Department of Urology
Last Updated: 1/29/02
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Goals & Objectives:

The general goals for the teaching program are to provide for the residents a balanced educational experience in the cognition, attitudes, and skills necessary for modern urologic practice.  This assumes that upon the conclusion of such education, residents will be qualified to deliver high quality care to urologic patients.  The general objective of our program for urology resident education is to ensure that each resident masters the educational program and that this will be accomplished through the implementation of a fully-developed curriculum that most effectively utilizes the skills of a highly-qualified and experienced faculty, the available patient population and all of the participating institutions facilities and resources.

 

Specific Goals and Objectives for Urology Resident Education for Each Resident Assignment

 

URO-1/PGY-2.  During the first year of urology, residents are assigned for 8 months to the VA Hospital and 4 months to the University rotation (UT-MED Hospitals). Goals and objectives for these two rotations are similar and therefore reflect the goals and objectives for the entire first year of urology training. In order to build a foundation for their urologic training, the goals and objectives for urology residents are to accumulate a knowledge base in the following:

 

 An appreciation of urologic anatomy and an understanding of the pathophysiology of urologic conditions and diseases such as; hydronephrosis, voiding dysfunction, bladder outlet obstruction, renal functional disorders, calculus disease, neurogenic disease, cancer, trauma, infectious diseases, and congenital conditions. Acquire an understanding of the various presentations of urologic diseases and conditions.  Develop an understanding of the indications and contraindications for urological diagnostic studies. Acquire appropriate skills in the performance of a urologic history and physical examination, the ability to formulate reasonable differential diagnoses, the proper use of urologic diagnostic studies, and selection of appropriate treatment programs, especially for ambulatory patients.

 

Develop the abilities to provide appropriate pre- and post-operative care, having been provided the opportunity to observe the hospitalization care and/or surgical care of the these patients.

 

During the first year of urologic training, the resident will acquire the following urological diagnostic and surgical skills:

 

Cystoscopy and associated diagnostic studies such as retrograde pyelography

Therapeutic endoscopic procedures such as internal urethrotomy, fulguration of   

     bleeding, bladder biopsies, and bladder lithotripsy

Transurethral prostatic resection of medium sized adenomas

Uncomplicated ureteroscopy with and without stone extraction

Placement and removal of ureteral stents

Scrotal and inguinal operative procedures including scrotal trauma and testicular torsion

Penile surgery including circumcision, trauma surgery and therapy of priapism

Bladder surgery including, but not limited to, repair of injuries, partial cystectomy, and 

    cystostomies

Pelvic lymphadenectomy

Ureterolithotomies

Pyelolithotomy

Simple open prostatectomies

 

During the first year of urology training, the resident will develop and demonstrate attitudes which will enhance providing the best possible care for urological patients, which support acceptable standards of medical ethics, and which provide personal professional satisfaction.

 

URO-2/PGY-3.  Second year urology residents are assigned for 4 months to Methodist Hospital, 4 months to the pediatric service of LeBonheur Children's Medical Center, and return for 4 months to the University rotation.  Specific goals and objectives for these three rotations are outlined below.

 

Methodist Hospital.  During this rotation, the residents are responsible for the urologic care, diagnostic evaluation, and operative procedures performed on non-private patients either admitted directly to this institution or seen by the resident in the non-private Urology Clinic.  The objectives of the rotation are for the residents to attain confidence in his/her abilities to manage a urologic service, under supervision, by providing appropriate pre- and post-operative care, operative care, and continuity of care during a 4 month rotation.  During this rotation, the resident is under the supervision of the assigned faculty.  An additional objective of the rotation is for the resident to acquire additional fundamental urologic knowledge, particularly applicable to urologic subspecialization.  The resident will acquire additional surgical skills such as:

 

Percutaneous renal surgery

Laparoscopic urologic procedures

Radical prostatectomy

Radical cystectomy

Radical nephrectomy

Nephrolithotomy

Retroperitoneal lymph node dissection

Surgery of incontinence

 

LeBonheur/St. Jude Rotation.  For most of the residents, this rotation represents the first direct exposure to pediatric patients since their pediatric experience as a medical student.  Therefore, a significant objective of this rotation is to provide the resident with an understanding of the basic principles and nuiances of pediatric care.  The resident is to acquire knowledge especially of congenital anomalies and the embrologic basis of these anomalies, an appreciation for the diagnosis and treatment of ambulatory pediatric problems such as enuresis, incontinence and urinary tract infections, the indications and contraindications for diagnostic studies and the pre and post-operative management of pediatric patients.  The resident will acquire knowledge specific for hospitalized pediatric patients, with particular attention to associated urological problems.  During this rotation, the resident will acquire the following clinical skills applicable to pediatric urology:

