Urology resident objectives.doc

Abbreviated Core Urology ObjectivesPGY 3-5 and PGY 1-2 on Urology Rotation

PGY 1 and 2 core objectives found at http://meds.www.queens-urology.ca Further rotation specific objectives for core residents can be found in the Urology Syllabus

PGY 1-2 Urology rotation

Medical Expert/Knowledge-based and procedural-based competencies

evaluation and principles of management of a patient with hematuria (microscopic and gross) evaluation of a patient with acute renal, bladder or urethral injury and principles of management diagnosis and treatment of a patient with urinary infection including: acute cystitis and pyelonephritis,

recurrent cystitis, persistent urinary tract infection, prostatitis (acute and chronic) and epididymo-orchitis diagnosis and management of a patient with a common urological malignancy including the treatment

options for the various stages of carcinoma prostate, bladder, testis and kidney with an understanding of the multidisciplinary approaches to these disease processes including the palliative care of a patient with advanced stage metastatic carcinoma

diagnosis and management of a patient with urinary obstruction (prostatic, bladder neck or ureteric) diagnosis and management options for a patient with urolithiasis (including acute renal colic and chronic

renal calculi) evaluation and diagnosis of the common paediatric urological problems including hydrocele,

cryptorchidism, ureteropelvic junction obstruction and vesicoureteric reflux evaluation and diagnosis of various forms of urinary incontinence diagnosis and management of various scrotal masses including hydrocele, epididymal cysts, orchitis, testis

tumor, varicocele, torsion testis or appendages principles and practice of renal transplantation - including organ harvesting including multi-organ

harvesting, organ preservation, implantation and immunosuppression psychological and emotional aspects of urological diseases including the emotional implications of a

diagnosis of malignant disease, anaesthetic hazards in the elderly and in the management of acute confusional states in the elderly, medical/legal and ethical issues arising in urological patients with respect to transplantation, infertility and impotence evaluation, and the awareness of the concept of body image in surgical patients.

Principles of Preoperative Assessment of the Surgical Patient

routine preoperative assessment of surgical patient with particular reference to patients with renal disease assessment of patients with various co-morbidities (cardiac, pulmonary, renal and metabolic) examination and management of a patient in shock (septic due to urinary infection vs. hypovolemic,

neurogenic, cardiogenic shock)

Emergency Urological Care:

management of the patient with an acute ureteric colic management of the patient with acute urinary infection including a patient with urosepsis management of a child with an acute scrotum principles of management of a patient with urological trauma suprapubic catheterization

Technical Skills:

catheterization including urinary catheter care. urethral manipulation and dilatation using filiforms and followers cystoscopy installation of intravesical therapeutic agents wound closure vasectomy (if resident is so interested)

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introduction to therapeutic technologies including electrosurgery, Extracoporeal Shock Wave Lithotripsy, lasers in urology (carbon dioxide, Nd/YAG, Holmium-YAG).

DIAGNOSTIC SKILLS:

Urinalysis, including routine urinalysis, urine culture techniques, urinary collections for metabolic studies and urine cytologic studies Renal function tests Adrenal function tests Tumor markers – e.g. alpha-feto protein, b-HCG, PSA, etc. Radiological Studies Including intravenous excretory urography voiding cystourethrography Ultrasonography – including doppler studies Radioisotope Studies CT scanning and MRI Scanning of the urinary tract

Communicator

The resident will be able to:Establish therapeutic relationships with patients and families and primary care givers.Obtain and synthesize relevant history from patients, families and communities.Listen effectively.Record accurately and succinctly data collected from patients, laboratory tests and radiological studiesDiscuss appropriate information with patients and families and the health care team.Be sensitive to patients fears, anxieties and needs for privacy

Collaborator

The resident will be able to:Consult effectively with other physicians and health care professionals.Contribute effectively to other interdisciplinary team activities.

Manager

The resident will be able to:Utilize personal resources effectively to balance patient care, learning needs and outside activities.Understand health care resources are finite Work effectively and efficiently in a health care organization.

Health Advocate

The resident will be able to:Identify the important determinants of health affecting patients with urological disease.Recognize those issues where advocacy may be appropriate.

Scholar

The resident will be able to:Develop a personal continuing education strategy to ensure life-long professional growth.Critically appraise sources of medical information.Facilitate learning of patients, housestaff/students and other health professionals.To use information technology to optimize patient care, life-long learning and other activities

1. Demonstrate continuing evaluation of their own capabilities and limitations.2. Develop techniques for continuous improvement, information acquisition and information handling and

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participate in the quality improvement and quality assurance programs of the institutions in which they practice.

