Urology Policy and Procedures - Policy 2 - Competency-Based Goals and Objectives can be found in the Urology Residency Handbook
There is a gradual step-wise increase of responsibility in the program. PGY1 Urology Interns are responsible only for their own activities in order to help them adjust to life as a house officer and learn the important skills and knowledge which is the basis of their career. PGY2 residents have some added responsibility to supervise some student teaching and to see urologic consults initially. They still gather information organize and present it to staff physicians but are given more complex tasks and responsibility. PGY3 residents are in more complex environments with more independent time to perform their work. They have some independence to organize their daily activities and can chose in some instances which cases to participate. PGY4 residents have the first opportunity to run a service at the VA and learn how to direct younger residents and student learning activities. They will work with infertility and men’s health and spend time on the urogynecology service which provides a considerable amount of complex pelvic floor surgical experience in both the inpatient and outpatient settings, and with the uro-oncology service for urologic care. As PGY5s, residents function as a Chief Resident participating in the most complex urologic cases and directing the junior residents and student learning activities in each hospital. They also assume more responsibility in organizing the educational activities of the Department by helping organize conferences and participating in the resident selection process.
PGY1 Urology Intern – Surgery Rotation at University and UofL Health Jewish Hospitals (6 months)
The internship year is a standard one year rotating surgical internship with rotations on critical care, general surgery, vascular surgery, and trauma among others. The interns are given typical duties to perform such as: initial history and physical exams, seeing floor and emergency department consults, and performing perioperative floor management. They take some in house call and some home call depending on the service. They attend General Surgery Conferences and take the AUA In-service exam in the spring. Their responsibilities are basically data gathering, learning to master medical records and IT systems, patient evaluation, medical management of surgical patients and basic surgical skills.
Educational Goals
Learn perioperative surgical care, critical care, and fluid and electrolyte management.
Learn basic surgical techniques.
Learn basic physical examination and history taking skills.
Learn basic data management.
Learn how to function as part of a clinical care team.
Learn principles in general surgery, vascular surgery and transplantation.
Educational Objectives- By the end of the PGY1 year the resident should be able to:
Perform basic initial evaluation of surgical patients.
Perform basic perioperative care for surgical patients in general surgery, vascular surgery, and transplantation
Provide critical care of surgical patients including lines, monitors, and ongoing evaluation.
Assist with minor and major surgical procedures.
Learn general surgical principles and participate in the general surgery in-service exam.
Start their personal operative log to be continued throughout training.
Perform as an effective part of the system-based practice of medicine.
PGY1 Urology Intern – Urology Rotation at University Hospital (2 months)
Educational Goals
University of Louisville School of Medicine will provide a learning environment for the care, treatment and follow up of urology patients in the environments which includes but not limited to pre, per and post-operative settings. PGY1 residents will learn surgical basic science, including fluids, electrolytes, wound healing and nutrition, will be emphasized. Clinically, residents will assess surgical pathology pre-operatively, develop clinical judgment on managing these issues, and learn operative skills to address the problem. Careful postoperative care and follow up will be emphasized.
Educational Objectives
Medical Knowledge
1. Describe the components of a focused genitourinary history and physical examination in evaluating the following urologic problems:
a. pain
b. hematuria
c. dysuria
d. urinary incontinence
e. flank masses
f. penile lesions
g. testicular masses
h. prostate nodule or enlargement
i. elevated P.S.A. (prostate specific antigen)
j. urinary retention
2. Discuss the evaluation and management of the following urologic infections:
a. cystitis
b. pyelonephritis
c. prostatitis
3. Discuss the management of urologic trauma involving the following:
a. penis/urethra
b. scrotum
c. bladder
d. ureter
e. kidney
4. Summarize the indications for diagnostic procedures/imaging in urology including:
a. renal/bladder ultrasonography (U/S)
b. CT urogram (CTU)
c. retrograde urethrography (RUG)
d. cystography (VCUG)
e. transrectal ultrasound (TRUS)
f. nuclear renal scan (MAG-3, DMSA)
g. arteriography
h. MRI
5. Discuss the nature and indication for the following therapeutic procedures:
a. bladder catheterization
b. use of Coude-tip foley catheters
c. urethral meatotomy
d. suprapubic cystostomy (SP tube)
e. percutaneous nephrostomy (Perc tube)
f. bed side flexible cystoscopy
6. Discuss the following conditions including the embryology and management of the following:
a. hypospadias
b. ureteropelvic junction obstruction (UPJ obstruction)
c. vesico-ureteral reflux (VUR)
d. posterior urethral valves
e. myelomeningocoele and its urologic sequelae
f. cryptorchidism (undescended testicle)
