New Primary Certificate Approved

The Accreditation Council for Graduate Medical Education has approved the new Program Requirements for the Primary Certificate in Vascular Surgery, which was initiated by the SVS in conjunction with the American Board of Surgery in 2004. Prior to this approval, vascular surgery was designated as a subspecialty certificate issued by the American Board of Surgery (ABS). The primary certificate approval is a significant milestone because it eliminates the current requirement for certification in general surgery prior to certification in vascular surgery. Equally important, it allows for the creation of more flexible and in-depth training paradigms, opening the door to a larger and even better pool of potential applicants for vascular fellowships.

Medical students and junior residents may ask you about this change. The following questions will help you explain how moving from a subspecialty certificate to a primary certificate will affect their training.

• What is a primary certificate?
  Primary certificates (also known as general certificates) are issued by each of the 24 Member Boards of the American Board of Medical Specialties (ABMS) to formally recognize physicians' qualifications in their chosen specialty fields. Primary certificates may be distinguished from subspecialty certificates, which are also issued by most ABMS member boards. Subspecialty certificates may be held only by physicians who hold general certification in the parent specialty. Primary certificates can be held by physicians without the requirement of certification in the parent specialty--in our case, the ABS.
• What are the advantages?
  A primary certificate will enhance the appeal of vascular surgery careers and provide better training to those who choose vascular surgery as a specialty. Specifically, the certificate will help bring about the following changes:
  Shorter training period. By reducing time spent in general surgery rotations, the certificate will result in a shortened vascular surgery training period for junior residents or medical students who choose vascular surgery early on. This will enhance the attractiveness of the specialty to young physicians.
  More opportunities to choose vascular surgery. The primary certificate will bring more freedom of career choice to medical students and residents, who would be able to make the vascular surgery choice at various stages of training--during medical school, after several years of initial surgical training, or after completion of full general surgery training.
  Expanded training in vascular surgery-specific areas. The primary certificate will make more time available for training in areas such as non-operative prevention, diagnosis, and management of vascular disease.
• What options are being pursued for vascular surgery training?
  Students now have the option of more than one training pathway. The options include:
• Seven-year track--5 years of general surgery and general residency plus 2 years of vascular surgery with eventual board certification in both surgery and vascular surgery.
• Six-year track ("3 + 3")--vascular surgery certification only, for residents who match in initial surgical training. This is analogous to the plastic surgery training model.
• Five-year track--vascular surgery integrated track for trainees who match during medical school.
• How do students and residents learn more about a specific program?
  The Association of Program Directors in Vascular Surgery is working to finalize the core general surgery and vascular surgery curricula for the new training paradigms. Each training program will adapt a program specific to its criteria, while maintaining the core general surgery and vascular surgery curricula. Therefore, students interested in a training program should contact their specific vascular surgery program of interest.