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Department of
Urology |
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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 |
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