g. infant hernia/hydrocele
h. febrile UTI
i. pediatric trauma
7. Describe the types of incisions and exposure required for the following operations:
a. nephrectomy
b. radical cystectomy
c. radical retropubic prostatectomy
d. renal transplantation
e. simple vs radical orchiectomy
f. basic laparoscopy, port placement, camera/bed side assistance
8. Discuss the management of renal, ureteral and bladder calculi.
9. Discuss common peri-operative complications and their management of the following operations:
a. radical retropubic prostatectomy (RRP)
b. renal transplantation
c. radical cystectomy
d. bladder augmentation
e. transurethral resection of the prostate (TURP)
f. laparoscopic vs open nephrectomy
Patient Care
Establish basic proficiency in providing pre-operative and post-operative care (writes appropriate pre-op and post-op orders for floor patients, informed consent, handles nursing calls appropriately, and manages most routine post-operative care with minimal intervention by supervisor). Take an appropriate history to evaluate patients with urological issues to include:
A complete history of present illness
Presence of any co-morbidities
A review of social and family history impacting the present problem
A complete review of systems thorough physical examination including digital rectal examination
Develop a proficiency in evaluation and interpretation of the different diagnostic modalities including: X-rays, ultrasounds, CT scans, Contrast studies and MRIs.
Discuss treatment options, risks and potential complications of patients with urological issues.
Assist in the performance of urology procedures. Opening and closure of the abdomen in layers. Recognize and manage postoperative surgical complications, deep venous thrombosis including wound infection, dehiscence and leaks, lymphocele, seroma and hematoma formation.
Demonstrate skill in basic surgical techniques, including:
Knot tying
Exposure and retraction
Knowledge of instrumentation
Incisions
Closure of incisions
Handling of graft material including mesh
Establishing penumoperitoneum
Handling of laparoscopic instruments
Handling of the laparoscopic camera
Coordinate pre and post-surgical operative care for patients in the urology rotation.
Assist in closure of surgical incisions and exhibit competency in suture technique.
Be able to apply and remove all types of dressings.
Make and close a variety of incisions and tie knots using sterile technique.
Professionalism
The resident should be receptive to feedback on performance, attentive to ethical issues and be involved in end-of-life discussions and decisions.
Understand the importance of honesty in the doctor-patient relationship and other medical interactions.
Treat each patient, regardless of social or other circumstances, with the same degree of respect you would afford to your own family members.
Learn how to participate in discussions and become an effective part of rounds, attending staff conference, etc.
Complete all assigned patient care tasks for which you are responsible or provide complete sign out to the on-call resident.
Maintain a presentable appearance that sets the standard for the hospital this includes but is not limited to adequate hygiene and appropriate dress. Scrubs should be worn only when operating or while on call.
Assist with families of critically injured/ill patients and guidance of families towards or through difficult decisions.
Demonstrate mentoring and positive role-modeling skills.
Provide an appropriate orientation and guide all medical student as to their roles and responsibilities during the rotation.
Provide an appropriate orientation to other PGY 1's that are about to rotate through the urology service.
Systems-Based Practice
Understand, review, and contribute to the refinement of clinical pathways
Understand the cost implications of medical decision-making
Partner with health care management to facilitate resource efficient utilization of the hospital's resources.
Describe in general terms the benefits of clinical pathway implementation
Develop a cost-effective attitude toward patient management
Develop an appreciation for the benefits of a multi-disciplinary approach to management of critically ill surgical patients.
Comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations regarding patient privacy and confidentiality.
Demonstrate knowledge in steps and conduct during major surgical procedures.
Have clear indications and know when it is appropriate to perform a surgical procedure.
Have an understanding of when it is not appropriate to operate.
Demonstrate knowledge of steps to be taken to have a patient ready for surgery including pre-op workup and medical clearance.
Gain knowledge in developing and executing a quality improvement project with in urology and across the services.
Recognize the importance of patient safety, quality and satisfaction.
