We are the referral center for the state of Kentucky and surrounding regions. Our population has a very high incidence of occlusive/aneurysmal pathology, and they present with advanced disease. Our fellows perform a high volume of cases, and their case logs routinely are over the 90th % in complex cases. Our volume and case mix requires us to have two vascular surgery inpatient services. The trainees, AAPs, and faculty rotate on both services.