Recognition of this trend has led to the adoption of alternative training pathways, in particular the integrated “0 + 5” pathway, to supplement the traditional “5 + 2” independent pathway. However, the traditional “5 + 2” training paradigm appears to be less appealing to the current generation of surgical students, resulting in fellowship positions going unfilled, and potentially predicting a shortage of vascular surgeons. Traditionally-trained vascular surgeons have adapted to these trends by acquiring endovascular skills vascular surgery fellowships were standardized to 2-years to incorporate endovascular training. Current trends in vascular surgery in the USA are driven by increased demand for endovascular procedures.
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