Practice Based Learning & Improvement
Demonstrate the ability to:
Evaluate published literature in critically acclaimed journals and texts
Apply clinical trials data to patient management
Participate in academic and clinical discussions
Accept responsibility for all dimensions of routine patient management on the wards
Apply knowledge of scientific data and best practices to the care of the surgical patient
Facilitate learning of medical students and physician assistant students on the team.
Use the University of Louisville library and databases on on-line resources to obtain up to date information and review recent advances in the care of the surgical patient.
Demonstrate a consistent pattern of responsible patient care and application of new knowledge to patient management.
Demonstrate a command and facility with online educational tools.
Interpersonal & Communication Skills
Work as effective team members
Cultivate a culture of mutual respect with members of nursing and support staff
Develop patterns of frequent and accurate communication with team members and attending staff
Gain an appreciation for both verbal and non-verbal communication from patients and staff
Demonstrate consistent respectful interactions with members of nursing and support staff
Demonstrate consistent, accurate and timely communication with members of the surgical team
Demonstrate sensitivity and thoughtfulness to patient’s concerns, and anxieties.
The resident will demonstrate the ability to provide and request appropriate consultation from other medical specialists.
PGY1 Urology Intern – Pediatric Urology Rotation at Norton Children's Hospital (one month)
This rotation is the resident’s first exposure to pediatric urology in a freestanding, full service children’s hospital. They will evaluate and work up patients in the ambulatory surgery service, outpatient clinics, spina bifida multidisciplinary clinics, private offices, floor and emergency consults. They will learn indications and uses of urodynamics in children. They will be closely supervised and work one-on-one with faculty. Their responsibility will grow as their skill and knowledge expands.
Educational Goals
a. Learn basics in pediatric urologic disease and conditions.
b. Learn perioperative care in children with urologic disease
c. Learn objectives and interpretation of urodynamics in children.
Educational Objectives
a. Develop basic laparoscopic and endourology skills.
b. Develop understanding of basic urodynamic evaluation and interpretation.
c. Present and discuss cases in conference.
PGY1 Urology Intern – Vascular/Interventional Radiology Rotation at University Hospital (15 days)
Educational Goals
Patient care: residents should provide compassionate, appropriate, and effective care for health problems and should make efforts to promote health.
Obtain relevant history from patient or medical record, when indicated, to optimize IR studies. If appropriate, perform focused physical exam and write a complete pre-procedure note.
Describe clinical indications and techniques for the most frequently utilized IR procedures.
Demonstrate an ability to synthesize a management plan based on a combination of scintigraphic, radiological and clinical data.
Interview patients to obtain pertinent clinical history needed for procedure consent.
Demonstrate proper technique in planning and performing basic IR procedures.
Competently perform post procedure patient assessment.
Medical Knowledge: residents should be knowledgeable, scholarly, and committed to lifetime learning.
Learn to operate angiography table and controls.
Learn how to set up and use angiography sterile tray.
Learn sterile techniques, including pre-procedure scrub and patient preparation and dressing
Learn basic anatomy (external and fluoro) for standard procedures.
Learn peripheral venous and arterial access techniques including Seldinger technique.
Learn hemostasis with manual compression techniques.
Learn the indications, techniques, and contraindications for image-guided drainages and biopsies.
Understand and perform proper filming sequences to document procedure technique and findings.
Describe frequent pathological findings seen on the most common types of IR studies. Demonstrate an ability to recognize and understand the significance of pathological findings associated with those exams.
Interpersonal and Communication Skills: residents should communicate and teach effectively.
Communicate effectively and interact appropriately with all IR technology and nursing staff.
Show sensitivity to and effectively communicate with patients. Obtain informed consent, when indicated.
Produce reports that are accurate, concise, and grammatically correct after having reviewed IR studies with faculty.
Perform appropriate basic consultations with referring physicians after having reviewed studies with faculty. Recognize, communicate, and document in the medical record urgent or unexpected findings or complications.
When appropriate, effectively teach residents, medical students, and other healthcare professionals.
Practice-based Learning and Improvement: residents should investigate and evaluate patient care practices, and appraise and assimilate scientific evidence in order to improve their practices.
Review the studies and interpretation of procedures performed by other members of the department during your rotation.
Watch and study the technique used by more experienced radiologists during your rotation to learn from them.
Review any complications or poor outcomes that occurred in the division during your rotation to learn the root cause of the problem and develop and implement mechanisms to avoid the complications or poor outcomes in the future.
Recognize and correct personal errors.
Incorporate positive and negative feedback into improved performance.
