Welcome to Vascular Surgery at VCU!

Medical Student Expectations

As part of your medical student rotations in surgery, you’ll be rotating with us on vascular surgery for the next 2 weeks. During this time, you will be exposed to the specialty through various experiences on the floors, the office, and of course, the OR. This document will outline your expectations, roles, and responsibilities while on service. 

WHO WE ARE:

The vascular team is made up of two fellows (one Fellow is “On-Service” for inpatients and one Fellow is “On Consults”), a NP, and a PGY1 intern and/or occasional senior resident (changes each month depending on their rotation schedule).  You will be assigned to the inpatient service and will therefore interact mostly with the “On-Service” team, consisting of the fellow, the NP, and the intern. 

FACULTY:

Dr. Mark Levy, Division Chair
Dr. Francisco Albuquerque
Dr. Robert Larson

VASCULAR OFFICE ADMINSTRATIVE STAFF: (828-3211)

Abigail LaFoon
Chandra Stokes

FELLOWS:

Dr. Issa Mirmehdi, 2nd year (graduating 2019)
Dr. Michele Richard, 1st year

NURSE PRACTITIONER:

Shirley Yau

The Week at a Glance:

Monday:  OR cases vs consults vs floors

Tuesday:

  • Vascular surgery interdisciplinary didactics @715a, Radiology Conference Rm, 3-201
  • Levy clinic in the AM

Wednesday:  OR cases vs consults vs floors

Thursday:

  • M&M @7am; Grand Rounds @730am
  • The 4th Thursday of every month is Dr. Albuquerque’s “Prison Clinic” in the AM
  • No scheduled cases; emergencies only
  • Consults vs floors

Friday:  OR cases vs consults vs floors

 

Your Expectations/Roles/Responsibilities:

You are an integral part of the team!  Before your first day on the rotation, contact one of us for instructions or help finding your way. Plan to meet around 630 on 10C at the NP work room. You are encouraged, but not required, to share your cell phone number or pager number with the fellows who may distribute to the team to enhance service wide communication. 

Your priorities for your education should be:

#1:  OR cases—any time there is an operation, you should be there! One student should attend all vascular surgery cases unless they have a mandatory conference, exam etc. 

#2:  consults—from the floor or the ED, these are highly educational!

#3:  office hours (when scheduled)

#4:  assisting on the floors

 

ON THE FLOORS—Morning Rounds:

  • We typically round as a group between 630-7am, depending on the in-patient census (timing will be driven by the rounding fellow).
  • You should pick 1-2 patients to follow as your own. Ideally, these would be patients you have assisted in their surgeries; but can be any interesting patient on the list. Since surgery rounds are fast paced, don’t expect to give a full H&P/SOAP note presentation. You should pre-round on your patient, and know what happened in the last 24h & overnight. These updates, as well as your morning evaluation updates can be presented to the team prior to everyone seeing that patient on group rounds. A rough example:
    • This is 65F who is POD#1 from a left fem pop bypass. Needed blood overnight for a low Hgb. Doing well this am, Hgb responded to the transfusion. Her pain is controlled. On exam left graft pulse and DP/PT pulses are palpable, incisions are clean/dry/intact. Today I want to ___[trend her Hgb, work with PTOT, continue her pain regimen,...]___
  • Helping with dressings! There is a duffle bag of various dressings that you will be responsible for bringing to rounds and keeping stocked. Ask the intern/NP which patient dressings you can assist with, and on these patients it is very helpful for you to remove the dressings prior to rounds, as well as replacing the dressings when rounding with the team, facilitating an efficient wound care process. Please check with the team after you start your rotation about dressing preferences. 

ON THE FLOORS—General:

  • Consults is another area of high educational value. If you aren’t in the OR, then check with the intern or fellow if there are any pending consults you can work up!
  • When there aren’t any OR cases or consults, check in with the team if there are any procedures or other educational activities that you may be able to assist with. The intern may also have some floor work that you can help with.

IN THE OR:

  • You should be scrubbing in every case possible! All and any open cases should be scrubbed by you. You are an integral part of the surgical team, helping with exposure, etc.
  • Endovascular cases should not be scrubbed by the student. But you should still be in the room learning! There are usually various pauses in the case, where you can learn anatomy/etc. either from the XR monitor, or in the control room.
  • To prepare for any scheduled case – open or endovascular – please read the basic vascular anatomy relevant to that case. If unsure, please ask the team how to best prepare for the next day cases.
  • You are expected to meet each patient before the case to introduce yourself and review the patient’s history, understand the treatment approach. 

IN THE OFFICE:

  • The exact nature of the office hours will vary day to day, depending on timing, being behind, and staffing, etc.
  • In general, you should expect to either see a patient individually, or with the fellow/attending, and ideally present your patient, along with your assessment and plan.

ON CALL:

  • Your call schedule is established by the overall schedule from the school of medicine. If on call on the weekend during your vascular rotation, please contact the fellow on call prior to that weekend.
  • We understand you have student-specific lectures and meetings throughout the week. No problem! Just let us know either at the start of the day or at the beginning of the case, and excuse yourself at the proper time.

STUDENT DIDACTIC SESSIONS:

  • We understand you have student-specific lectures and meetings throughout the week. No problem! Just let us know either at the start of the day or at the beginning of the case, and excuse yourself at the proper time.

 

Your Evaluation:

Your rotation evaluation will be completed by at the end of your rotation, this will reflect the impressions and opinions of all faculty, fellows, and the nurse practitioner.  Your evaluation will be primarily based on your “reporting” “interpreting” and “managing” skills.  These will be assessed during rounds, in clinic, and in the OR. 1-800-HowAreWeDoing:

This rotation is all about your learning experience.  If you are having any issues at all, please feel free to approach the fellows, or the attending, to voice any concerns.  We are here to make sure you get the best educational experience in vascular surgery.  

Let’s have some fun!