher, MD Professor of Surgery
Director, Thoracoabdominal Aneurysm Program
Residency, University of Wisconsin, Madison, WI,
Fellowship, GI and Peripheral Vascular Surgery, Gloucestershire Royal Hospital, Gloucester, England,
Peripheral Vascular Fellow, Baylor College of Medicine,
Clinical and Research interests
Prevention of ischemic spinal cord injury in repair of TAAs
Management of Complex Aortic and Visceral artery disease
Repair of Aortic Arch and Thoracoabdominal Aneurysms by open and endovascular techniques

6. Gretchen Schwarze, MD, MPH
Associate Professor of Surgery
Harvard Medical School, Boston, MA, 1995
JFK School of Government, Boston, MA, MPH 1995
General Surgery Residency at Mass General 2002
Vascular Residency, University of Chicago, 2004
Research and Clinical Interests
KL2 “Prevention of postoperative conflict about life supporting therapy by improving preoperative communication with older patients” 12-’15
Greenwald Faculty Scholars Award 08-’14 Advance Directives for High Risk Surgical Patients
NIA 1R03AG GEMSSTAR:A Communication Tool to Assist Older Adults Making Difficult Surgical Decisions” “14-’16
Developer of the UW Medical School Ethics Curriculum
Evaluating tools and processes to help close the gap between what surgeons know and patients understand
Navigating Major Surgery: supported through a Patient-Centered Outcomes Research Institute (PCORI) Program Award (CDR )
Best Case / Worse Case
Patient Experience Physician Champion UWHC 2012
Recipient Dean’s Teaching Award 2011

7. Dai Yamanouchi MD, PhD Associate Professor of Surgery
Surgical Residency, Saiseikai Maebashi Hospital, Japan,
Research Fellowship, Nagoya University Graduate School of Medicine, Japan,
Clinical Fellowship in Vascular Surgery, Nagoya University Hospital,
Japan,
Research Fellowship, Weill Cornell Medical College, New York, NY,
Fellowship in Advanced Endovascular Surgery, University of Wisconsin-Madison, Madison, WI,
Research interests:
AHA Scientist Development Grant ‘12-15
Role Osteoclast-like Cells in AAA
Industry sponsored EVAR clinical trials
National PI Branched TEVAR Trial
Industry Sponsored Research Grant to study the effect of Nano-Bubble
Biomedical Engineering Project to develop Endovascular Devices

8. Kyla Bennett, MD Assistant Professor (2015 – present)
Duke University: medical school, general surgery residency and vascular surgery fellowship at Duke University Medical Center.
Clinical focus on aortic, carotid and limb salvage surgery.
Vascular thoracic outlet syndrome interventions and management of venous obstruction.
Research interests include: outcomes and access-to-care disparities, methodology for large database analysis to improve model integrity and pre-hospital management of ruptured AAA and dissections.

9. Paul DiMusto, MD Assistant Professor (2015-present)
Associate Program Director, residency & fellowship
University of Michigan: undergraduate, medical school, general surgery residency, and vascular surgery fellowship.
Clinical interests focus on aortic disease: including aneurysms, dissections, and occlusive disease. He performs both open and complex endovascular repair of the aorta.
He spent two years during residency studying the molecular biology underlying the gender difference in abdominal aortic aneurysm formation.  
Interest in education of medical students, residents and fellows.  
Working with Dr. Hoch to develop a simulation curriculum for the vascular trainees.

10. Bo Liu, PhD PhD, Biochemistry, SUNY Downstate, New York, NY, 1993
Postdoctoral fellow, Transcription regulation; signal transduction,
Memorial Sloan-Kettering Cancer Center, New York, NY,
Research: RO1: understand regulatory mechanisms
underlying l functions of vascular smooth muscle cells
and how these mechanisms malfunction in vascular diseases
AAA and Restenosis
T32 NIH-sponsored Vascular Biology Training Grant
Available after PGY5 year

11. Vascular Surgery Residency
Provide incremental, progressive training in core surgery (CS) and vascular surgery (VS) during the five year program
Four integrated sites: UW Hospital, Wm. S. Middleton VA Hospital (connected by corridor), Meriter Hospital (5 minute drive) and Transformations (aesthetic center; 10 min drive)
Affiliated Rotations: St Mary’s Hospital, Madison and Theda Clark Hospital, Neenah, WI.
Future site Swedish American Hospital Rockford, Il
Optional research year(s)
after 5 years training or after PGY-2 T-32 funding mechanism