Utilize information technology to investigate clinical questions and for promotion of continuous self-learning.
Systems-based Practice: residents should understand healthcare practice.
Review for appropriateness any requests for procedures that the technology staff are uncertain about.
Demonstrate knowledge of cost effectiveness in imaging practices, including appropriate utilization of high cost imaging procedures such as arteriography.
Attend multi-disciplinary conferences when appropriate.
As per hospital policy: Confirm that you have the correct patient with two identifiers before starting a procedure. Confirm that you are about to perform procedure on the correct side before starting procedure.
Use hospital information system to obtain laboratory data needed prior to study.
Ensure that the personnel caring for the patients on the clinical units are aware of special orders or other preparation needed prior to study e.g. infusing platelets. As per hospital policy: For telephone orders, have appropriate personnel write down orders and read it back to you.
Be certain that arrangements have been made to have patient transported to the special procedures suite.
Be certain that the personal caring for the patients on clinical units are aware of needed follow-up care. As per hospital policy: For telephone orders, have appropriate personnel write down orders and read it back to you.
Educational Objectives
Basic peri-procedural care
Basic vascular access techniques
Appropriate patient work-up
Basic vascular anatomy (i.e., interpretation)
PGY1 Urology Intern – Anesthesia Rotation at University Hospital (15 days)
Educational Goals
Understand basic of anesthesia machine and routine monitors (pulse oximetry, capnography, circuits, oscillometric blood pressure cuffs, electrocardiogram)
Understand basics of neuromuscular blockade (relaxants, train-of four monitoring, reversal) Understand use of routine vasoactive drugs
Understand the indication for commonly used anesthetic drugs
Understand major hemodynamic and respiratory effects of routine anesthetic agents and their indications Understand comprehensive examination and classification of the airway
Understand key preoperative findings in history, physical, and laboratory work
Understand application of “Universal Precautions” and aseptic technique Advanced Cardiac Life Support certification
Present cases to faculty and colleagues with details of: how a patient’s problems were analyzed what basic science information was pertinent to the case how resolutions were developed how the resolutions were ordered in significance
Communicate to patients and their families in term that they can understand the relevance of the patient’s medical condition to anesthesia
PGY1 Urology Intern – Nephrology Rotation at University Hospital (1 month)
Educational Goals
The interns will develop the skills to evaluate, diagnose and manage inpatients referred to the Nephrology consult service and outpatients evaluated, followed and treated in the Nephrology clinics under the supervision of teaching attending physicians.
The interns will observe the performance of and learn to perform as indicated the diagnostic and therapeutic procedures required for the evaluation and care of patients referred to the Nephrology consult service or outpatient clinics.
The interns will learn to effectively employ interpersonal and communication skills in a professional manner during the rotation on the Nephrology consult service and outpatient clinics.
Educational Objectives
Recognize common clinical presentations and cardinal manifestations of diseases encountered on the Nephrology inpatient consult service or the Nephrology outpatient clinics to formulate initial clinical impression and a prioritized patient care plan
Demonstrate comprehensive evaluation, presentation and, documentation skills including history taking, physical examination, laboratory evaluation and diagnosis of patients referred to the Nephrology consult or outpatient service
Effectively employ medical knowledge to formulate evaluation and management plan for patients referred to the Nephrology consult or outpatient service under the supervision of fellow and attending physician
Learn to appropriately select, recommend and interpret laboratory tests and other ancillary resources necessary for the evaluation and management of inpatients referred to the Nephrology consult service or the outpatient clinics under the supervision of fellow and attending physician.
Learn to effectively and efficiently provide evaluation and management recommendations to the primary physician of patients referred to the Nephrology consult service under the supervision of the fellow and attending physician
Develop the skills to evaluate and manage patients as a consulting physician and learn to communicate in a professional manner with the primary referring physician under the supervision of the fellow and attending physician.
Plan and perform in a safe manner the appropriate diagnostic and therapeutic procedures necessary for the evaluation and management of patients referred to the Nephrology service under the supervision of the fellow and attending physician.
Demonstrate exemplary attitude and develop effective communication skills towards patients, their families, colleagues and members of the multidisciplinary Nephrology team including support staff, and learn to apply these skills to improve patient care and own performance by asking supervisors for feedback.
