Standards of Performance
A resident will have one year of general surgical residency training before beginning formal urologic residency. On the basis of this general surgical training, the resident should be experienced in the care of patients who have had a wide spectrum of operative procedures, serious illness and trauma. The resident should be experienced in the operating room, be moderately facile with instruments and suturing and be able to perform general surgical procedures of minor to moderate complexity. The resident should have passed one annual In-Service Examination in General Surgery and be familiar with the literature and basic sciences pertinent to General Surgery. Upon arriving in Urology, the resident is expected to become familiar with all surgical procedures related to the genitourinary system. He or she is expected to read journal articles and textbook chapters related to the care of specific patients' diseases and surgical procedures. He or she is expected to become familiar with material and basic textbooks of urology, to study the AUA Update articles and to read and study regularly in The Journal of Urology. He or she is expected to be knowledgeable about the basic sciences related to Urology. Other reading and study may be assigned. The resident is expected to become competent in interpretation of various imaging studies including ultrasound and to learn the basics of urodynamics, andrology, lithotripsy and laparoscopy in addition to traditional urologic surgical procedures.
The annual in-service examination is administered by the American Urological Association and is required for all urology residents, unless exempted by the Program Director because of extenuating circumstances. There is no defined pass/fail standard, but each resident will be evaluated relative to their national peer group. Scoring above the 80th percentile will be considered an outstanding performance; 50 to 80th percentile will be considered good; 20 to 50th percentile will be considered acceptable, but in need of improvement; and scoring less than the 20th percentile will be considered inadequate and suggest the need for remedial studies and possible disciplinary action.
Residents will be provided with a broad exposure to outpatient and inpatient urology and will have vast opportunity to gain experience with surgical techniques and procedures. Residents are expected to dress and act in a professional manner and to be respectful with staff, fellow residents, nurses, patients, patient relatives and hospital employees. They should set an example of dedication to duty, honesty and patience. There is no place for losing ones temper.
By the end of the residency training, the resident will have a broad knowledge of the urologic literature and basic sciences related to urology. He or she will be a capable urologic surgeon who can practice urology independently. He or she will be prepared to enter private practice or pursue Fellowship training leading to a career in academic urology. Every effort will be made by the faculty to help the resident expand his or her experience, judgement, education, technical skills and ultimately his or her ability to become Board certified and function as a mature urologist.
Residents are expected to study research techniques and disciplines and will be expected to participate in one or more research activities. As part of this activity, each resident will take a turn at being responsible for the division research conferences.
Residents will be promoted to the second and then the third year of residency training when they demonstrate to the faculty that they are making satisfactory progress in the knowledge of urology in the development of appropriate skills. Also residents must pass the annual In-Service Examination given to all urologic residents. Their attitude, professional behavior and character will be assessed. At least twice annually the resident will meet with the Chief of Service to review progress.
PGY 1 - Urology/General Surgery
During this period the resident is expected to become familiar with the operating room and to learn to carry out simple and moderately complex general surgical procedures under supervision. The resident should be experienced in preoperative and postoperative patient management, managing patients in the intensive care setting, and evaluating patients prior to surgery. The resident should read extensively in general surgery, participate in rounds and conferences; however, the resident will sit for the Urology In-Service Examinations.
In the initiation to Urology, the resident will have a large experience in the pre-operative evaluation of urologic patients and postoperative care. The resident will participate as an assistant in a wide spectrum of urologic procedures and operations, and will carry out many procedures of mild to moderate complexity under the supervision of the Chief residents and faculty. He or she is expected to read extensively in assigned urologic texts, The Journal of Urology, AUA Urology Updates and to participate in all conferences. The resident will gain much experience with urologic imaging through x-ray conferences and will become familiar with urologic instruments. He or she will participate in urologic clinics at the University and VA Hospitals - under resident and faculty supervision. The resident is expected to begin a research project and to pass the annual in-service examination.
Assignments at the University and VA Hospital will be a continuation of the activities in Urology in the PGY-2 year. The resident in this year is expected to become experienced in cystoscopy, the use of catheters, lithotripsy, urodynamics, trans-rectal prostatic ultrasound and ultrasound-guided prostatic biopsies. He or she will gain experience in TUR of the prostate and TUR of bladder tumors as well as percutaneous renal procedures. The resident's surgical skills and experience will be expanded under the guidance and supervision of Chief Residents and faculty. He or she should continue research activity and the study of the urologic literature. The resident is again expected to pass the annual in-service examination.
During this year the resident will have a rotation to the Primary Children's Hospital. On this rotation, the resident will work closely with the pediatric urologic faculty on rounds, in clinics, and in the operating room. He or she will see patients in consultation and discuss findings and recommendations with the pediatric urologic faculty. He or she will learn pediatric urologic procedures and operations in the operating room. The resident will present the pediatric urology conference which is held twice monthly.
On the rotation to the Intermountain Medical Center during this year the resident is supervised by the Urology education director and will participate in surgery with the urologic clinical faculty. He or she will be the primary surgeon in more operative procedures and first-assist in many others. He or she will have an opportunity to evaluate preoperative patients and to follow postoperative patients. The resident will conduct the weekly urology conference and present the Intermountain Medical Center statistics at the monthly Morbidity and Mortality conference for the division.
Primary Children's Hospital and Intermountain Medical Center rotations are a continuation of the experience from the PGY-3 year. The resident will perform more complex procedures under supervision and will continue to function under the direction and supervision of the pediatric urologic faculty and the clinical faculty at the Intermountain Medical Center. During this year there is a six month research and outpatient procedure rotation. During this period the resident will be actively engaged in research projects and scholarly activity under the direction of the urologic faculty. The resident will participate in a routine weekend call schedule and fill in as needed for another resident who is ill or on vacation. Also during this six month period the resident will be actively engaged in outpatient procedures - specifically lithotripsy, transurethral ultrasound examination of the prostate and ultrasound guided biopsy and urodynamics. He or she will participate in andrology procedures, the andrology laboratory and working andrology conferences. He or she will acquire experience and knowledge of the state-of-the-art in andrology and fertility procedures.
PGY 5 - Chief Resident
This is the culmination of the urologic residency training. Each Chief Resident spends six months at the University Hospital and six months at the VA Hospital. In each institution the resident will assign junior residents, teach and supervise them and teach medical students assigned to Urology. He or she will carry out a great deal of major urologic surgery under the supervision of the faculty. The resident will supervise junior residents in other surgical procedures. He or she will supervise junior residents in rounds and clinics and review major problems and cases with the faculty. At the culmination of this year, the resident should be prepared for American Board of Urology Qualifying Examinations and should be prepared to enter urologic practice or pursue fellowship training on the way to an academic career.
All residents will be invited to attend all meetings of the Utah Urologic Society. Residents at the PGY-3, 4 levels will attend the annual AUA meetings. PGY-2 residents will generally attend the AUA - Basic Sciences in Urology meeting.
Residents may also attend meetings of the Western Section of the American Urological Association and the American Academy of Pediatrics - Urology section and other specialty society meetings if their papers are accepted for presentation at these meetings. Attendance at meetings is considered important as it allows residents to experience first hand the activities of Urology on a large academic level and to meet urologists from other parts of the country and throughout the world.