Message from the VSB Chair

Colleagues,

I trained during a time of extraordinary change in vascular surgery. Now I practice during another one. The pace of change has only accelerated. The endovascular revolution has affected nearly every patient care decision we make. Stents, catheters, wires, and devices are constantly hitting the market with the promise of not only treating more challenging pathology but also of expanding our scope of practice. Thrombectomy contraptions, bioabsorbable scaffolds, stents doused with cytotoxic agents: I do things every week that would have gotten me thrown out of that hotel room 20 years ago.

The value of your board certification should be self-evident. Certification is meaningful because it represents something deeper: a public promise that the surgeon caring for a patient today is practicing medicine of today, not medicine as it was on the day of their oral exam.

To stay current, there is work required. I know the overwhelming majority of you accept this work willingly. But burnout and administrative fatigue are real. Most burnout stems from the weight of the tasks we must perform that are unrelated to being a vascular surgeon. We love the job but hate the growing burden of the EMR, prior authorizations, hospital paperwork, and the burgeoning proportion of our lives spent just trying to keep up with documentation. I’m also well aware that ‘a letter from your certifying board’ isn’t high on the list of things that spark joy.

As chair of the Vascular Surgery Board, one of my priorities is therefore simple: if we are going to ask you to do something to maintain certification, it should be worth your time. You became board certified because of your demonstrated sound knowledge and decision making. Now you maintain that certification through a commitment to professionalism, lifelong learning, and practice improvement. While these requirements must be met by all ABMS certified physicians, I know vascular surgeons, and I know we want to be the best. That is what I want to deliver to you —the finest resources to be the best.

Today, 3,320 vascular surgery certificate holders are enrolled in the Continuous Certification Assessment (CCA) process. Another 150 time-limited certificate holders are due to enter this year, with 769 set to join soon thereafter. As the pathway grows, we are constantly reviewing the CCA to ensure we are curating scientific articles relevant to the modern practice of vascular surgery: consensus statements, guidelines, and large randomized trials. I believe the CCA is the most efficient pathway ever designed to stay current. Certainly, better than cracking a textbook every ten years.

Our expert group of volunteers hand pick each article. Will CREST-2 change your practice? Perhaps, but everyone can agree that vascular surgeons should be familiar with the findings.

This year the CCA contains questions and detailed rationales on CREST-2, BEST-CLI, and ECST-2 as well as the current clinical practice guidelines for 11 different conditions. I took the assessment myself last week and learned several things, which was mildly concerning since I helped edit the questions a few short months ago. You will learn something too.

Vascular surgery has never been a field that stands still. Neither should our knowledge. Certification should not simply prove what we once knew. It should demonstrate our commitment to knowing what matters now.

Thank you for the extraordinary work you do every day, for the patients whose limbs and lives you save, and for your continued commitment to improving our specialty.

– Dr. Malachi G. Sheahan III