12. Integrated Residency (0-5)
Year 1
10m Core and 2m Vascular
Year 2 and Year 3
7m Core and 5m Vascular both years
Year 4 and Year 5
12m Vascular each year

13. Integrated Residency (0-5)
Core General Surgery:
Surgical Intensive Care 2 months
Emergency General Surgery 2 months
Surgical Trauma 2 months
Night Float (vascular) 2 months
Anesthesia 0.5 months
Off-site general/vascular 1 month
General Surgery 8.5 months
Core Surgical subspecialties:
Transplantation 2 months
Plastic Surgery 1 month
Thoracic Surgery 2 months
Cardiac Surgery 1 month
24 months

14. Integrated Residency (0-5) PGY 1-3 Years Vascular Rotations
Vascular Surgery :
UW Vascular 5 months
Vascular Lab 1 month
Vein Care 1 month
VA Vascular 2 months
Vascular - related:
Cardiology 1 month
Vascular Access 1 month
Elective/Research 1 month
12 months

15. Integrated Residency (0-5) PGY 4 & 5 Years
Vascular Surgery 24 months
Alternating 3 month rotations with PGY-4, PGY-5 and PGY-7 Fellow
UW Vascular 12 months (6m/yr)
VA Vascular 6 months (3m/yr)
OnService 6 months (3m/yr)
Acute care
Endovascular
Veins
V-lab
Research ______________
24 months
No conflict between Residents and Fellow; pair fellows &

16. Core Surgery Training PGY 1-3
Provide complete “foundation of the principles and practices of surgery” ACS course
SCORE Curriculum
Similar training experiences as categorical general surgery residents
Core Surgery Technical Skills Lab
Instrument identification, knot-tying and suturing
Management and repair of central lines and enteric feeding tubes
Wisconsin Elements of Laparoscopic Surgery (WELS)
Advanced Trauma Life Support (ATLS) and ACLS
Laparatomy and bowel anastomosis
Principles of Ultrasound – FAST and line placement
Principles of vascular anastomosis

17. Core Surgery Training PGY 1-3
Specialized conferences e.g. Trauma
Call during PGY1-3 no greater than 1:3
Excellent working relationship with general surgery
SCORE curriculum
VSITE PGY 1-5
Resident Evaluation by core faculty

18. Core Surgery Rotations Outside UWHC
Theda Clark Hospital - Neenah, WI (PGY-3; 1 month)
Community general surgery; no residents
Nice mix of open and laparoscopic operations
4 weeks; weekends off
St Mary’s Hospital - Madison, WI (PGY-3; 2 months)
Community general surgery; no other residents
Mix of general, cardiac surgery and vascular patients
Meriter Hospital (PGY-1 & 3; 2 months)
Community general surgery
VA Hospital General Surgery Service (PGY-1; 1 month)

19. Integrated Vascular Surgery Rotations
Curriculum
APDVS curriculum on-line with references, both Basic Science and Clinical Curricula
Vascular SCORE
Written Curriculum Goals and Educational Objectives
UCLA/SVS Vascular Review Course in September of PGY4
RPVI Exam in PGY3 year (Division covers cost)
Web-based universal curricula being developed by APDVS
Milestone Driven
Monthly Global (Web-ex online) and Local Journal Clubs

20. Vascular Conferences Monday morning 6:30 to 9:30 am (excused from OR)
6:30 to 7:15 Indications
7:15 to 7:30 Web-Ex morning sign out
7:30 to 8:30 Basic Science 1/mo; Noninvasive Lab conference 1/mo; Global Journal Club 1/mo; Clinical Research conference 1/mo
8:30 to 9:30 Teaching conference
Faculty sponsored Monthly Journal Club

21. Integrated Vascular Surgery Residents
Attendance at Monday conferences required on all rotations; excused from OR and general surgery rotations
Divisional support for meetings at which you present
Prepare the resident for the design, implementation and conduct of clinical trials
Assigned research mentor:
Expected to present at least once at National or Regional vascular meeting during residency
Expected to take at least one research project from concept, through the IRB, data collection, statistical and conceptual analysis and publication