PGY2 – University Hospital (3 months)
At this level the residents are given more responsibility to participate in surgery and clinics. They see urology consults in the hospital, outpatient clinic and emergency department. They prepare patients for ambulatory urologic procedures and begin to master basic urologic surgical skills such as endoscopy and genital surgery. They begin to assist in major urological procedures. They are given responsibility to help in student educational activities and are given instruction in all ACGME core competencies including medical knowledge, patient care, practice based learning and improvement, professionalism, system-based practice, and interpersonal skills and communication. In short they are expected to begin to learn how to function as a member of the urologic team and the larger health care system as urologists.
Educational Goals
Learn basics of urologic diseases.
Learn basic skills of lower urinary endoscopy.
Learn basic skills of ultrasonography including transrectal ultrasound of the prostate and prostate biopsy.
Learn basic teaching skills for medical students and house officers.
Learn how to read and evaluate urologic literature.
Develop abilities to work with other members of the health care system.
Gain an introductory understanding of multidisciplinary urologic cancer care.
Educational Objectives - By the end of the PGY2 year the resident should be able to:
Demonstrate knowledge of the basic principles of common urologic diseases.
Perform cystoscopy, bladder biopsies, and ureteral catheter insertion under supervision of attending staff.
Place urethral catheters in patients.
Dilate urethral strictures.
Perform basic ureteroscopy including diagnostic and therapeutic procedures including laser lithotripsy, upper tract biopsy, and fulguration.
Provide perioperative care for urology patients.
Provide inpatient and outpatient care for patients under supervision of attending staff.
Provide care for the patient with GU trauma including evaluation, monitoring, surgical care, and medical management.
Perform increasingly difficult surgical tasks such as scrotal surgery, minor urological procedures, abdominal wound opening and closing, and first assisting in abdominal and flank surgery.
Identify and develop a project for clinical research and one for system-based learning.
Continue to develop communication skills and coordination skills between members of the health care system.
Submit at least one abstract to a national meeting.
PGY2 - VA Hospital Junior Resident (6 months)
At this level the residents are given more responsibility to participate in surgery and clinics. They see urology consults in the hospital, outpatient clinic and emergency department. They prepare patients for ambulatory urologic procedures and begin to master basic urologic surgical skills such as endoscopy and genital surgery. They begin to assist in major urological procedures. They are given responsibility to help in student educational activities and are given instruction in all ACGME core competencies including medical knowledge, patient care, practice based learning and improvement, professionalism, system-based practice, and interpersonal skills and communication. In short they are expected to begin to learn how to function as a member of the urologic team and the larger health care system as a urologist.
Educational Goals
Learn basics of urologic diseases.
Learn basic skills of lower urinary endoscopy.
Learn basic skills of ultrasonography including transrectal ultrasound of the prostate and prostate biopsy.
Learn basic teaching skills for medical students and house officers.
Learn how to read and evaluate urologic literature.
Develop abilities to work with other members of the health care system.
Gain an introductory understanding of multidisciplinary urologic cancer care.
Educational Objectives - By the end of the PGY2 year, the resident should be able to:
Demonstrate knowledge of the basic principles of common urologic diseases.
Perform cystoscopy, bladder biopsies, and ureteral catheter insertion under supervision of attending staff.
Place urethral catheters in patients.
Dilate urethral strictures.
Perform basic ureteroscopy including diagnostic and therapeutic procedures including laser lithotripsy, upper tract biopsy, and fulguration.
Provide perioperative care for urology patients.
Provide inpatient and outpatient care for patients under supervision of attending staff.
Provide care for the patient with GU trauma including evaluation, monitoring, surgical care, and medical management.
Perform increasingly difficult surgical tasks such as scrotal surgery, minor urological procedures, abdominal wound opening and closing, and first assisting in abdominal and flank surgery.
Identify and develop a project for clinical research and one for system-based learning.
Continue to develop communication skills and coordination skills between members of the health care system.
Submit at least one abstract to a national meeting.
PGY3 – University Hospital - Jewish Hospital (3 months)
Residents are given the responsibility to perform more independently and to keep their own daily schedule. They will see patients in a variety of settings such as floor and emergency room consults, clinics, and private offices. They have some ability to choose which cases in which to participate. In addition, the rotation provides a considerable amount of complex urologic surgical experience and time in the geriatric urology clinic. We expect the rotation to provide geriatric and rehabilitation urology experience in both the inpatient and outpatient settings.
Educational Goals
Develop a more complex knowledge of urologic disease.