3. Maintain an inquisitive attitude, and understand the time commitment required for ongoing self-study for the maintenance of competence.

4. Demonstrate the use of data bases for literature searches and reviews.5. Formulate a research plan to answer clinical problems.6. Understand the ethics of animal and human experimentation.7. Describe basic statistical methods used in clinical trials.8. Residents will be able to critically evaluate reports of clinical trials and research protocols. All residents

must demonstrate an ability to incorporate gender, cultural and ethnic perspectives in research methodology, data presentation and analysis.

Professional

The resident will be able to:Deliver highest quality care with integrity, honesty and compassion.Exhibit appropriate personal and interpersonal professional behaviours.Practice medicine ethically consistent with the obligations of a physician.

PGY 3 Urology

ROTATION SPECIFIC OBJECTIVESFIRST 4 MONTHS


The following is a listing of disease entities, diagnostic and surgical skills that are commonly included in the specialty of urology. This list is not meant to be inclusive but an example of the knowledge and skills that the junior resident should be able to demonstrate by the completion of the first 4 month rotation.

Congenital and Developmental AbnormalitiesCystic Diseases of the KidneyHorseshoe Kidney and Other Renal AnomaliesScrotal and External Genital Anomalies

Obstructive Disease of the Lower Urinary TractBladder Outflow ObstructionBenign Prostatic HypertrophyLower Urinary Tract Symptoms (“LUTS”)

Urinary Calculus DiseaseRenal and Ureteral Calculi

Urinary and Genital Infections, and Sexually Transmitted Disease Bacterial (complicated and uncomplicated) and non-bacterial cystitis and urethritis

Pyelonephritis and other renal infections

Trauma(including the management and evaluation of a patient with multisystem trauma involving the GU Tract and the role of the urologist in multidisciplinary approach to multisystem trauma)

Renal TraumaUreteral Trauma

Urological Oncology

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For tumors (benign and malignant) of the genito-urinary tract, the junior resident should be able to describe the etiology, prevention, nutritional and environmental aspects of urologic malignant disease, including the natural history, histology and pathology.

Renal cell carcinoma - etiology (including von Hippel Lindau syndrome)Transitional Cell Carcinoma of the bladderAdenocarcinoma of the prostate:

Voiding Disorders including Relevant NeurourologyUrinary incontinence (including stress urinary incontinence, urgency incontinence, total incontinence)Enuresis

DIAGNOSTIC SKILLS

The junior resident will understand the indications for the following investigative techniques of specific importance to the practice of urology, and the physiologic basis for each study.

Urinalysisa. routine urinalysis b. urine culture techniquesc. urinary collections for metabolic studiesd. urine cytologic studies

Biochemical Serum Studies a. Renal function testsb. Adrenal function testsc. Tumor markers – e.g. alpha-feto protein, b-HCG, PSA, etc.

Imaging StudiesThe junior residents will demonstrate knowledge of the application of each of the following techniques to particular clinical situations, including the indications, interpretation, potential complications and management of complications for each technique, and the use of appropriate contrast agents when indicated:

Intravenous excretory urographyVoiding cystourethrographyUltrasonography -

The principles and application of ultrasound techniques for imaging: kidney bladder

Radioisotope Studies -The indications, application to clinical urology, principles, pharmacokinetics and application of radiopharmaceuticals used in:

renal imaging (including function studies)

CT scanning and MRI Scanning of the urinary tract

Diagnostic HistopathologyThe resident will be able to describe and recognize the gross and microscopic characteristics of the following:

malignant lesions of the kidney - renal cell carcinoma, Wilm's tumorbenign lesions of the kidney - oncocytoma, angiomyolipomaurothelial neoplasms of the renal pelvis, ureter, bladder and urethra

Surgical SkillsEndoscopic Procedures:

Cystoscopy and urethroscopy, ureteric catheterization including ureteric stent insertion and removal, retrograde pyelographyUrethral dilatation and visual internal urethrotomyTransurethral biopsy of bladder and urethra

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Open SurgeryCircumcisionSuprapubic catheterizationUrethral meatotomy, meatoplastyScrotal surgery - hydrocele, epididymal cyst, epididymectomy, simple orchidectomyLaparotomy

Communicator

General Requirements:Establish therapeutic relationships with patients and families and primary care givers.Obtain and synthesise relevant history from patients, families and communities.Listen effectively.Discuss appropriate information with patients and families and the health care team.

