The Urology Residency Program in Israel—Results of a Residents Survey and Insights for the Future

Abstract

ObjectiveUrology practice has undergone several changes in recent years mainly related to novel technologies introduced. We aimed to get the residents’ perspective on the current residency program in Israel and propose changes in it.MethodsA web-based survey was distributed among urology residents.Results61 residents completed the survey out of 95 to whom it was sent (64% compliance). A total of 30% replied that the 9 months of mandatory general surgery rotation contributed to their training, 48% replied it should be shortened/canceled, and 43% replied that the Step A exam (a mandatory written certifying exam) in general surgery was relevant to their training. A total of 37% thought that surgical exposure during the residency was adequate, and 28% considered their training “hands-on.” Most non-junior residents (post-graduate year 3 and beyond) reported being able to perform simple procedures such as circumcision and transurethral resections but not complex procedures such as radical and laparoscopic procedures. A total of 41% of non-junior residents practice at a urology clinic. A total of 62% of residents from centers with no robotics replied its absence harmed their training, and 85% replied they would benefit from a robotics rotation. A total of 61% of residents from centers with robotics replied its presence harmed their training, and 72% replied they would benefit from an open surgery rotation. A total of 82% of the residents participated in post-graduate courses, and 81% replied they would engage in a clinical fellowship.ConclusionGiven the survey results we propose some changes to be considered in the residency program. These include changes in the general surgery rotation and exam, better surgical training, possible exchange rotations to expose residents to robotic and open surgery (depending on the availability of robotics in their center), greater out-patient urology clinic exposure, and possible changes in the basic science period.

Laparoscopic Training in Urology Residency Programs: A Systematic Review

“…In terms of experience in laparoscopy during residency, there is a generalized feeling amongst residents that training is inadequate, with most residents having a low degree of confidence in independently performing laparoscopic procedures by the end of residency [4,5,6,7,8,9,10,11]. The only exception is the study by Preston et al [10] where 67% of Canadian responders considered their experience to be good or extensive.…”

“…The studies analyzed reported considerable differences in terms of exposure to laparoscopy during residency programs [4,5,6,7,8,9,10,11]. The article by Furriel et al [9] reported that 25% of respondents from European Union Urology residency programs do not have access to laparoscopy.…”

“…From a total of 238 reports identified, 8 articles that complied with the previously defined inclusion criteria, comprising a total of 985 residents [4,5,6,7,8,9,10,11] were included. Table 1 summarizes the information on the included articles.…”

“…It was answered by 61 residents. On average, residents were not confident in independently performing laparoscopic procedures (on a scale from 1 to 5, 1.35 for partial nephrectomy and 1.67 for radical nephrectomy), with only final year residents showing a higher degree of confidence in independently performing those procedures (2.5 and 2.75, respectively) [4]. No information was provided on the actual exposure to laparoscopy during the residency or the future expectations regarding laparoscopy [4].…”

“…The article by Lavi et al [4] was based on a survey of the urology residency program in Israel. It was answered by 61 residents.…”