Should vascular surgeons receive additional certification in specific areas of practice? That question was explored at VAM 2026, where Kellie Brown, MD, professor of surgery at the Medical College of Wisconsin, discussed the potential benefits and challenges of formal subspecialty certification.
Brown noted that vascular surgery itself emerged from general surgery after advances in the field outpaced traditional surgical training. While the establishment of a primary vascular surgery certificate helped standardize education and competency, the specialty has continued to evolve with increasingly complex procedures and greater involvement from other specialists.
“The question really isn’t whether subspecialty standards have merit,” said Brown. “It’s whether the cumulative burden is sustainable and whether it’s the right instrument for the problem we’re trying to solve.”
She said additional subspecialization could allow surgeons to develop deeper expertise in specific disease areas, align continuing medical education with their clinical practice and provide clearer signals of advanced competency for patients and referring physicians.
At the same time, Brown cautioned that creating multiple certifications could narrow the scope of practice for vascular surgeons and add to the growing number of training and credentialing requirements they already face.
She also warned against allowing outside organizations to define competency standards for vascular procedures. “Standards should be physician-controlled,” said Brown. “We need to be careful about who’s creating those standards.”
Brown proposed a framework for evaluating future subspecialties, including evidence that they improve patient outcomes, sufficient clinical volume to maintain competency and training pathways that preserve the broad skills needed to manage vascular emergencies.
“Subspecialization is neither inherently good nor bad,” said Brown. “It’s a tool. Like all tools, its value depends entirely on whether it’s solving the right problem.”
