Subspecialty Fellowship: Vascular Medicine
When I initially started my cardiovascular disease fellowship at Brigham and Women's Hospital, I didn't pay much attention the latter half of "cardiovascular". Sure, we all go into cardiology knowing the heart is the center of our specialty, but I think you'll agree that vascular disease also plays a significant role.
Vascular medicine is not yet an ACGME recognized subspecialty. Thus, the requirements for vascular medicine training are determined, in part, by the specialty's professional organization, the Society for Vascular Medicine, and licensing group, the American Board of Vascular Medicine. While many people will go into vascular medicine from cardiology, others will enter through internal medicine, vascular surgery, or even interventional radiology. Currently, vascular medicine requires an additional 12 months of clinical training in both inpatient and outpatient experiences, as well as the vascular ultrasound lab, vascular surgery, and vascular imaging.
The types of vascular diseases are as broad and diverse as our larger cardiovascular specialty. There are arterial diseases, which include coronary atherosclerosis and peripheral arterial disease, aortopathies like dissection and aneurysm, vasculitic diseases, both acquired and genetic. There are also numerous venous diseases including thromboembolic disease like DVT and PE, as well as venous insufficiency and varicose veins.
I became interested in vascular medicine because it aligned with my research interests. My background is in immunology, and as you might expect, there's a lot of interesting inflammatory pathology in both arterial and venous disease. When choosing a clinical subspecialty, I wanted one that would differentiate me from other cardiologists and drive research questions.
My year is roughly divided into two halves. The first half of the year is split between vascular medicine inpatient consults and time in the ultrasound lab reading vascular studies. The second half of the year is spent among a number of electives, including interventional vascular lab, vascular surgery, and vascular imaging. At Brigham and Women's, we do not take call as vascular medicine fellows, and while on consults we cover Sundays. Otherwise my evenings and weekends are free for other activities, which is a welcome change from cardiology fellowship!
There are only a handful of vascular medicine training programs around the country, but if you ask around, you may be surprised to find one closer to you than you might think. The Society for Vascular Medicine is a good place to start, as is the American College of Cardiology. I would be remiss if I didn't mention the Peripheral Vascular Disease Section. As an FIT, you may join as many of the sections as you want for free!
Vascular medicine is a dynamic subspecialty with diverse opportunities for your career, including direct inpatient and outpatient care, research, imaging, and procedures. I couldn't be happier with my decision, and I hope you will feel the same!