22. Cardiology Rotation PGY1
A focused exposure to consultative cardiovascular medicine, echocardiography and nuclear myocardial perfusion imaging stress testing.
2 weeks with the UW Hospital Cardiology Consult Service, and spending 1 week each reading studies in the UW Hospital Echocardiography Laboratory and Nuclear Cardiology Laboratory.
Will function on each service in a role equivalent to a first year cardiovascular medicine fellow

23. Non-invasive Vascular Lab Rotation PGY-2
Daily reading at the University Hospital and West Clinic; no night call
Daily hands-on participation in UW vascular lab with time spent in UW West clinic and VA vascular labs
Didactic lectures on CD from SVS/APDVS
Gain a complete understanding of the indications, interpretation and limitations of each test.
Prepared to pass ARDMS RPVI examination during third year of residency
Vascular lab interpretation responsibilities continue in PGY3- and 4 years at VA

24. Venous Disease Rotation PGY-3
1 month rotation at Meriter Hospital
Venous clinic at Meriter, UW West Clinic and Transformations
Office-based and hospital operating room-based interventions
Minimally invasive techniques, and the postoperative care of patients with venous disorders
Hands on venous imaging in the vascular labs at West and UWHC
Also participate in vein care during Meriter Hospital core surgery rotations years 1-3 and when rotating on Onservice rotation PGY 4&5.

25. Vascular Surgery Elective PGY3
To allow the resident one month of elective time in the third year to conduct vascular research or pursue additional training in open vascular procedures or endovascular techniques
The PGY-3 resident will work with the Program Director and Chair of the Division of Vascular Surgery to identify programs of interest either within the University of Wisconsin system, or elsewhere in the United States.
Option for AV Access rotation at Swedish American Hospital, Rockford, IL

26. University and VA Vascular Rotations PGY2 and PGY3
Junior resident on the UW and VA Vascular teams working with Gen Surg PGY1 & 3 and Vascular PGY4 & 5 and fellow.
Experience in endovascular and open interventions
With the input of faculty, develop therapeutic plans, perform endovascular and open interventions and follow up the patients
Responsible for majority of endovascular procedures in the UW Cath lab and VA Hybrid OR under the guidance of vascular surgery faculty when on rotation.
Perform CEA, femoral to popliteal bypass, CFA endarterectomy, EVAR, amputations, extra-anatomic bypass, assist with complex open aortic reconstructions
Participate in weekly VA and UW clinics

27. Vascular Rotations PGY4 and PGY5
UW Vascular Service (6 months/yr)
2 three month blocks each of the PGY4 & 5 years
GenSurg PGY-3 (at times vascular PGY2 or 3)
PGY 1 (shared with VA Vascular Service)
3 nurse practitioners on the floor (They are awesome!)
Seven 7:30 OR starts
Zeego Angio Operating Suite (also at VA)
Complex open and Hybrid procedures
Endovascular diagnostic and therapeutic interventions in OR and cath lab, staffed by vascular surgery faculty
Vascular Clinic at UW West clinic average of ½ day/wk

28. Vascular Rotations PGY4 and PGY5
VA Vascular Service (3 months/yr)
1 three month block as chief each of the PGY-4 & -5 years
Open and endovascular general vascular cases
PGY-1 (shared with UW Service)
Inpatient VA NP and case managers
Clinic on Wednesdays at VA, morning and afternoon
Junior residents on UW service also attend VA clinic
Active faculty teaching in clinic
OR 4 7:30am starts
Endovascular experience in new Zeego Hybrid Angio Suite/Operating Room.