Assume more responsibility in surgical cases.
Learn basic laparoscopic principles.
Gain preliminary familiarity with robotic surgery of the urinary tract.
Gain expertise in urologic oncology diagnosis and management.
Educational Objectives
Develop basic laparoscopic and endourology skills.
Develop more advanced endoscopic skills such as TUR of prostate and more complex bladder tumors.
Perform outpatient urologic surgical perioperative management.
Perform ambulatory surgeries such as ESWL, cystoscopy, bladder biopsies, TURBT, ureteroscopy, vasectomies, TRUS/BX.
Develop understanding of basic urodynamic evaluation and interpretation.
Evaluate overall progress through urologic in-service examination.
Present and discuss cases in conference.
Perform more complex duties in patient care coordination and intra-service communication.
Submit at least one abstract to a national meeting.
PGY3 – Norton Hospital (3 months)
At this level the residents are given more responsibility to participate in surgery and clinics. They see urology consults in the hospital and emergency department. They prepare patients for ambulatory urologic procedures and begin to master basic urologic surgical skills such as endoscopy and genital surgery. They begin to assist in major urological procedures. They are given responsibility to help in student educational activities and are given instruction in all ACGME core competencies including medical knowledge, patient care, practice based learning and improvement, professionalism, system-based practice, and interpersonal skills and communication. In short they are expected to begin to learn how to function as a member of the urologic team and the larger health care system as urologists.
Educational Goals
Learn basics of urologic diseases.
Learn basic skills of lower urinary endoscopy.
Learn basic skills of ultrasonography including transrectal ultrasound of the prostate and prostate biopsy.
Learn basic teaching skills for medical students and house officers.
Learn how to read and evaluate urologic literature.
Develop abilities to work with other members of the health care system.
Gain an introductory understanding of multidisciplinary urologic cancer care.
Educational Objectives - By the end of the PGY3 year the resident should be able to:
Demonstrate knowledge of the basic principles of common urologic diseases.
Perform cystoscopy, bladder biopsies, and ureteral catheter insertion under supervision of attending staff.
Place urethral catheters in patients.
Dilate urethral strictures.
Perform basic ureteroscopy including diagnostic and therapeutic procedures including laser lithotripsy, upper tract biopsy, and fulguration.
Provide perioperative care for urology patients.
Provide inpatient and outpatient care for patients under supervision of attending staff.
Provide care for the patient with GU trauma including evaluation, monitoring, surgical care, and medical management.
Perform increasingly difficult surgical tasks such as scrotal surgery, minor urological procedures, abdominal wound opening and closing, and first assisting in abdominal and flank surgery.
Identify and develop a project for clinical research and one for system-based learning.
Continue to develop communication skills and coordination skills between members of the health care system.
Submit at least one abstract to a national meeting.
PGY3 - Norton Children’s Hospital Resident (6 months)
This rotation is the resident’s opportunity to learn pediatric urology in a freestanding, full service children’s hospital. They will evaluate and work up patients in the ambulatory surgery service, outpatient clinics, spina bifida multidisciplinary clinics, private offices, floor and emergency consults. They will participate in all levels of pediatric urologic surgery. They will learn indications and uses of urodynamics in children. They will learn outpatient management of urologic disease. They will be closely supervised and work one-on-one with faculty. Their responsibility will grow as their skill and knowledge expands.
Educational Goals
Develop a more complex knowledge of urologic disease.
Learn basics in pediatric urologic disease and conditions.
Learn perioperative care in children with urologic disease
Learn basics of pediatric urologic surgery.
Learn basic laparoscopic principles.
Develop understanding of evaluation and management of outpatient urologic conditions in children.
Learn objectives and interpretation of urodynamics in children.
Educational Objectives
Develop basic laparoscopic and endourology skills.
Perform pediatric urologic procedures such as circumcision, scrotal/groin surgery, hypospadias, pyeloplasty and surgery for reflux.
Perform outpatient urologic surgical perioperative management.
Perform ambulatory surgeries such as ESWL, cystoscopy, ureteroscopy, and genital surgery.
Develop understanding of basic urodynamic evaluation and interpretation.
Evaluate overall progress through urologic in-service examination.
Present and discuss cases in conference.
Perform more complex duties in patient care coordination and intra-service communication.
Submit at least one abstract to a national meeting.
