Define the exposure you need
- Open reconstruction
- Endovascular intervention
- Complex aortic planning
- Limb salvage
- Venous intervention
- Vascular access
- Trauma
- Ultrasound and diagnostics
Ask about the fellow’s role
- Observation, assistance or defined procedural steps
- Progression during the programme
- Number and level of competing trainees
- Simulation and planning responsibilities
- Logbook or competency assessment
- Effect of registration restrictions
Interpret numbers carefully
Ask whether a number represents the institution, service, consultant, programme or individual fellow. Request the period, procedure definition and whether the figures are audited. Do not compare numbers with different denominators.
Look beyond volume
Case selection, supervision, feedback, imaging review, complication analysis and continuity of care may matter as much as raw procedure counts.
Understand the unit of measurement
A hospital may report thousands of procedures a year, but a fellow’s share depends on how many consultants, residents and other fellows work in the service and on how cases are allocated. Always ask what the number counts and who it is attributed to before using it to compare programmes.
Evidence that is more informative than a headline figure
- Current fellows’ or recent alumni’s accounts, obtained directly
- A sample weekly timetable showing theatre, clinic and on-call
- The mix of elective and emergency cases
- Rotation structure and any time away from the core service
- How case allocation is decided between fellows and residents
Technique-specific questions
For endovascular and aortic work, ask about access to planning software, in-house imaging review and the proportion of complex repairs performed by the service. For open and limb-salvage work, ask about the multidisciplinary wound and diabetic foot pathway. For venous and access surgery, ask about outpatient and procedural-room exposure as well as theatre lists.
Registration shapes exposure
The same service can offer very different experience to a fellow with full local registration and to a visitor with limited registration. Ask what previous fellows with your registration status actually did, rather than what the service offers in general.