The educational experience of the urology resident provides a foundation of basic research, basic clinical skills, scientific knowledge, and attitudes necessary for the development of competence as a practicing urologist. The appropriate clinical skills are emphasized by discussions of methodology and closely supervised on-the-job training intended to establish an attitude of confidence and a continuing life-long desire for learning.
The facilities to develop these objectives are abundant and state-of-the-art. The urology service has several thousand hospital admissions annually and approximately 24,000 outpatient visits, providing exposure to the complete spectrum of urologic disorders in adult and pediatric patients. In the course of their training, our urology residents perform over 3,000 surgical procedures representative of the principals of all types of urologic surgery. This large clinical volume places our program over the 90th percentile nationally for major adult and pediatric urology cases.
The six-year training program has the following educational goals:
- Become familiar with the development of an hypothesis-driven research plan
- Develop competency with the design and execution of specific sets of experiments
- Become competent in data analyses and interpretation
- Develop competency in the recording, writing and reporting of specific sets of research results.
Year 2 (General Surgery)
- Become familiar with the initial assessment of patients who may be considered surgical candidates.
- Become familiar with the preoperative assessment of surgical patients.
- Develop competency in the postoperative management of surgical patients.
- Develop competency in basic operative skills.
Year 3 (Clinical Urology)
- Become familiar with common urologic operative procedures and postoperative management of urologic patients.
- Develop competency with office-based diagnosis and treatment of common urologic conditions. This includes familiarity with urinalysis, urologic ultrasound/prostate biopsy, (TRUS Bx) cystoscopy, and urodynamics.
- Master urologic diagnostic procedures including cystoscopy, ureteroscopy, retrograde pyelography, and stent placement.
- Develop a basic knowledge of the pathophysiology and diagnosis of urologic disease states.
- Become competent in the management of common outpatient urologic problems and urologic emergencies.
- Develop competency in basic urologic surgical procedures such as scrotal and testicular surgery as well as the endoscopic management of urologic disease including ureteroscopic treatment of stone disease.
Year 4 (Clinical Urology)
- Develop competency in the evaluation and management of common pediatric urologic conditions and familiar with common pediatric urologic procedures and postoperative care of pediatric patients.
- Develop additional competency in the endoscopic management of urologic disease including TURP.
- Demonstrate competency in ESWL and metabolic stone evaluation.
- Develop additional competency in open surgical procedures, demonstrating an ability to adapt basic surgical skills to a variety of urologic procedures with sound intraoperative decision making.
Year 5 (Clinical Urology)
- Demonstrate a mastery of routine adult and pediatric urologic diagnosis and treatment.
- Demonstrate a high level of competency in open and endoscopic surgery.
- Develop the independent medical and surgical judgment necessary to enter the chief residency year.
- Develop diagnostic and management expertise in the subspecialty areas of urologic oncology, neurourology/female urology, and demonstrate competency in the evaluation and treatment of male infertility.
Year 6 (Chief Residency)
- Demonstrate competency in complex urologic operative procedures such as radical cancer surgery, reconstructive urology, and laparoscopy.
- Demonstrate the leadership ability, management skills, and interpersonal skills to independently operate a busy urologic practice.
- Function as an effective teacher to more junior residents.
Basic Urology Curriculum
Urology residents are expected to acquire knowledge in the field of urology in at least the following ways: didactic lectures and clinical conferences, in the care of patients in the clinic, hospital, and operating room, guided by attending supervision and in self-study. The department has an established basic urology curriculum that is a comprehensive coverage of the major fields of urology including (1) anatomy and evaluation of the urologic patient, (2) renal and adrenal physiology/pathophysiology and renal transplantation, (3) oncology, (4) female/neurourology, (5) BPH, (6) infectious disease, (7) sexual function and dysfunction, (8) trauma/reconstruction, (9) stone/endourology, (10) infertility and (11) pediatric urology.
The curriculum is designed to follow a two-year cycle such that during the course of the full urology training, residents will have completed a complete curriculum several times before graduation. In addition to the core curriculum weekly conference, the department conducts urology grand rounds, which cover a host of topics germane to the practice of urology. A weekly indications/case presentation conference is also held wherein upcoming surgical cases are discussed in detail in an educational format. In addition to these weekly conferences, the department also conducts a monthly journal club, multidisciplinary conference, and a monthly morbidity and mortality conference.
Research and Scientific Presentations
All residents in the urology training program are required to engage in scholarly activity. This is accomplished through one year of research. If a resident possesses specific talents that lend themselves to participation in an ongoing basic scientific research project throughout the residency, and if it is approved by the appropriate faculty, then permission will be granted for these special cases. Residents are expected to have at least one publication in order to satisfactorily complete the training program. In fact, most residents will complete a number of projects and present their findings at national and regional meetings. All residents are required to present two researched topics (in didactic lecture form) at the Wednesday morning conference each year of their residency. In addition, a standard resident travel policy exists in which residents are funded for approved meetings if he or she is presenting an academic paper or participating in an academic program. Intermediate level urology residents are also supported to attend the annual American Urological Association Basic Science Review Course.