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During the first year, the vascular fellow participates in clinical care and research activities while developing endovascular skills. First-year fellows participate in a large amount of endovascular surgery and a modest amount of traditional open vascular surgery procedures. These procedures are done under the supervision of staff vascular surgeons who train the fellows in these skills. The vascular surgeons at Geisinger are primary interventionalists for all procedures including carotid, peripheral and visceral stenting, thoracic stent grafts and AAA stent grafts. Overall endovascular volume includes approximately 500 interventional cases per graduating fellow. These cases are performed in dedicated endovascular suites used by the vascular staff. 

A one-month block is spent in learning vascular lab skills including hands-on scanning in our own vascular laboratory with one of our registered vascular technicians. Our vascular laboratory performs approximately 14,000 examinations per year, allowing the fellow to develop competency in the interpretation and performance of vascular laboratory procedures. The fellows also read studies during their month rotation with instruction from the staff vascular surgeons, allowing the fellows to prepare for the RPVI exam. 

The remaining time in the first year (approximately 15 percent) is spent in research efforts looking at either clinical projects basic science research. The basic research program is supported with full-time research technicians. Presentations of findings at national and regional meetings and in publications in referred journals are strongly encouraged and supported.

During the second year, the vascular surgery fellow serves as the surgeon for more than 300 vascular disease patients whose conditions represent all the significant vascular reconstructive procedures. The attending staff physician supervises the fellows in clinic a half day per week, making regular patient rounds and providing consultation. Emergent and urgent procedures comprise approximately 10 percent of the caseload. 

The clinical aspects of training are complemented with daily didactic, preoperative, staff rounds, a monthly journal club and morbidity and mortality conferences. The fellow is expected to participate in continued medical education activities for which a stipend is provided.