Challenges for Vascular Surgery as a 'Speciality' in Pakistan
Vascular surgery is relatively new but rapidly emerging speciality in Pakistan. Section of Vascular Surgery is one of first unit to offer its services to the vascular surgery patients within the country. This was amind of the significant challenges faced such as:
- Lack of trained vascular surgeons
- Adequate training programmes in vascular surgery
- Inadequate referral systems
- Insufficient awareness about vascular diseases among patients and physicians
Peripheral vascular trauma, dialysis access surgery, and venous diseases are quite prevalent in Pakistan. Aneurymal and atherosclerotic diseases are on arise.
Section of Vascular Surgery was a part of General Surgery and was approved as a separate section in 2019. Dr Ziad Sophie was the founding section head.
Year 4 medical students rotate in Vascular Surgery as part of the integrated vascular-orthopaedical and plastic surgery rotation. This integrated rotation was started in 2021.
In this short rotation, students are taught basics of common vascular conditions such as acute and chronic limb ischemia, deep venous thrombosis (DVT), diabetic foot, chronic venous insufficiency, and leg ulcer. This rotation has dedicated teaching sessions and clinical exposure in outpatient settings. Students are formally assessed at the end of this clerkship.
An intern is regularly rotates as part of PGME internship program in Vascular Surgery for two months. The interns regard this rotation valuable for improving their basic surgical skills, getting ample patient exposure and interaction in dealing patients with vascular diseases. Very few centres within the country provide this opportunity to the interns.
General surgery residents are part and parcel of the section of Vascular Surgery. Senior general Surgery residents (Year 3, 4, or 5) lead the team along with vascular surgery fellows and junior residents (Year 1, 2). They are actively involved in teaching and patient care. The chief resident leads the morning round and is actively involved in clinical decision-making.
Department of Surgery, AKU initiated the first-ever dedicated Vascular Surgery training as a fellowship for 2 years in 2003. This programme is the first of its kind in Pakistan. The vascular surgery fellowship program is now CPSP accredited. The programme's objective is to produce a competent and academically sound vascular surgeons.
So far, the following 7 fellows have graduated fom this program.