Endovascular Fellowship Training Program

Peoria, Illinois hasn’t always been the first place that comes to mind when considering the best place to undertake post-graduate training in endovascular interventions, but that’s changing. Dr. James B. Williams has spent the last six years pioneering a truly unique fellowship training program that has trained more than 20 physicians to date from around the country in the latest techniques for treating peripheral arterial disease (PAD).

As one of the early adopters of balloon angioplasty and stenting, Dr. Williams has been on the forefront of the endovascular revolution since the mid-1980s. A board-certified cardiothoracic and vascular surgeon, he is widely recognized as an authority on aortic endografting, has performed thousands of catheter-based interventions, and has served as principal investigator in a number of U.S. clinical device trials for endovascular devices. When endovascular procedures began to gain widespread acceptance, he realized that there was a gap in the endovascular training provided in the academic environment and the skills required to perform these cases in the OR and cath lab. Dr. Williams’ passion for education and endovascular treatment options eventually led him to develop the Endovascular Therapies Fellowship Training (ETFT) Program, a six-week visiting fellowship program designed to provide interested mid-career physicians with endovascular skills they may not be able to acquire anywhere else.

Dr. Williams has developed a reproducible curriculum designed to provide a thorough understanding of the indications for endovascular diagnosis and treatment. The program provides enough case experience to meet credentialing requirements at the fellow’s home institution while allowing an individualized, one-on-one mentoring relationship focused on the needs of the trainee. Curriculum components include hands-on training in the use of wires, sheaths, catheters, stents, balloon angioplasty, atherectomy, endografting, and thrombolysis in all non-coronary vascular beds. In addition, the program includes comprehensive didactic sessions in each of these areas and extensive work in diagnostic angiography. Procedure tutorials are provided in infrarenal and thoracic endografting, infrainguinal interventions, and renal, carotid, and iliac angioplasty and stenting.

The training program also includes unlimited access to a dedicated Simbionix^™ Angio Mentor^™ Simulator, which is available to the fellow whenever he/she isn’t in clinic or cases. The simulator provides realistic visual and tactile feedback, allowing the fellow to practice endovascular skills and maneuvers repeatedly and without clinical consequence. No other training center in the country offers this much exposure to simulation technology.

In addition to the hands-on component of the training, fellows are required to read and discuss two textbooks selected by Dr. Williams during the course of their stay. Participants who successfully complete the program receive a detailed letter of competency from Dr. Williams attesting to their basic, intermediate, or advanced endovascular skills.

Upon completion of the ETFT Program, fellows continue to enjoy a close relationship with Dr. Williams as their mentor. He provides unlimited consultations, opinions, and film reviews at no charge to his former fellows. In addition, the ETFT Program sponsored its first Williams Visiting Fellowship Roundtable Event in 2010. All former fellows were invited to this two-day meeting that included guest speakers, business and clinical presentations, case reviews, and small-group discussions on the latest advances in endovascular interventions. Dr. Williams hopes to do more of these events in the future, citing the enthusiastic response and the fellows’ need for a network of peers with shared experiences and treatment paradigms.

The ETFT Program trained its first fellow in December 2005. Dr. Michael Brown was a thoracic surgeon in a multi-specialty group in Bismarck, North Dakota, who was interested in expanding his skill set. He approached Dr. Williams at a medical conference after hearing him speak, which ultimately led to the first visiting fellowship. Along with Dr. Andreas Sakopoulos, a cardiothoracic surgeon from Napa, California, Dr. Brown spent six weeks training under Dr. Williams. “The ETFT program cut my learning curve by three to five years,” he says. Another former fellow, Dr. James Locher, concurs. After 14 years as a cardiothoracic surgeon, he saw his practice being steadily eroded by changes in the healthcare landscape and realized that he needed to expand his repertoire of procedures. “I saw the fellowship with Dr. Williams as an opportunity to give myself the skills needed to maintain a productive practice that can take me to retirement. I doubt I could have obtained this training anywhere else in the country.”

Today, the ETFT Program accepts only one applicant at a time, ensuring a volume of case experiences that typically equates to a year in a regular fellowship. Fellows can expect to participate in all aspects of patient care, including pre-operative planning, significant intra-operative maneuvers and decisions, and post-operative follow-up. At the same time, they have no responsibility for dictation or a call schedule, allowing them to focus on and immerse themselves completely in the training experience.

Over the course of the six-week stay, the typical fellow will perform 200 major cases and at a minimum, 100 angiograms (50 as primary operator), and 50 interventions (25 as primary operator). The number of procedures the average ETFT fellow performs in a six-week rotation exceeds the minimum credentialing requirements of more than 90% of the hospitals in the United States. A standard week includes seeing 140 patients in four clinics and performing 16 procedures in three different facilities.

It takes approximately three months to secure the local state licensure and credentialing required for the program. Interested physicians may contact the program administrator, Debra Hawley, at (309) 472-1779, dhawley2@cvendo.com or see www.etft.org for more information.