Vascular Surgery and Endovascular Therapy Fellowship

Clinical Experience
The Vascular Surgery Fellowship Program at Loyola University Medical Center was created in 1978, with the primary objective of providing comprehensive training for the management of arterial, venous and lymphatic diseases. In addition to the clinical training we offer at Loyola and the Edward Hines Jr. Veterans Affairs Hospitals, we have an established a strong tradition in graduate and undergraduate education and research. Our program is a two-year fellowship that provides exposure to the entire spectrum of arterial and venous disease, and includes non-operative care, as well as open surgical and endovascular management. The fellowship includes exposure to clinical research and non-invasive vascular laboratory training, the latter being particularly essential in the armamentarium of practicing vascular surgeons. Fellows are expected to pursue certification as a Registered Vascular Technologist (RVT) or Registered Physician in Vascular Interpretation (RPVI) on completion of their training.

Fellows divide their time and rotate between Loyola University Medical Center and the Edward Hines Jr. VA Hospital. These institutions are located within one block of each other approximately 12 miles west of downtown Chicago. Loyola University Medical Center is a 568-bed University Hospital and Level-1 trauma center. The Hines VA Hospital, the largest in Illinois, is a comprehensive 471 bed facility with extended care, rehabilitation and spinal cord injury services.

Loyola University Medical Center is an academic hospital associated with the Stritch School of Medicine. This tertiary care center offers the spectrum of open vascular and endovascular cases, including cerebrovascular, aortoiliac and infrainguinal occlusive disease, abdominal aneurysms, visceral arterial disease, arteriovenous access and venous interventions. The vascular service at Loyola supports the facility’s busy Level 1 trauma Center. The volume and complexity of both open and endovascular procedures easily fulfills Vascular Surgery Fellowship case requirements. All fellows to date have far exceeded this goal. In addition to participating in the operating room, catheterization lab, and outpatient clinic, fellows are expected to supervise and lead the team of medical students, general surgery residents and podiatry residents rotating on the vascular service.

The Vascular Surgery Fellowship Program at Loyola University Medical Center is geared towards, but not exclusive to, the surgeon who is interested in an academic career. The fellowship emphasizes acquiring endovascular techniques, open surgical skills, a noninvasive vascular laboratory background and involvement with clinical research projects. It is expected that the projects developed will be completed over the two-year fellowship.

Conference Schedule

Monday	Tuesday	Wednesday	Thursday	Friday
5-6 pm Department of Surgery Morbidity and Mortality Conference	-no conference	7-8 am Department of Surgery Grand Rounds	-no conference-	7-8 am Vascular Topics / M & M 8-9 am Case Conference 9-10 m Divisional Meeting

Positions Offered
One 2-year clinical fellowship position is offered each year.

Application Requirements
Each candidate must have satisfactorily completed an ACGME-accredited General Surgery residency and be eligible for examination by the American Board of Surgery. Applicants must apply for the fellowship position through the Electronic Residency Application Service (ERAS). Minimal application contents for consideration include 3 letters of recommendation, a personal statement, ABSITE scores and USMLE or ECFMG scores.

Program Director
Bernadette Aulivola, MD, RVT, RPVI, FACS
Associate Professor of Surgery

Program Coordinator
Sheila Lawshea
slawshea@lumc.edu
708-327-3041 office

Faculty
All faculty members share appointments at Loyola University Medical Center the Edward Hines Jr. VA Hospital, and Gottlieb Memorial Hospital.

Jae Sung Cho, MD, FACS
Chief of Vascular Surgery and Endovascular Therapy
Professor of Surgery and Cardiothoracic Surgery

Jae Sung Cho, MD received his BS and MD degrees from the University of California, Irvine. He completed his internship and general surgery residency at the University of Rochester, Rochester, NY, and his vascular surgery fellowship at the Mayo Clinic in Rochester, MN. He began his career at Henry Ford Hospital in Detroit, MI and was recruited to the University of Pittsburgh School of Medicine in 2003. There he rose through the academic ranks to become Professor of Surgery and Chief of Vascular Surgery at University of Pittsburgh Medical Center Mercy Hospital. Dr. Cho joined the Loyola University's Stritch School of Medicine in August of 2012 as Professor of Surgery and Cardiothoracic Surgery and Chief of Vascular Surgery and Endovascular Therapy.

His research interests are focused on clinical outcomes on a wide range of vascular surgical procedures. His clinical interests are focused on diseases of the aorta, such as ruptured abdominal aortic aneurysm, thoracoabdominal aortic aneurysm and traumatic injuries of the aorta. Other areas of expertise include the management of thoracic outlet syndrome, renal and mesenteric ischemia and carotid disease.