 

Cystoscopy and associated diagnostic studies

lnguinal and scrotal operative procedures

Penile and urethral surgery such as circumcision, meatotomy, chordee’, and uncomplicated hypospadias

Uncomplictaed ureteral reimplantations

 

University Rotation.  The resident will build upon the knowledge base established as a Uro-2 trainee.  During this rotation, the resident will expand this knowledge base to include areas of subspecialization such as infertility, impotence, bladder dysfunction, renal diseases, adrenal dysfunction, medical aspects of renal stone disease, and sexual dysfunction.  A further objective of this rotation is to provide the resident with a higher level of clinical responsibility, decision making, and a more thorough understanding of urological trauma.  The resident will acquire skills necessary in providing urologic consultation services and the appropriate ajudication of these consults.  The resident will acquire the following surgical skills during this rotation:

 

Complex stone disease

Ileal and colonic urinary diversion

lnvasive therapy of priapism

Uncomplicated renal surgery

Transurethral resection of bladder tumors

Transurethral resection of larger adenomas and for those patients with significant

     co-morbidities

Complicated ureteroscopy

Penile prostheses

 

URO-3/PGY 4: This year serves as a precursor for their senior year by increasing the responsibility expectations of this level resident.  This will be the first time they actually manage a smaller service with a lower level resident. This serves as a prelude to their upcoming senior year. Third year urology residents are assigned for 4 months to the University, Methodist Hospital and the VA Urology Spinal Cord Injury and Stone Center.  Specific goals and objectives for these rotations are outlined below:

 

 University Rotation.  During this rotation, the PGY-4 resident is responsible for the urologic care, diagnostic evaluation, and operative procedures performed on non-private patients either admitted directly to these institutions or seen by the resident in the non-private Urology Clinic.  The objectives of the rotation are for the resident to attain confidence in his/her abilities to manage a urologic service, under supervision, by providing appropriate pre- and post-operative care, operative care, and continuity of care during a 4 month rotation.  During this rotation, the resident is under the supervision of the  Drs. Clair Cox and Robert Wake.  An additional objective of the rotation is for the resident to acquire additional fundamental urologic knowledge, particularly applicable to urologic subspecialization.  The resident will acquire additional surgical skills such as:

 

Percutaneous renal surgery

Laparoscopic urologic procedures

Radical prostatectomy

Radical cystectomy

Radical nephrectomy

Nephrolithotomy

Retroperitoneal lymph node dissection

Surgery of incontinence

 

 VA Urologic Spinal Cord-Stone Center Rotation.  The specific objective of this rotation is for the resident to acquire additional knowledge in neurogenic diseases of the genitourinary tract, urodynamics, and renal stone disease.  The resident will acquire this knowledge under the direction of Dr. Ragi Wiygul (neurology and urodynamics) and Dr. Robert Wake (endourology). The resident will acquire skills in specialized urologic procedures such as:

 

Evaluation and management of complex urologic problems in the spinal cord 

     injury population

Complicated percutaneous stone surgery

Complicated ureteroscopy with stone extraction and lithotripsy

ESWL

Complicated open renal stone surgery

Bladder augmentation

Single and multiple stage urethroplasty

Reconstructive urology

 

 Methodist Rotation.  This is the first opportunity for this level resident to function as a chief resident.  It is a prelude to their senior year.  The faculty maintains a supervisory role, but the resident will manage the service and participate in the education of the junior resident on the service.  This is an exciting rotation for the residents as they continue to develop. 

 

 URO-4/PGY-5: During the fourth and final year of the urology program, residents serve as chief for 4 months at the University, VA and LeBonheur Children’s Hospital.

 

Goals and objectives for the final year of training are for the resident to assume in a responsible manner the administrative requirements of a chief resident.  As a chief, residents will assume a commanding role and actively pursue a fine tuning of their service.  Although the faculty maintains a supervisory role, chief residents will manage their respective services and will participate in the education of junior residents on their service.  Having built a solid foundation of urologic knowledge and clinical expertise, chief residents, although still responsible to the faculty, will be capable of independently managing their respective services.  Additional surgical expertise will be acquired as follows:

 

Complicated hypospadias repair

Complicated renal surgery

Bilateral ureteral reimplantation

Fulguration of posterior urethral valves

Transurethral resection of prostatic adenomas in excess of 60 grams

Transurethral resection of large bladder tumors

Continent urinary diversion

Pelvic exenteration

Adrenal surgery

Laparoscopic surgery and reconstructive/female urology

The Department of Urology

The University of Tennessee Health Science Center

Text Box: Residency