Upon completion of the Vascular Surgery rotation, the neurosurgery resident shall be able to:
- Outline the risk factors for atherosclerosis.
- Describe the pathogenesis of atherosclerosis.
- Discuss the patient with cerebrovascular ischemia, including: history, physical examination, investigations and treatment (anterior/posterior circulation)
- Discuss the results of clinical trials evaluating efficacy of carotid endarterectomy (e.g. NASCET, ACAS) as well as surgical indications for symptomatic and asymptomatic carotid stenosis.
- Describe the pathophysiology of intermittent claudication, and differentiate if from neurogenic claudication.
- List the risk factors for developing deep vein thrombosis, and methods to help prevent deep vein thrombosis.
- Outline the diagnosis and treatment of deep venous thrombosis, including indications for Greenfield filters.
- Describe the surgical steps involved in performing a carotid endarterectomy.
- Outline brachocephalic ischemic syndromes.
- Describe vascular compartment syndromes, their investigation, natural history and management.
- Develop rapport, trust, and ethical therapeutic relationships with patients and families, be able to review/update day to day care with patients.
- Conduct, document and present pertinent history and physical exam in context of Vascular diseases/surgery; with particular attention to diseases seen also in neurosurgery – ie. carotid disease.
- With appropriate supervision discuss relevant information with patients and family in a compassionate way and be able to obtain consent for common procedures.
- Share and present information with other health care providers, with attention to communicating information to when organizing diagnostic tests and procedures.
- Work/collaborate effectively in an interdisciplinary team, including interventional radiology to coordinate patient care.
- Consult other services when appropriate in context of a complicated vascular patient with multiple medical comorbidities – nephrolology/internal medicine/endocrinology/geriatrics.
- Take part in all educational activities and teaching afforded by the service during the rotation.
- Be able to share workload and duties appropriately with other residents and medical students
- Be able to teach medical students, other residents and patients.
- Describe the surgeon’s roles and responsibilities to other professionals; Describe the elements of a good consultation
- Work with other health professionals effectively to prevent, negotiate, and resolve conflict
- Effectively utilize and allocate finite resources, prioritize tests and OR emergency cases.
- While on a busy surgical service manage own time, education and personal life for a balanced lifestyle.
- Work effectively and efficiently
- Triage patients being able to identify vascular surgery emergencies that require prompt and immediate management such as ruptured abdominal aneurysm, and ischemic limb
- Demonstrate an understanding of the influences that affect the workings of the health care system at various levels
- Participate in discharge planning of a complex surgical patient
- Recognize and council patients on determinants of health in patients, especially with respect to vascular risks such as smoking, DM and bmi.
- Contribute to overall patient well-being and outcome, though appropriate pre and post-operative care.
- Promote lifestyle which improves surgical risks, especially preoperatively in clinic setting.
- Facilitate return of patient to community/alternate care and help put care/support in place to reduce return to hospital for surgical care.
- Ensure consults and tests are done in an appropriate timely manner.
- Participate in rounds and educational activities provided by the vascular surgery service.
- Identify and seek out personal learning needs, especially with conditions relevant to neurosurgical patients such as stroke, carotid disease, coagulation and vascular access.
- Apply principles of critical appraisal to medical information.
- Participate in patient, student and peer learning
- Contribute to development of new knowledge and be involved in appropriate research projects as available.
- Demonstrate a commitment to their patients, profession, and society through ethical practice
- Exhibit appropriate professional behaviors in practice, including honesty, integrity, commitment, compassion, respect and altruism
- Maintain appropriate relations with patients and other health care providers.
- Show appropriate respect for opinions of other health care providers
- Be able to appraise and identify own limits with respect to knowledge and patient care, and when to ask for assistance and consult effectively