Evaluation of Urology Residency Training and Perceived Resident Abilities in the United States

Okhunov, Zhamshid; Safiullah, Shoaib; Patel, Roshan; Juncal, Samuel; Garland, Harwood; Khajeh, Nikta Rezakahn; Martin, Jeremy W.; Capretz, Taylor; Cottone, Courtney; Jordan, Mark L.; McDougall, Elspeth M.; Clayman, Ralph V.; Landman, Jaime

doi:10.1016/j.jsurg.2019.02.002

Cited by 64 publications

(45 citation statements)

References 29 publications

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“… 9 , 17 , 18 Based on survey data, nearly all residency programs have surgical training facilities with various forms of simulation. 4 Moreover, there is increasing work and interest in developing urologic training curricula with the use of simulation. 19 , 20 , 21 For example, the EAU Section of Robotics has developed a validated 12-week training program for robotic prostatectomy.…”

Section: Discussionmentioning

confidence: 99%

“…A correlative study design was used to evaluate the association between (1) workforce demand and perceived resident competency, and (2) workforce demand and ACGME case requirements. For this analysis, 3 distinct data sets were used, including: (1) the 2017 Medicare Part B National Summary Data File; (2) the 2017 National Data Report published by the ACGME; and (3) a graduating resident survey from Okhunov et al 4 …”

Section: Methodsmentioning

confidence: 99%

“…Finally, survey data from Okunov et al 4 were used to determine if graduating resident perceived readiness for practice was correlated with urology workforce demand. In this study, a 45-item survey was administered to residents in their chief year or within five years of graduation.…”

Section: Methodsmentioning

confidence: 99%

“…In a study by Okhunov et al, for example, 61% of recent residency graduates reported not being able to independently perform a robot assisted laparoscopic prostatectomy. 4 These findings are especially concerning in the face of an anticipated workforce deficit, driven by projections showing an alarming shortage of urologists over the coming decades 5 , 6 , 7 and an aging patient population that has increased urologic need. 8 …”

Section: Introductionmentioning

confidence: 99%

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Aligning Urology Residency Training With Real-World Workforce Needs

Cruz

Skolarus

Ambani

et al. 2021

Journal of Surgical Education

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Objective Research suggests recently graduated urology residents do not feel ready for independent practice. We conducted a study to determine if Accreditation Council for Graduate Medical Education (ACGME) minimum case requirements, resident case logs, and graduating resident perceived readiness for practice are aligned with the procedural demand and needs of the current urology workforce. Design Correlative study comparing the association between (1) workforce demand and ACGME case requirements, and (2) workforce demand and perceived resident competency. Three distinct datasets were used; (1) the 2017 Medicare Part B National Summary Data File; (2) the 2017 National Data Report published by the ACGME; and (3) a graduating resident survey from Okhunov et al. Setting N/A. Participants N/A. Results In 2017, there were a total of 6,784,696 urologic cases performed through Medicare. We found nonsignificant positive associations between resident case logs (rho = 0.16, p = 0.5784), ACGME minimum procedure requirements (rho = 0.42, p = 0.1255), and Medicare procedural demand. Our 15 index procedures accounted for 21.1% (n = 1,431,775) of all Medicare cases, with a median number of 7706 procedures. Endopyelotomy was the least common procedure (n = 98), while cystoscopy was the most common (n = 980,623). Medicare case volume was positively correlated with graduating residents’ procedural confidence (r = 0.86, p < 0.0001). We identified four categories with varied alignment of training and demand: (1) high volume and high confidence, (2) high volume and low confidence, (3) low volume and high confidence, and (4) low volume and low confidence. Conclusions Optimizing urology residency training is time-sensitive and important. Using national Medicare data coupled with recently graduated urology resident survey results, we provide a guiding framework for improving the alignment of training with workforce demand. Informed by these results, we recommend altering training requirements to reflect these needs.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Aligning Urology Residency Training With Real-World Workforce Needs

Cruz

Skolarus

Ambani

et al. 2021

Journal of Surgical Education

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“…4 The USA urology residency programs last for 5 or 6 years, depending on the institution. 5 Urological training in India is a 3-year program after having compulsorily completed 3 years in general surgery. 6 It is practically impossible to receive training in all subspecialties of urology (endourology, reconstructive urology, andrology, pediatric urology, uro-oncology, urogynecology) during a urology residency, and most urology residents tend to acquire skills in endourology only.…”