PGY4 - Chief Resident at VA Hospital (6 months)
This is the resident’s first opportunity to run a service and direct the activity of junior residents and student activities. They have responsibility to organize clinics and to take more independence in evaluating and deciding on management options in the clinic. The will take a more advanced role in the operating room and will help assist junior residents in less complex surgical cases under the supervision of faculty. They will make management decisions about medical and perioperative care of urology patients both in and out of the hospital.
Educational Goals
Increase knowledge of general urologic disease.
Expand involvement in complex urological surgical cases.
Develop problem solving skills for diagnosis and management of urologic disease.
Develop initial skills at management of a service at the VA Hospital.
Increase teaching skills.
Increase understanding of health care system.
Present results of system-based learning project.
Learn advanced multidisciplinary management of urologic cancer.
Educational Objectives - By the end of the PGY4 year the resident should be able to:
Manage common outpatient urologic conditions.
Perform as the chief resident at the VA Hospital.
Evaluate overall progress through urologic in-service examination.
Present and discuss cases in conference.
Submit one manuscript for publication.
Assume a leadership role in Campbell’s Conference.
Assume a leadership role in planning some case conferences.
Refine interpersonal skills and system-based learning skills.
Participate in resident candidate interview process.
Submit at least one abstract to a national meeting.
PGY4 - Resident at University/Norton Downtown/Norton Audubon/Baptist East/PMC (6 months)
During this six-month rotation, four months are spent on service at Norton Audubon hospital and two months on the urogynecology service. The resident will participate with full time and clinical faculty some of whom specialize in oncology, fertility, impotence, female urology, urodynamics and urologic reconstruction. At this point the resident is expected to act in a responsible manner and to organize their time to maximize this variety of teaching opportunities. The rotation provides a considerable amount of complex pelvic floor surgical experience and extensive female/pelvic floor dysfunction and complex urodynamic experience in both the inpatient and outpatient settings.
Educational Goals
Learn principles of infertility including evaluation and management options.
Develop basic skills in microsurgery.
Learn principles of urodynamics, female urology, pelvis floor dysfunction
Learn urologic care of renal transplantation.
Increase knowledge of general urologic disease.
Expand involvement in complex urological surgical cases.
Learn principles of geriatric urology, female urology, and the multidisciplinary approach to these problems.
Learn urologic principles of rehabilitation medicine.
Develop problem solving skills for diagnosis and management of urologic disease.
Increase teaching skills.
Increase understanding of health care system.
Educational Objectives
Participate in evaluation and management of urologic conditions in transplant patients.
Participate in surgery for infertility and impotence.
Participate in geriatric urology and female urology clinics and surgeries.
Participate in urologic consultation of rehabilitation medicine patients.
Participate in evaluation and management of female urinary incontinence, pelvis floor dysfunction, prolapse of female pelvic organs and learn performance and interpretation of complex urodynamics.
Evaluate overall progress through urologic in-service examination.
Present and discuss cases in conference.
Submit one manuscript for publication.
Assume a leadership role in Campbell’s Conference.
Assume a leadership role in planning some case conferences.
Refine interpersonal skills and system-based learning skills.
Participate in resident candidate interview process.
Submit at least one abstract to a national meeting.
PGY5 - Chief Resident at University Hospital (6 months)
This rotation carries with it the most administrative responsibility because of the size of the teaching service and presence of medical students. The resident is expected to organize the patient care and teaching aspects of the service. They are expected to supervise the floor work and emergency department and floor consultations under the supervision of the faculty. They are expected to learn the most complex and challenging surgical and medical care. They have responsibility to help with the teaching efforts of the Department and the selection of new residents. Teaching is an important part of their assignment and they are expected to learn how to develop and present a short medical lecture. They will participate in and help organize a multidisciplinary urologic cancer clinic at the Brown Cancer Center. Due to acute drop in clinical and operative experience at University Hospital the Chief Resident will spend Monday and Friday at Physicians Medical Center. The learning experience will focus on urologic oncology in a same day surgery setting.
Educational Goals
Become proficient in the pathophysiology of urologic diseases.
Mature in surgical skills to the level of primary surgeon.
Learn administrative skills and responsibility to run a teaching service.
Supervise resident team and organize student activities.
Develop speaking and organizational skills necessary to be a medical speaker.
Learn practice issues such as coding, compliance, regulatory, legal and ethical aspects of urology.
Learn advanced interdisciplinary cancer management with radiation oncology and medical oncology.
