Every vascular surgeon in the country needs to pass this exam. In fact, they cannot be ‘certified’ without it. And as of October, it will be rather different. The CASH-3 Vascular, a post-academic program for vascular surgeons provided at the TechMed Centre and co-designed with the Dutch Society for Vascular Surgeons (NVvV), is celebrating its tenth anniversary by redesigning its approach.
Text: Michaela Nesvarova
‘We’ve had a great programme co-created with experts from the entire country, but being satisfied with what you achieved is a guarantee to fail,’ says one of the programme’s main initiators Bob Geelkerken, a vascular surgeon at MST and UT Professor of Clinical Translation of Advanced Technologies Diagnosis and Treatment of Vascular Disorders.
Interactive discussions
‘Exactly, that is why we decided to develop a new approach,’ agrees Michelle Heijblom, CASH-3 Vascular coordinator from TechMed Centre. ‘A year ago we started a discussion with NVvV about a new trajectory. The surgical residents expressed that they appreciated the examination a lot, but that they missed interactive discussions and learning directly from supervisors, and so now we will celebrate the tenth anniversary of CASH-3 Vascular with a fresh start.’
Two parts
CASH-3 Vascular was established in 2010 in order to ensure that all vascular surgeons in the Netherlands have the same competencies. Until recently, the programme consisted of a physical exam, during which the surgical residents showcased their skills. Now – based on the trainees’ wishes – the initiative is expanded. ‘It is now split into two parts: four training sessions and then the examination, divided over two-year time-span,’ explains Geelkerken. ‘This allows the residents to come to the TechMed Centre and train specific skills with an expert, ask questions about issues they encounter in their clinical training and practice surgeries in a completely safe environment.’
Mimic the operation
The residents have access to e-learning and practical sessions with various simulators and models at the TechMed Centre. ‘This allows them to mimic the operation and demonstrate their skills in a risk-free scenario,’ explains Heijblom. ‘Every trainee is given a specific case to treat. For example, they are asked to “treat” a 75-year-old man with an aneurysm in the aorta. Do they perform open surgery or try an endovascular, minimally invasive approach? They need to discuss what to do and try the surgery in a specified timeframe. The huge advantage of this approach is that we can stop the procedure at any point and discuss what should or should not be done next.’
Demonstrate skills
After completing the training sessions, which should cover all aspects of vascular surgery, the trainees all have to pass one final day or exams. ‘At this point, there are no discussions,’ says Geelkerken. ‘The resident needs to demonstrate his or her skills and perform the simulated surgery correctly, otherwise, they cannot pass. In the last ten years, there hasn’t been a single certified vascular surgeon in the country who has not passed CASH-3 Vascular at TechMed.’