The Specific Aims of this Application reflect the two stated purposes for which this Award was developed: 1) to improve the quality of clinical, educational, and research programs in vascular disease; and 2) to encourage the professional development of the awardee so that he can serve as the focal point for multidisciplinary interactions in the field of vascular medicine. Regarding Specific Aim 1, the Proposal outlines the manner in which a recently established multidisciplinary approach to vascular diseases will be strengthened in each of the above-indicated areas. The clinical program, which has from its inception included a multidisciplinary approach to patients with vascular disease, will be strengthened by the focussed inclusion of pulmonary vascular disease; expanded emphasis on risk-factor modification; creation of a formal vascular consultation service; organization of a centralized follow-up system for medically, surgically, and non-treated patients; and initiation of an outreach program within the local community. The educational program, which currently includes a weekly seminar series, monthly journal club, and traditional undergraduate elective opportunities, will be expanded to include monthly evening seminars in vascular medicine for physicians in the metropolitan area; tutorial opportunities for practicing physicians; a formal two-year fellowship program in vascular medicine; a formal elective in vascular medicine for medical and surgical house staff; a formal rotation in Vascular Medicine for all fellows training in Cardiology; and off-semester electives for medical students. The research program, which presently includes participation in multi-center clinical trials of thrombolytic therapy, medical therapy, and novel revascularization modalities, will continue to search for new opportunities in these areas, while at the same time maintaining a tenacious commitment to on-going laboratory research in vascular biology. Progress in all three aspects of the Institutional Program will be monitored by a select group of individuals comprising an Internal Advisory Committee, and a separate External Advisory Committee, consisting of extra-institutional experts in Vascular Disease. Regarding Specific Aim 2, the Institution has generously agreed to protect fully 50% of the Applicant's time to accomplish the goals outlined in this Proposal. Furthermore, the Institution, by guaranteeing a sincere collaboration among relevant disciplines, has created the environment required for refinement of clinical skills in the diagnosis and treatment of vascular disease. Finally, by renovating and equipping facilities for clinical and laboratory research, the Institution has provided the Applicant with the tools necessary to perform and guide investigations of vascular disease.
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