At the end of my intern year, I was tired. It had been a long year of rounding, placing orders, seeing consults and refining basic suturing skills on primarily general surgery rotations—an experience not dissimilar from many of my fellow integrated trainees. I was looking forward to attending the 2022 Vascular Annual Meeting (VAM), not only as a reprieve from intern responsibilities, but also as a mental reset and reminder of why I chose to become a vascular surgeon. I stuck around until the end of the meeting for one of the final Saturday sessions, which I had been eagerly anticipating: “Improving Vascular Care in Underserved Communities.” In this small conference room, I heard about truly amazing community engagement and outreach projects in Oklahoma, Sacramento, Houston, San Antonio and Morgantown (among others). I was incredibly inspired by the passion and perseverance of the men and women who shared their successes and failures, in building these programs and initiatives, primarily with the goal of improving limb salvage in the highest-risk communities.
It was the first time I had ever considered what it truly meant to be a community-engaged vascular surgeon. I had spent four years learning about healthcare disparities as a medical student, another year experiencing them as a bright-eyed intern, and I was preparing for a lifetime of justifying to family and medical colleagues why I chose a field where I was seemingly fighting a losing battle against amputations. It was beyond exciting to know that mentors in the field were also ready to do something to challenge and change the status quo.
In the years since I was so impacted as an audience member, I have continued to follow the progress of the growing number of programs and outreach initiatives aimed at improving awareness of vascular disease and promoting limb salvage. It continues to inspire me that we, as surgeons, can become leaders, not only in the operating room, but also in the community and in guiding multidisciplinary teams to make a real difference in patient care.
A growing number of publications and general publicity and financial support from the SVS, and organizations like the Foundation to Advance Vascular Cures and the American Limb Preservation Society, continue to promote patient-engagement programming aimed at limb salvage.1,2 The community engagement sessions were well incorporated into last year’s VAM. There is consistent buzz about efforts like community diabetic foot screenings, outreach to patients experiencing homelessness,3,4 rural cardiovascular education initiatives5—the list, excitingly, goes on. Even the front page of the November issue of Vascular Specialist touted the novel “Days of Service” at the most recent American Venous Forum and Eastern Vascular Society meetings—a testament to the ever-growing visibility and recognition of building this cadre of community-engaged vascular surgeons.
I am proud that I am now using my academic time to do what I can to learn the necessary skills to engage with my local Pittsburgh community and join forces with existing programming to build awareness of PAD and diabetic foot care. I am collaborating with a multidisciplinary team to improve amputation care at my institution. I am lucky to have mentors who paved the way in establishing programming to provide foot exams and cardiovascular disease education to patients experiencing homelessness that I am now excited to continue and expand.
There are, without a doubt, a growing number of patients with diabetes and advanced cardiovascular disease manifestations like chronic limb-threatening ischemia (CLTI). Despite improved therapies and novel interventions, the incidence of amputations remains high, particularly in the most socioeconomically disadvantaged communities.6 While this admittedly feels particularly daunting, especially as many of my fellow trainees and I are on the precipice of our careers, it is not the time to be tired. I am so thankful for all those that have paved the way in establishing a precedence for community engagement and continue to bring awareness to the role vascular surgeons can play in outreach and beyond.2
References
- Minc SD, Powell C, Drudi LM, et al. Community-engaged research in vascular surgery: An approach to decrease amputation disparities and effect population-level change. Seminars in Vascular Surgery. 2023/03/01/ 2023;36(1):100-113. doi:https://doi. org/10.1053/j.semvascsurg.2022.12.001
- Kempe K. Vascular surgeons are positioned to fight healthcare disparities. Journal of Vascular Surgery: Venous and Lymphatic Disorders. 2024;12(1) doi:10.1016/j.jvsv.2023.08.013
- Boelitz KM, Lee J, Pepin MD, et al. Utilizing Multidisciplinary Mobile Outreach Clinics To Provide Comprehensive Diabetic Foot Care To Patients Experiencing Homelessness. JVS-Vascular Insights: An Open Access Publication from the Society for Vascular Surgery. doi:10.1016/j.jvsvi.2024.100183
- Benadda I, Lozano-Franco R, Coutu F-A, et al. A Preliminary Assessment of Barriers and Facilitators to Accessing Foot Care in Homeless Shelters: A Scoping Review. Annals of Vascular Surgery. 2025;111:279- 289. doi:10.1016/j.avsg.2024.10.026
- CHAMPIONS: Comprehensive Heart and Multidisciplinary Limb Preservation Outreach Networks. 2025. https://www.championshealth.org/
- Creager MA, Matsushita K, Arya S, et al. Reducing Nontraumatic Lower-Extremity Amputations by 20% by 2030: Time to Get to Our Feet: A Policy Statement From the American Heart Association. Circulation. 2021;143(17):e875-e891. doi:doi:10.1161/CIR.0000000000000967
Lindsey Olivere, MD, is a vascular surgery resident at the University of Pittsburgh Medical Center (UPMC) in Pittsburgh, Pennsylvania.
