1Matthew R. Smeds, MD, FACS

Identification of Modifiable Factors Associated with Success and Failure on Vascular Surgery Trainees on the VSITE

1Division of Vascular and Endovascular Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas

2Michael Harlander-Locke, 1Mohammed M. Moursi, MD, FACS

2Lake Erie College of Osteopathic Medicine, Bradenton, Florida

Disclosures

None.

Background

The Vascular Surgery In-Training Examination (VSITE)is offered yearly-Allows evaluation of clinical training programs and curriculum-Means of evaluation of residents

Factors associated with success/failure are not well elucidated

Objective

Describe current vascular trainees’ study habits/sources for VSITE preparation

Determine factors associated with success or failure on the VSITE examination

MethodsVoluntary anonymous electronic survey

(www.surveymonkey.com) sent to all vascular trainees (n= 481) in United States vascular surgery integrated residencies (0+5) and fellowships (5+2)• Demographics• Study Habits• Career Interests• Residency Characteristics• Academic Output• Self-reported VSITE Performance

Results

Surveys completed by 203 (42%) trainees • 71 (35%) Fellows (5+2)• 132 (65%) Residents (0+5)

ResultsDemographic n (%)

Age

<25 2 (1%)

25‐30 74 (37%)

30‐35 100 (49%)

>35 27 (13%)

Male 133 (66%)

Married 103 (51%)

Children 63 (31%)

On (or had) a research year

38 (19%)

Advanced Degree (otherthan MD)

44 (22%)

Results

Results

0

20

40

60

80

100

120

Frequency ofReading forClinical DutiesFrequency ofReading for VSITE

Results

0

20

40

60

80

100

120

140

TwoWeeksPrior

TwoMonthsPrior

All OtherMonths

Minimal (< 1 Hour)1‐5 Hours6‐10 Hours11‐15 Hours>15 Hours

ResultsClinical Duty Preparation(n = 203)

Most Important(n = 201)

VSITE Preparation(n = 203)

Most Important (n = 200)

Vascular Surgery Textbook

188 (93%) 128 (64%) 151 (75%) 34 (17%)

Journal Articles 111 (55%) 13 (7%) 0 (0%) 0 (0%)

Peer‐Reviewed Internet Sources

51 (25%) 14 (7%) 17 (8.4%) 0 (0%)

VESAP 39 (19%) 36 (18%) 177 (87%) 154 (77%)

SCORE Curriculum 17 (8%) 0 (0%) 15 (7%) 0 (0%)

Other 7 (3%) 10 (5%) 28 (14%) 12 (6%)

ResultsMost Important Textbook Used n (%)

n = 203

Rutherford’s Vascular Surgery 110 (54%)

Moore’s Vascular and Endovascular Surgery:  A Comprehensive Review

33 (16%)

Stanley’s Current Therapy in Vascular and EndovascularSurgery

31 (15%)

Hallet’s Comprehensive Vascular and Endovascular Surgery

13 (6%)

Chaikof’s Atlas of Vascular Surgery and Endovascular Surgery

9 (4%)

ResultsWhen did you study for the VSITE?

During the day when Igot a free minuteAfter work when I feltlike itSet study time after workmost days of the weekI didn't study for theVSITESet study time after workat least weeklyOther

ResultsWhere do you study?

At home

At the hospital/work

At a public place (coffee house)

At a library

Other

Results

0

10

20

30

40

50

60

70

VeryDisciplined

SomewhatDisciplined

NotConsistentlyDisciplined

orUndisciplined

FairlyUndisciplined

VeryUndisciplined

ResultsMost Important Barrier To Studying (n = 203)

Resident Work Hours 105 (52%)

Desire to spend time with friends/family

52 (26%)

Non‐Clinical Academic Duties 17 (8%)

Lack of Motivation 12 (6%)

Interests Outside of Medicine 9 (4%)

No Barriers 8 (4%)

Results2016 VSITE Scores (percent correct):

• <50%: 7 (3.5%)• 50-70%: 51 (25%)• 70-90%: 126 (62%)• >90%: 5 (2.5%)

Satisfied with score?• Yes: 132 (66%)• No: 69 (34%)

Results

020406080100120140160

My VSITE ScoreDoesn't Matter to

Me

I just need to"pass"

I want to do "well" I must do well

Opinion Regarding VSITE

ResultsFactors Associated with <70% Score on the 

VSITEp ‐ value

Being “somewhat disciplined” in study habits

0.014

Being “not consistently disciplined or undisciplined

0.34

Being on a research year 0.04

Being married 0.027

Having children 0.018

Being a foreign medical graduate* 0.031

*There was no correlation of undergraduate degree type or medical training (MD vs DO) with VSITE performance 

ResultsFactors Associated with >90% Score on the 

VSITEp ‐ value

Daily reading/studying for the VSITE .016

>15 hours reading/studying for the VSITE in two weeks prior to examination

.006

6‐10 hours reading/studying for the VSITE in two months prior to examination

.026

>15 hours reading/studying for the VSITE in two months prior to examination

.001

Being “very disciplined” <.001

Conclusions

Most vascular trainees report studying for clinical duties on a weekly or daily basis while studying for VSITE only sporadically or less frequently

The “most important” resource for clinical duty preparation is standard vascular textbooks while VESAP is deemed the most important for VSITE preparation

Conclusions

Most trainees report being rather undisciplined in preparation for the VSITE

Barriers to study include residency work hours and desire to spend time with family

ConclusionsFactors associated with high scores on

the VSITE include more frequent reading and a disciplined approach to study

Factors associated with lower scores include being married, having children, and lack of discipline in preparation