Section: Introductionmentioning

confidence: 99%

Cadaveric Penile Prosthesis Workshop training improves surgical confidence levels of urologists: South Asian Society for Sexual Medicine course survey

Krishnappa¹,

Srini²,

Shah

et al. 2020

Int J of Urology

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Objectives: To analyze the impact of South Asia's first cadaveric hands-on workshop on urologists' training in inflatable penile prosthesis surgery. Methods: A total of 72 urologists/andrologists participated in the 2019 South Asian Society for Sexual Medicine Pre-congress Penile Prosthesis hands-on workshop. The workshop included 4 h of lectures and 2 h of hands-on cadaveric laboratory experience using three-piece inflatable penile prosthesis. The Shapiro-Wilk test was used on selfrated procedural confidence levels, which proved the normality. A non-parametric McNemar test was used to examine the change in the number of correct answers. Results: Of those who attended the cadaver laboratory, just 45 who answered the survey both before and after the workshop were included for analysis. Significant objective improvements were noted in procedural knowledge test scores (44.30 AE 0.027 vs 72.44 AE 0.024, P < 0.05) and median surgical confidence levels (4 vs 3 and 2, P < 0.001) of the urologists after the completion of the workshop. Conclusions: Cadaveric hands-on workshop training improves urologists' procedural knowledge and surgical confidence levels in carrying out three-piece inflatable penile prosthesis surgery. The feasibility of such workshops should be considered in increasing the surgical expertise of general urologists in prosthetic urology.

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Current exposure to Female Pelvic Medicine and Reconstructive Surgery faculty during urology residency

Wang

Smith

et al. 2023

Neurourology and Urodynamics

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IntroductionContemporary US resident exposure to Female Pelvic Medicine and Reconstructive Surgery (FPMRS) faculty during urology residency is unknown.MethodsAccredited US urology residencies were identified through the American Urological Association (AUA). Accredited, urology‐based FPMRS fellowships were identified through the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction. The number of faculty and residency positions were obtained from program AUA profiles if they were last modified within the current application cycle; this information was obtained from program websites if AUA profiles were outdated. Data on faculty fellowship training was manually extracted from program websites. A quality control cross‐check of program and faculty training characteristics was performed through direct communication with 5% of programs.ResultsOf 139 accredited residency programs assessed, 10.8% were affiliated with an accredited, urology‐based FPMRS fellowship. In total, 29.5% of residency programs, representing 25% of US urology residents, had neither a FPMRS fellowship nor any FPMRS certified faculty. The national FPMRS faculty‐to‐resident ratio was 1:10.8, and 7.4% of faculty at all residency programs were FPMRS certified. In comparison, faculty‐to‐resident ratios for other subspecialties were: 1:4.7 for pediatrics, 1:3.6 for oncology, 1:5.9 for minimally invasive surgery/endourology, 1:14.2 for trauma/reconstruction, and 1:11.8 for andrology or male sexual/reproductive health. The FPMRS faculty‐to‐resident ratio was 1:5.1 in programs with a urology‐based FPMRS fellowship compared with 1:13.4 in programs without a FPMRS fellowship.Conclusions30% of US urology residency programs lack FPMRS trained faculty. Even when FPMRS faculty are on staff, the field is often underrepresented relative to other urologic subspecialties. Further studies are required to ascertain if inadequate exposure to FPMRS cases and mentors during training contribute to the shortage of urology residents who choose to specialize in FPMRS. This link has important implications for the current shortage of FPMRS providers.

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Evaluation of Urology Residency Training and Perceived Resident Abilities in the United States

Cited by 64 publications

References 29 publications

Aligning Urology Residency Training With Real-World Workforce Needs

Aligning Urology Residency Training With Real-World Workforce Needs

Cadaveric Penile Prosthesis Workshop training improves surgical confidence levels of urologists: South Asian Society for Sexual Medicine course survey

Current exposure to Female Pelvic Medicine and Reconstructive Surgery faculty during urology residency

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