To achieve these objectives, the junior residents must develop the ability to:1. Record accurately and succinctly data collected from patients, laboratory tests and radiological studies and

to communicate conclusions based on these data to referring physicians and other involved health care personnel;2. Be sensitive to patients fears, anxieties and needs for privacy;

3. Be able to explain clearly and concisely:a. management plans to other health care personnel in a way that ensures their effective participation; b. steps necessary for problem management when acting as a consultant for other

physicians, particularly in the situation of consults in the emergency room or on the telephone with primary care givers.

c. Ensure adequate information has been given to the patient prior to undergoing an invasive procedure

Collaborator

General Requirements:Consult effectively with other physicians and health care professionals.Contribute effectively to other interdisciplinary team activities.

To achieve these objectives, the junior resident must develop the ability to:1. Interact effectively with:

a. personnel in community service agencies,b. other health care personnel, for example, attending in discharge planningC. PATIENTS FROM ALL VARYING LIFESTYLES, SOCIOECONOMIC BACKGROUNDS AND VALUE

SYSTEMS ALWAYS RESPECTING THE CONFIDENTIALITY OF THE PATIENT-PHYSICIAN RELATIONSHIP. (IE. CLINICS IN MOOSE FACTORY)

2. Accept responsibility for participation in activities that foster good patient care, including contributions to the administration of patient care facilities (such as in the OR or in the clinic).

3. Participate in professional organizations – such as the CUA, AUA and SLUG.

Manager

General Requirements:Utilize personal resources effectively to balance patient care, learning needs and outside activities.Allocate finite health care resources wisely.Work effectively and efficiently in a health care organization.Utilize information technology to optimize patient care and life-long learning and other activities.

To achieve these objectives, the junior resident must develop the ability to: 1. Access appropriate urological diagnostic and therapeutic technology in a timely and efficient manner

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to benefit all patients, especially in hospital given constraints of long admissions. (Discharge planning rounds)

2. Maintain a sytematic program of self directed learning suitable for life long learning. (preparing for didactic rounds)

Health Advocate

General Requirements:Identify the important determinants of health affecting patients with urological disease.Contribute effectively to improved health of patients and communities.Recognise and respond to those issues where advocacy is appropriate.

To achieve these objectives, the junior resident must develop the ability to:1. Recognize the importance and existance of community based patient support groups such as the

Prostate Cancer Support Group.2. Understand the role and function of the Canadian Urological Association and related urological

societies in support of urologists and the urological care in Canada and internationally.

Scholar

General Requirements:Develop, implement, and monitor a personal continuing education strategy to ensure life-long professional growth.Critically appraise sources of medical information.Facilitate learning of patients, medical students and other health professionals.Contribute to the development of new knowledge.To use information technology to optimize patient care, life-long learning and other activities

To achieve these objectives, the junior resident must develop the ability to:1. Demonstrate continuing evaluation of their own capabilities and limitations.2. Develop techniques for continuous improvement, information acquisition and information handling

and participate in the quality improvement and quality assurance programs of the institutions.3. Maintain an inquisitive attitude, and understand the time commitment required for ongoing self-study

for the maintenance of competence.4. Demonstrate the use of data bases for literature searches and reviews.5. Formulate a research plan to answer clinical problems.6. Understand the ethics of animal and human experimentation.7. Describe basic statistical methods used in clinical trials.8. Residents will be able to critically evaluate reports of clinical trials and research protocols. All

residents must demonstrate an ability to incorporate gender, cultural and ethnic perspectives in research methodology, data presentation and analysis.

Professional

General Requirements:Deliver highest quality care with integrity, honesty and compassion.Exhibit appropriate personal and interpersonal professional behaviours.Practice medicine ethically consistent with the obligations of a physician.

To achieve these objectives, the junior resident must develop the ability to:1. Demonstrate personal responsibility to patients by availability, confidentiality and respect for each patient's

physical and emotional comfort.2. Demonstrate adherence to the best available practice, including referral to other qualified practitioners

when appropriate.3. Demonstrate meticulous accuracy in reporting clinical and scientific information.

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4. Demonstrate knowledge of the ethical problems of human organ procurement for the purposes of transplantation.

5. Demonstrate a working knowledge of provincial and federal laws and regulations related to the practice of medicine in general and urology in particular.

6. Demonstrate an understanding and appreciation for patients' legal rights in matters related to informed consent, delegated consent and informed decision making.

7. Understand medical protective procedures and the role of the Canadian Medical Protective Association in areas of patient-physician dispute.