He has authored more than 50 peer-reviewed manuscripts in various scientific journals, 16 book chapters, and has presented over 50 abstracts at national and regional meetings and has received many awards and honors for his teaching and research. An active member of all major vascular societies including an election to the Distinguished Fellow designation of The Society for Vascular Surgery, he serves as a reviewer for multiple journals.

Dr. Cho is board certified in General Surgery and in Vascular Surgery.

Bernadette Aulivola, MD, RVT,RPVI, MS, FACS

Dr. Aulivola is an Associate Professor of Surgery who joined the division in January 2005 and has been the Program Director of the Vascular Surgery Fellowship since July 2008.

Dr. Aulivola is a graduate of Washington University School of Medicine in St. Louis, Missouri. She obtained her general surgery training at the Rush University Medical Center/Cook County Hospital program in Chicago, and completed a vascular fellowship at the Beth Israel Deaconess/Harvard Hospitals program in Boston. After fellowship, she was awarded the Marco Polo Traveling Scholarship, an international award sponsored by the Society for Vascular Surgery and the European Society for Vascular Surgery to support the exchange of vascular surgical trainees between North America and Europe. With this award, Dr. Aulivola trained in advanced endovascular techniques at the University of Bologna and several other centers in Italy prior to joining the Division.

Dr. Aulivola is board certified in both General and Vascular Surgery. She is RVT and RPVI certified. Her clinical areas of interest include carotid artery intervention, endovascular aneurysm repair and complex distal lower extremity revascularization.

Pegge Halandras, MD

Dr. Halandras joined the division in August of 2009 and is an Assistant Professor of Surgery. She serves as Chief of the Vascular Surgery Division at the Edward Hines Jr. Veterans Affairs Hospital.

Dr. Halandras attended medical school at the University of Colorado School of Medicine. Subsequently, she did her General Surgery training at the University of Colorado Medical Center and Vascular Surgery Fellowship at Emory University. She was in practice for one year at the University of Colorado Medical Center prior to joining the Division at Loyola.

Dr. Halandras is board certified in both General and Vascular Surgery. Her primary interests include the open and percutaneous treatments of thoracic and abdominal aortic aneurysms, cerebrovascular disease and peripheral arterial disease.

Richard Hershberger, MD, RVT, RPVI, FACS

Dr. Hershberger joined the division in August of 2009 as Assistant Professor of Surgery. He serves as the Director of medical education within the division.

Dr. Hershberger attended medical school at the University of Texas Health Science Center in San Antonio, Texas. He did his General Surgery training at Univeristy of Texas, Southwestern in Dallas. He subsequently trained in Vascular Surgery here at Loyola. He was recruited to stay on as faculty after completion of his training.

Dr. Hershberger is board certified in both General and Vascular surgery. He is RVT and RPVI certified. His interests include the open and percutaneous treatment of carotid disease, aneurysms, and peripheral arterial disease.

Detailed two-year fellowship curriculum

Vascular surgery is a mature program at Loyola and has been complemented by the development of our endovascular program. We offer the complete spectrum of endovascular training that includes diagnostic arteriography, balloon angioplasty of peripheral and visceral arteries (renal, mesenteric), carotid angioplasty and stenting, and endograft repair of abdominal aortic and iliac aneurysms. The endovascular program that has been developed complements our open vascular surgery experience, which includes both routine and complex procedures (aortic aneurysm and occlusive disease, lower extremity bypass, carotid endarterectomy, mesenteric and renal artery bypass, venous surgery, and arteriovenous access).

Fellowship Objectives
Inpatient and outpatient care of the patient with arterial and venous disease

Identification and management of co-morbidities prior to planning intervention
Performance, interpretation and application of non-invasive vascular laboratory techniques to the diagnosis and management of vascular disease
The ability to provide the best treatment options, including medical management of artherosclerotic disease, as well as open and endovascular techniques
Open vascular surgery – routine and complex procedures, including aortic aneurysm and occlusive disease, lower extremity bypass, carotid endarterectomy, mesenteric and renal artery bypass, venous surgery, and arteriovenous access.
Endovascular intervention – diagnostic arteriography, balloon angioplasty and stenting of peripheral and visceral atherosclerotic lesions, carotid angioplasty and stenting, endograft repair of thoracic, abdominal, iliac and extremity aneurysms, arteriovenous access interventions, endovenous laser ablation, mechanic al and medical thrombolysis (arterial and venous)
Designing and conducting vascular clinical outcomes studies

Fellowship General Description
Vascular surgery fellows alternate two-month rotations between Loyola University Medical Center and Edward Hines Jr. Veterans Affairs Hospital over the 2-year fellowship period. At both hospitals, the fellow functions as the leader of the service, helping the attending surgeons care for the patients in both the outpatient and inpatient settings. In the outpatient setting, the fellow is required to attend at least one half day of clinic per week. In addition, they participate in outpatient surgical procedures. Inpatient care consists of active involvement in providing pre and post-operative care as well as the management of inpatient consults. Fellows are expected to actively participate in the majority of inpatient surgical and interventional procedures.

