Regional Disparities in Vascular Surgery Training and Practice Location - Implications for Predicted Workforce Shortages.

OBJECTIVES: The predicted shortage of vascular surgeons disproportionally affects different regions. Studies suggest efforts to address shortages should incorporate strategies to increase training opportunities in underserved areas. We compared individuals' regional location for general surgery residency (GSR), vascular surgery fellowship (VSF), and practice location. METHODS: GSR attended, VSF attended, and current residence for Vascular Qualifying Exam (VQE) Examinees (VQEEs) who completed VSF from 2007-2024 were obtained from the American Board of Surgery (ABS). Divisions were determined according to US Census Bureau definitions. RESULTS: Of 2,149 VQEEs, 433/2,149 (20.15%) completed GSR and VSF at the same institution. Among VQEEs completing GSR, the % completing VSF in that same region was: East North Central 44.40%, East South Central 45.30%, Middle Atlantic 51.00%, Mountain 15.60%, New England 39.20%, Pacific 50.60%, South Atlantic 45.40%, West North Central 47.30%, West South Central 44.70%. Among VQEEs in a region, the % staying in the same region as their VSF vs. GSR upon completion of VSF was: East North Central 40.00% vs. 50.70%, East South Central 33.80% vs. 44.10%, Middle Atlantic 42.60% vs. 73.60%, Mountain 40.40% vs. 24.80%, New England 36.70% vs. 46.60%, Pacific 67.00% vs. 46.70%, South Atlantic 49.50% vs. 39.30%, West North Central 31.10% vs. 40.20%, West South Central 42.90% vs. 49.00%. CONCLUSIONS: Where vascular surgeons train is strongly associated with where they practice. Regional retention was strong in most divisions. As the gap between vascular surgery supply and demand continues to widen, regionally directed creation of training infrastructure will be a critical component of addressing this workforce shortage.