8. Be aware of their own feelings and biases and recognise any personal reactions which may be detrimental to physician-patient relationships because of these feelings or biases and explore and willingly accept possible ways of changing detrimental or prejudicial feelings.

9. Identify a colleague or faculty member with whom they may discuss personal and professional goals, conflicts and stresses.

PGY 3 Urology

ROTATION SPECIFIC OBJECTIVESSECOND 4 MONTHS

Medical Expert/Knowledge-based and procedural-based competenciesThe following is a listing of disease entities, diagnostic and surgical skills that are commonly included in the specialty of urology. This list is not meant to be inclusive but an example of the knowledge and skills that the junior resident should be able to demonstrate by the completion of the second 4 month rotation.

Cognitive Skills

Congenital and Developmental Abnormalities

Bladder and UrethraVesicoureteral refluxEpispadias and ExtrophyHypospadias and chordeeOther anomalies

Obstructive Disease of the Upper Urinary Tract

Obstructive Uropathy, Hydronephrosis and Obstructive Renal FailureUreteropelvic Junction Obstruction

Obstructive Disease of the Lower Urinary Tract

Bladder Outflow ObstructionBenign Prostatic HypertrophyLower Urinary Tract Symptoms (“LUTS”)

Urinary Calculus Disease

Bladder Calculi

Trauma

Renal TraumaUreteral TraumaVesical TraumaUrethral TraumaExternal Genital Trauma

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Urological Oncology

Cancer of the kidney: Renal adenocarcinoma - etiology (including von Hippel Lindau syndrome)

Transitional Cell Carcinoma of Renal Pelvis and Ureter Angiomyolipoma

Cancer of the prostate:Adenocarcinoma PIN

Cancer of the testis:Germ cell (including seminoma and non-seminoma )Non-germ cell tumors

Voiding Disorders including Relevant Neurourology

Urinary incontinence (including stress urinary incontinence, urgency incontinence, total incontinence)Voiding dysfunction due to neurological disease

Systemic Diseases and Other Processes Affecting the Urinary Tract

Miscellaneous

External Genital problems (including hydrocele, varicocele, spermatocele, cysts)Torsion of testis, cord and appendagesDermatological lesions of the male external genitalia (including benign, pre-malignant and malignant

lesions)Interstitial CystitisMale Sexual Dysfunction

Imaging Studiesintravenous excretory urographyretrograde urethrography, cystography and pyelography antegrade pyelographyloop-o-graphyvoiding cystourethrography

Ultrasonography - The principles and application of ultrasound techniques for imaging:

kidneybladderprostate (including transrectal ultrasonography)scrotal contents Doppler studies of renal, gonadal and penile vessels

Radioisotope Studies -scans for adrenal localization


Urodynamic Studiescystometrogramuroflowmetryvoiding pressure studies

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Diagnostic Histopathologytestis tumors - including germ cell tumors, (seminoma and non-seminoma), functional tumors of the testis

(Leydig tumors), Sertoli tumors inflammatory lesions of the kidney - xanthogranulomatous pyelonephritis, tuberculosis, chronic

pyelonephritis inflammatory lesions of the lower urinary tract - interstitial cystitis, cystitis cystica, cystitis glandularis,

cystitis follicularis, prostatitis

Therapeutic TechnologiesElectrosurgeryExtracoporeal Shock Wave LithotripsyLasers in urology - carbon dioxide, Nd/YAG, Holmium-YAG, etc.

SURGICAL SKILLS

Endoscopic Procedures:

Cystoscopy and urethroscopy, ureteric catheterization including ureteric stent insertion and removal, retrograde pyelographyUrethral dilatation and visual internal urethrotomyTransurethral biopsy of bladder and urethraTransurethral resection of prostateTransurethral resection of bladder tumorsUreteroscopy and lithotripsy of ureteric calculi

Open ProceduresCircumcisionSuprapubic catheterizationFulguration of venereal warts, biopsy of penile lesions Scrotal surgery - hydrocele, epididymal cyst, epididymectomy, simple orchidectomyInguinal surgery - varicocele, herniotomy, orchidopexy

1. Demonstrate personal responsibility to patients by availability, confidentiality and respect for each patient's physical and emotional comfort.

2. Demonstrate adherence to the best available practice, including referral to other qualified practitioners when appropriate.

3. Demonstrate meticulous accuracy in reporting clinical and scientific information.4. Demonstrate knowledge of the ethical problems of human organ procurement for the purposes of

transplantation.