The fellow works with a first and fourth year general surgery resident while rotating at Loyola University Medical Center and with a first and second year general surgery resident while at Hines VA Hospital. One or two 3rd year medical students rotate on the Loyola service for two week periods. In addition, a 4th year medical student may be on the Loyola service for one-month rotations. A podiatry resident may rotate on the service at Hines VA Hospital. The fellow is responsible for aiding attending surgeons in the teaching of these colleagues and directing them in the care of patients at both institutions.

While rotating at Loyola, the fellow will have dedicated time in the vascular ultrasound lab. This experience will consist of two separate one week blocks per year for a total of four weeks during the fellowship. It is expected that this experience will complement the didactic teaching gained through the lectures which the junior fellow gives to the division on a bimonthly basis. While in the vascular ultrasound lab, the fellow is expected to observe, perform and interpret various arterial exams to include interrogation of the carotid, aortic, extremity, renal and mesenteric circulations. In addition, the fellow is expected to observe, perform and interpret venous duplex exams. While rotating at Hines VA, the fellow can review, with the attending, all ultrasound studies performed within the vascular lab. Although the attendings’ signature is required for finalization, the studies are available for review by the fellow so that he or she may sit for the Registered Physician in Vascular Interpretation (RPVI) exam.

Finally, it is expected that both fellows actively participate in all conferences offered by the Division of Vascular Surgery and Endovascular Therapy and the Department of Surgery. Specifically, these include vascular case presentation conference, vascular topics conference, vascular lab conference, and morbidity and mortality conferences, both departmental and divisional.

The first-year fellow is responsible for weekly vascular ultrasound lab conference including speaking on assigned topics and arranging for demonstration of specific vascular ultrasound techniques and studies.

The second-year fellow is responsible for running weekly vascular case conference and weekly vascular topics conference. This includes speaking on vascular topics, organizing a joural club, and organizing morbidity and mortality conferences within the division. The second-year fellow is also expected to take responsibility for organizing the call schedule which is split between both fellows and the PGY-4 surgery resident.

Evaluation Process
At the conclusion of each two-month rotation, the fellow’s performance is evaluated by all faculty members. Faculty members evaluate each fellow in the six core competencies in addition to technical skills. The fellow also is provided an opportunity to evaluate the merits of the rotation and the faculty. On a quarterly basis, fellows are expected to sit for a mock oral examination, which is also used to evaluate the fellow. On a semiannual basis, the Program Director meets with the fellow to review his or her progress in the training program. A summative review and evaluation takes place at the conclusion of the fellowship.

Current and Past Fellows

Years	Name	Post-Fellowship Location
2012-14	Omar Al-Nouri, D.O	PGY 1 Vascular Surgery Fellow (2012-2014)
2011-13	Michael Malinowski, M.D.	PGY 2 Vascular Surgery Fellow (2011-2013)
2010-12	Pratheek Kakkasseril, M.D.	St. Elizabeth's, Youngstown Ohio
2009-11	Robert Craig, D.O.	Walter Reed Army Medical Center, Washington DC
2008-10	Arash Bornak, M.D.	University of Miami, Miami FL
2007-09	Richard Hershberger, M.D.	Loyola University Medical Center, Maywood IL
2006-08	Omar Dorzi, M.D.	Saint Francis Hospital, Federal Way WA
2005-07	Hung Chu, M.D.	Surgical Associates of Dallas, Dallas TX
2004-06	Ahmad Bhatti, M.D.	Suffolk Vascular Associates, Port Jefferson NY
2003-05	Luis Leon, M.D.	Tucson VA Hospital, Tuscon AZ
2002-04	James Laredo, M.D.	Georgetown University Hospital, Washington DC
2001-03	Victor Erzurum, M.D.	Summit Vascular Specialists, Hudson OH
2000-02	Sung Kwon, M.D.	Jersey Coast Vascular Associates, Brick NJ
1999-01	A. Tassiopoulos, M.D.	Stony Brook University Hospital, Stony Brook NY
1998-00	Susanne Woloson, M.D.	Advocate Lutheran General Hospital, Park Ridge IL
1997-99	Paula Shireman, M.D.	University of Texas, San Antonio TX