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J Surg Educ. 2019 Feb 22. pii: S1931-7204(18)30762-1. doi: 10.1016/j.jsurg.2019.02.002. [Epub ahead of print]

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

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Department of Urology, University of California, Irvine, Orange, California. Electronic address:
Department of Urology, University of California, Irvine, Orange, California.
University of British Columbia, Gordon and Leslie Diamond Health Care Centre, Vancouver, British Columbia, Canada.



To identify differences and potential deficiencies in urology residency training programs in the United States as they are perceived by residents/recent graduates and program directors.


A 45-question and 38-question survey was sent to chief residents/recent graduates and program directors, respectively, at all 120 US urology programs regarding prior medical education, urologic training curricula, and perceived surgical proficiency, among other topics.


Survey response rate was 58% and 52% for residents and program directors, respectively. Responses regarding program characteristics (e.g., salary, vacation) and research training were similar between program directors and residents. However, their responses regarding skills training and subspecialty training (e.g., robotics and pediatrics) differed substantially. Program directors reported the availability of advanced skills trainers (robot-88%, laparoscopic-86%), whereas fewer residents felt they were available (robot 54% and laparoscopic 72%). The same discrepancies persisted with questions about subspecialty exposure (e.g., program directors reported 48% renal transplant experience vs. 13% reported by residents). Most residents felt comfortable performing essential urology procedures (e.g., cystoscopy/ureteroscopy, open nephrectomy). In contrast, the majority expressed a lack of confidence in performing unsupervised advanced minimally invasive procedures (e.g., laparoscopic and robotic partial nephrectomy, endopyelotomy). Among the responding residents, 72% pursued fellowship training; nearly two-thirds of these residents chose to enter fellowship in order to overcome perceived training deficiencies.


Program directors and residents have differing perceptions regarding the education and resources associated with US urology residency training programs. US graduates of urology residency programs express a perceived lack of confidence in several procedures that are commonly encountered in a general urologic practice.


American Council of Graduate Medical Education, ACGME; Fellowship; Internship; Medical Knowledge; Medical education; Next Accreditation System, NAS, Society of Urologic Chairpersons and Program Directors, SUCPD; Patient Care; Professionalism; Residency curriculum; Residency training; Urology residency

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