5. Demonstrate a working knowledge of provincial and federal laws and regulations related to the practice of medicine in general and urology in particular.

6. Demonstrate an understanding and appreciation for patients' legal rights in matters related to informed consent, delegated consent and informed decision making.

7. Understand medical protective procedures and the role of the Canadian Medical Protective Association in areas of patient-physician dispute.

8. Be aware of their own feelings and biases and recognize any personal reactions which may be detrimental to physician-patient relationships because of these feelings or biases and explore and willingly accept possible ways of changing detrimental or prejudicial feelings.


PGY 3 Urology

ROTATION SPECIFIC OBJECTIVESTHIRD 4 MONTHS

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Medical Expert/Knowledge-based and procedural-based competenciesThe following is a listing of disease entities, diagnostic and surgical skills that are commonly included in the specialty of urology. This list is not meant to be inclusive but an example of the knowledge and skills that the junior resident should be able to demonstrate by the completion of the third 4 month rotation.

Cognitive Skills


External Genital Anomalies Intersex Undescended Testis Scrotal and External Genital Anomalies


Bladder Outflow ObstructionPosterior Urethral ValvesFunctional Obstruction secondary to Neurological Disorders

Urinary Calculus Disease

Renal and Ureteral Calculi Bladder Calculi

Urinary and Genital Infections, and Sexually Transmitted Disease

Prostatitis including Prostatodynia Sexually transmitted diseasesGenito-urinary tuberculosisFungal/yeast urinary tract infectionsOther granulomatous infections (including xanthogranulomatous disease)Other Genital Infections (including Fournier’s gangrene)

Renovascular Hypertension

Surgically Correctable Hypertension

Renal Transplantation

Recipient selectionRelevant transplantation immunologyImmunosuppresion (including principles of management of rejection)

Andrology

Male Sexual Function and DysfunctionFertility and Male factor Infertility

Urological Oncology

Cancer of the kidney: Renal adenocarcinoma - etiology (including von Hippel Lindau syndrome)Wilm's Tumor Transitional Cell Carcinoma of Renal Pelvis and UreterAngiomyolipoma Other Tumors

Cancer of the bladder:

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Transitional Cell Carcinoma Squamous Cell Carcinoma Other Tumors

Cancer of the prostate:Adenocarcinoma Other tumors


Cancer of the adrenal: Pheochromocytoma NeuroblastomaAdrenal adenoma and adenocarcinoma "Incidentaloma"Other tumors


Urinary incontinence (including stress urinary incontinence, urgency incontinence, total incontinence)Functional Voiding Disorders

Adrenal Diseases

Adrenal cysts, hyperplasiaAdrenal hyperfunction and hypofunction and associated syndromes


Urological manifestations of systemic diseases (including e.g. diabetes mellitus, sepsis, AIDS, immunocompromised or immunoincompetent patients)The urinary tract in pregnancy (including normal physiologic and anatomic changes and management of urinary tract problems in the pregnant patient)

Miscellaneous

External Genital problems (including hydrocele, varicocele, spermatocele, cysts)Torsion of testis, cord and appendagesDermatological lesions of the male external genitalia (including benign, pre-malignant and malignant lesions)Interstitial Cystitis

Imaging Studies

Radiological Studies - intravenous excretory urographyangiography of the kidneys and pelvic vesselsvenography (including vena cavography)loop-o-graphyvoiding cystourethrography

Ultrasonography -


renal imaging (including function studies)voiding cystograms

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bone scans for staging of malignant diseasefor adrenal localization


Urodynamic Studies

cystometrogramuroflowmetryvoiding pressure studiespelvic floor electromyographyvideourodynamic studies

Therapeutic TechnologiesThe junior resident will be able to describe the basic physics and technological application of the following therapeutic modalities. He/she will be able to describe the indications, contraindications, peri-operative and post-operative complications specific for each modality:

ElectrosurgeryExtracoporeal Shock Wave LithotripsyLasers in urology - carbon dioxide, Nd/YAG, Holmium-YAG, etc.Transurethral prostatic hyperthermia/thermotherapy and other alternative modalities used in the management of patients with benign prostatic hyperplasia

SURGICAL SKILLS

Endoscopic Procedures:Transurethral resection of prostateTransurethral resection of bladder tumorsTransurethral resection/ incision of ureterocele

Ureteroscopy and lithotripsy of ureteric calculiPercutaneous renal surgery including nephrolithotomy with ultrasound / electrohydraulic / laser lithotripsy

Open Surgical Procedures:CircumcisionSuprapubic catheterizationCavernosal shunting procedures for priapismTestis biopsyVasectomyInguinal surgery - varicocele, herniotomy, orchidopexy Radical orchidectomyRepair of testis torsionOrchidopexy for undescended testisInsertion testis prosthesisVesical neck suspension and procedures for stress urinary incontinencePelvic lymphadenectomy

PGY 4 Urology



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The following is a listing of disease entities, diagnostic and surgical skills that are commonly included in the specialty of urology. This list is not meant to be inclusive but an example of the knowledge and skills that the senior resident should be able to demonstrate by the completion of the first 4 month rotation.

