Eversion Femoral Endarterectomy With Oblique Arteriotomy and Primary Closure for Ileofemoral Occlusive Disease: A Description of Technique and Series of Cases

Abstract

ACGME) requires evaluation of vascular surgery trainees by Clinical Competency Committees in 31 milestones that are based on six core competencies. This study sought to understand the vascular trainees' perception regarding their education in these milestones and how well they think they are currently evaluated.Methods: We administered an anonymous online survey to 71 trainees at 13 academic vascular surgery programs spanning the country. Trainees were asked about their education, their evaluation for the specific vascular surgery milestones, and their beliefs on how this education should be obtained.Results: The overall response rate was 73%, with 70% of residents and 76% of the fellows responding. Education of milestones within the core competencies of professionalism and communication skills was thought to be predominantly trainee-driven, and the majority of trainees agreed this education should be trainee-driven (P ¼ .54 and P ¼ .77, respectively). The majority of trainees believed education in both practice-based learning and system-based practice milestones is currently trainee-driven; however, the majority of trainees thought these should be attendingdriven (P ¼ .006 and P ¼ .004, respectively). Finally, the majority of trainees believed education in patient care and medical knowledge should be attending-driven, and while the majority of trainees thought their education is currently attending-driven in these two competencies, significantly more trainees thought they should be getting this training from attendings compared with where they actually receive the training (P ¼ .0001 and P ¼ .03, respectively). Eightytwo percent of respondents believe that milestones within the patient care and medical knowledge domains are appropriately and adequately evaluated. Conversely, 69% and 65% of respondents (respectively) believe that milestones within the practice-based learning and system-based practice domains are poorly and inadequately evaluated.Conclusions: When viewed through the lens of the vascular surgery milestones, trainees report a measurable, significant difference in how their education is received and how they think it should be delivered for milestones within four of the six ACGME competencies. Additionally, improved evaluation is needed in milestones within the practice-based learning and system-based practice competencies.