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To address the increasing shortage of qualified residents, which leads to further discontent and additional on-call rotations for the remaining physicians, an analysis of the current situation was performed. Stress in the daily working routine, not enough free time, too little pay, or too little compensatory time off for overtime as well as inadequate options for continuing education were reported to be the main elements of dissatisfaction. The economic pressure of day-to-day work continues to define the physician's role and places demands on the medical staff by burdening them with nonmedical and administrative tasks.The major causes mentioned were staff shortage and lack of support provided by supervisors and the administration. For this reason, human resource development should be considered a strategic and central goal. This requires a normative, cross-functional approach at all levels of management and inclusion of personnel departments in the strategic processes of the hospital. The most important aspects for resident satisfaction were the work environment, acceptable work-life balance and remuneration, compensation for overtime, and quality of available continuing education, which is often rated as being insufficient.Effective strategies to improve the motivation of residents comprise offering opportunities for structured continuing education, optimizing the everyday work processes, and involving employees in social networks. The establishment of feedback strategies, including recognition of residents' achievements, will help to ensure their loyalty and identification with their clinic. This can serve as a preventive measure to offset any potential willingness to change jobs.

During the 106th "Deutschen Arztetag" (German Medical Assembly) in 2003 new model further training regulations were finalized. Further training was to be more clearly arranged and the targets more clearly defined. There are no uniform training regulations for Germany. The new training regulations promise more clarity: the numbers of the individual interventions and investigations are no longer specified. Instead operation groups which are connected with respect to content and organization in a defined minimum are to be identified. The new further training regulations are geared to a process orientation. For the first time trainers and trainees have the possibility to actively work together in the further training process. The joint logbook"Urological further training" from the GeSRU (German Society of Residents in Urology), DGU (German Society for Urology) and BDU (Professional Association of German Urologists) is a milestone in Germany. The further training will be continuously improved through constant evaluation.

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