Learn advanced GU trauma management.
Educational Objectives
Master all aspects of urologic conditions and disease including pathophysiology, evaluation and management.
Prepare successfully for Part 1 of the ABU Qualifying Exam.
Organize teaching conferences for the department including Journal Club and the resident lecture series.
Participate and help organize multidisciplinary cancer conferences.
Develop and enforce the resident call schedule.
Supervise and lead medical student activities and teaching on service.
Refine surgical skills in the most complex cases such as radical prostatectomy, cystectomy and various forms of diversion, partial nephrectomy, reconstructive pediatric procedures and adult reconstruction.
Evaluate overall progress through urologic in-service examination.
Evaluate and discuss the comparative aspects of academic and private practice opportunities.
Express proficiency in all ACGME core competencies including medical knowledge, patient care, practice-based learning and improvement, professionalism, system-based practice, and interpersonal skills and communication.
Submit at least one abstract to a national meeting.
PGY5 Chief Resident at Norton/Norton Children's and UofL Health Jewish Hospitals (6 months)
This rotation involves supervising the junior residents and students on service with the help of the full time clinical faculty. The volume of surgical cases is remarkable and there is a variety which includes complex urologic cancer, complex stone disease, complex female urology and incontinence, and general urology. The Chief is expected to participate in the Departmental educational functions and selection of new residents. They will develop skills in robotic surgery, advanced laparoscopy and endourology. They have ability to direct their daily participation in various urologic activities.
Educational Goals
Become proficient in the pathophysiology of urologic diseases.
Mature in surgical skills to the level of primary surgeon.
Learn and develop robotic surgical skills.
Learn administrative skills and responsibility to run a teaching service.
Supervise resident team and organize student activities.
Learn advance urodynamic evaluation and analysis.
Learn advanced female urology and incontinence evaluation and management.
Develop speaking and organizational skills necessary to be a medical speaker.
Learn practice issues such as coding, compliance, regulatory, legal and ethical aspects of urology.
Learn advanced interdisciplinary cancer management with radiation oncology and medical oncology.
Educational Objectives
Master all aspects of urologic conditions and disease including pathophysiology, evaluation and management.
Prepare successfully for Part 1 of the ABU Qualifying Exam.
Organize teaching conferences for the department including Journal Club and the resident lecture series.
Participate and help organize multidisciplinary cancer conferences.
Develop and enforce the resident call schedule.
Supervise and lead medical student activities and teaching on service.
Master advanced surgical procedures in incontinence and female urology.
Refine surgical skills in the most complex cases such as radical prostatectomy, cystectomy and various forms of diversion, partial nephrectomy, reconstructive pediatric procedures and adult reconstruction.
Evaluate overall progress through urologic in-service examination.
Evaluate and discuss the comparative aspects of academic and private practice opportunities.
Express proficiency in all ACGME core competencies including medical knowledge, patient care, practice-based learning and improvement, professionalism, system-based practice, and interpersonal skills and communication.
Submit at least one abstract to a national meeting.
PGY5 - Chief Resident at Baptist East Hospital
This elective rotation is to focus on index urologic cancer cases particularly radical cystectomy. The volume of radical cystectomy at this site is about 25 cases a year. They will develop skills in open and robotic approaches to urologic cancer.
Educational Goals
Become proficient in the pathophysiology of urologic cancer.
Mature in surgical skills to the level of primary surgeon.
Learn and develop robotic surgical skills.
Learn advanced interdisciplinary cancer management with radiation oncology and medical oncology.
Master all aspects of urologic conditions and disease including pathophysiology, evaluation and management.
Refine surgical skills in the most complex cases such as radical prostatectomy, cystectomy and various forms of diversion, partial nephrectomy, reconstructive pediatric procedures and adult reconstruction.
Express proficiency in all ACGME core competencies including medical knowledge, patient care, practice-based learning and improvement, professionalism, system-based practice, and interpersonal skills and communication.
Educational Objectives
Master all aspects of urologic conditions and disease including pathophysiology, evaluation and management.
Refine surgical skills in the most complex cases such as radical prostatectomy, cystectomy and various forms of diversion, partial nephrectomy, reconstructive pediatric procedures and adult reconstruction.
Express proficiency in all ACGME core competencies including medical knowledge, patient care, practice-based learning and improvement, professionalism, system-based practice, and interpersonal skills and communication.