VASCULAR-SURGERY - THE BURR UNDER THE SADDLE

A decade ago vascular surgery ''came of age'' with formalization of accreditation of training programs and certification of subspecialists in the field. These events created turbulence in general surgery, with initial resistance to further subspecialization and fragmentation of the specialty. Subsequent reassessment of the trends in general surgery and its subspecialty disciplines has led to a reaffirmation of the integrity of the parent specialty. Recent proposals for reforms in resident training in general surgery and its subspecialties are currently being evaluated. Despite the current rapprochement between general and vascular surgery, many challenges remain for both disciplines. Atl surgeons, regardless of specialty, should broaden their respect for both ''microscience,'' particularly molecular biology, and ''macromedicine,'' including epidemiology, preventive medicine, and health services research.