29. Vascular Rotations PGY4 and PGY5
OnService Rotation (3 months/yr)
1 three month block as chief each of the PGY-4 & -5 years
Responsible for covering vascular cases at Meriter and new East side Hospital, as well as acute cases UW vascular service
Endovascular and open arterial cases
Vein care
Spine exposures
Endovascular experience in UWHC Zeego Angio Operating Room, UW cath lab, Meriter Cath Lab and VA Zeego Room.
Time for research, vascular lab work and additional vein care opportunities

30. Vascular Call PGY2 & 3 On core rotations
Every third night call from home
Except 2 months SICU in-house every third night
On vascular rotations
Share back-up call from home for in-house night-float intern with PGY3 general surgery resident, PGY4 & 5 and the fellow
PGY4 & 5
Call is from home
Backup night-float intern every 3-4 nights during week
Backup junior residents every fourth weekend in rotation with fellows
The vascular PGY4, PGY5 and fellows are on call and have rounding duties every fourth weekend
Weekend Midlevel NP support

31. Vascular Resident Cases 2011-2016
UW Resident
National Ave.
Breast 33 12
Transplant 7 6
Thoracic 21 18
Hernia 45 31
Biliary 28 20
Abd Gen 9
Lg Intest 15
Sm Intest
Skin 27 24
Total Major Core Operations
293
205
Total Primary Vascular Operations
869
861
Total Major Vascular
541
472

32. Vascular Resident 2011-2016 * Primary and secondary cases
UW Fellow
National Average Fellows
UW Resident
National Average Residents
Abdominal Obstructive 23 16 15
Open AAA 10 11
EVAR 73 59 65 60
All Aneurysm
119 89
130
123
Cerebrovascular 48 70 99 82
Peripheral
218
182
392
255
PTA AortoIliac 52 44 67 46
PTA/Stent Fem-Pop
128
121 93
Mesenteric 9 4 3
TEVAR 14 20 17
Open TAA 21 63 45 56 49
Total Major Vascular Operations
557
398
541/716*
472/664*
* Primary and secondary cases

33. Programs and Clinical Trials
Limb Salvage Angioplasty Program
Carotid Stent Program (1 post-marketing trials allowing treatment of asymptomatic and symptomatic patients)
Thoracic Endograft Program
Fenestrated EVAR program (>30 cases / year)
Cook: P-branch Endovascular Graft Pivotal Study
BEST CLI Trial
SCAFFOLD CAS Trial;
GORE® TAG® Thoracic Branch Endoprosthesis (TBE Device)
GORE IBE bifurcated iliac trial
Roadster flow reversal cerebral protection carotid stent trial
CREST 2 Trial; CEA vs CAS vs Medical Management

34. Clinical Research and Critical Thinking
Faculty research mentor assigned PGY1 year (PD acts as Resident advocate)
PGY1:
Present twice in Vascular conference
Case report
PGY2
Initiate clinical study involving imaging or other topic
Quality Project
PGY3
Retrospective Review
1 month research/elective rotation
Quality Improvement paper
Introduction to Clinical Trials Course
Initiate Prospective study
PGY4
Retrospective paper
Prospective study continues
Should be presenting at regional or national meeting
PGY5
Complete projects initiated in prior years
Should be presenting at national meeting
After PGY-5 year: T32 Grant: opportunity to spend years in postgraduate clinical or basic research

35. New Initiatives Global Health: Ethiopia
Beginning in January 2017
The first vascular residency in Africa (outside South Africa)
Faculty from the Univ. of Wisconsin and other invited institutions will rotate every other month to Addis Ababa
Opportunity for PGY-4 Vascular resident to rotate for 1 month when UW faculty present at end of 4th year.
Simulation Curriculum: #1 goal for Division this year
Simulation Center UWHC
Open skills training: low cost and high-end
Active faculty mentoring
Mentice Endovascular simulator

36. 80-Hour Work Week

37. Questions?

38. Vascular Imaging Rotation PGY2
The PGY-2 vascular resident will rotate for 1 month on the Vascular Imaging Service which includes CT and MR vascular imaging.
Demonstrate an understanding of the principles and practice of modern vascular cross sectional imaging using computed tomography and magnetic resonance imaging.
Understand principles of radiation safety
The resident will attend educational conferences in radiology on CT and MR imaging and radiation safety.

39. Resident Evaluation Resident performance evaluation
Faculty at end of each Rotation
Semi-annual Review
360 evaluation by nursing (floor and OR), cath lab personnel, NP’s and support staff
March In-service Exam (VSITE)
Quality Improvement Project
Anonymous evaluation of program and faculty via MedHub

40. 2016 Vascular Resident Graduate “Defined Categories”