Cognitive Skills


Kidney and UreterCystic Diseases of the KidneyHorseshoe Kidney and Other Renal AnomaliesDuplication, Retrocaval ureter and Other Anomalies


Obstructive Uropathy, Hydronephrosis and Obstructive Renal FailureUreteropelvic Junction ObstructionUrinary Fistulae


Bladder Outflow ObstructionPosterior Urethral ValvesFunctional Obstruction secondary to Neurological Disorders


Pyelonephritis and other renal infectionsGenito-urinary tuberculosis

Urological Oncology

Cancer of the kidney: Renal adenocarcinoma - etiology (including von Hippel Lindau syndrome)Angiomyolipoma

Cancer of the bladder:Transitional Cell Carcinoma

Cancer of the prostate:Adenocarcinoma


Urinary incontinence (including stress urinary incontinence, urgency incontinence, total incontinence)Voiding dysfunction due to neurological disease

Miscellaneous

External Genital problems (including hydrocele, varicocele, spermatocele, cysts)Torsion of testis, cord and appendagesDermatological lesions of the male external genitalia (including benign, pre-malignant and malignant lesions)Interstitial Cystitis

DIAGNOSTIC SKILLS

Imaging Studies

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Radiological Studies - residents will demonstrate knowledge of the application of each of the following techniques to particular clinical situations, including the indications, interpretation, potential complications and management of complications for each technique, and the use of appropriate contrast agents when indicated:

intravenous excretory urographyretrograde urethrography, cystography and pyelography


kidneybladder


renal imaging (including function studies)


Surgical Skills

Endoscopic Procedures:Cystoscopy and urethroscopy, ureteric catheterization including ureteric stent insertion and removal, retrograde pyelographyUrethral dilatation and visual internal urethrotomyTransurethral biopsy of bladder and urethra

Open Surgical Procedures:CircumcisionSuprapubic catheterizationVasovasostomy Inguinal surgery - varicocele, herniotomy, orchidopexy Repair of testis torsionOrchidopexy for undescended testisPelvic lymphadenectomy Simple retropubic prostatectomy

Communicator


To achieve these objectives, the senior residents must develop the ability to:2. Record accurately and succinctly data collected from patients, laboratory tests and radiological studies and

to communicate conclusions based on these data to referring physicians and other involved health care personnel;

2. Be sensitive to patients fears, anxieties and needs for privacy;3. Be able to explain clearly and concisely:

a. diagnosis and management plans that are understandable to patients, that motivates and facilitates patients' willing participation;

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c. management plans to other health care personnel in a way that ensures their effective participation;

d. steps necessary for problem management when acting as a consultant for otherphysicians, particularly in the situation of an intra-operative consult or ward consult.

Collaborator


To achieve these objectives, the ssenior resident must develop the ability to:1. Interact effectively with:

a. personnel in community service agencies (ie Homecare),b. other health care personnel, for example, attending in discharge planning

2. Accept responsibility for participation in activities that foster good patient care, including contributions to the administration of patient care facilities.


Manager


To achieve these objectives, the junior resident must develop the ability to: 1. Access appropriate urological diagnostic and therapeutic technology in a timely and efficient manner to

benefit all of their patients, for example, arranging appropriate investigations and follow-up when on call.2. Maintain a sytematic program of self directed learning suitable for life long learning.

Health Advocate


To achieve these objectives, the senior resident must develop the ability to:1. Participate with community based patient support groups such as the prostate cancer support group.2. Understand the role and function of the Canadian Urological Association and related urological societies in

support of urologists and the urological care in Canada and internationally.

Scholar

General Requirements:Develop, implement, and monitor a personal continuing education strategy to ensure life-long professional growth.Critically appraise sources of medical information.Facilitate learning of patients, housestaff/students and other health professionals.Contribute to the development of new knowledge.To use information technology to optimize patient care, life-long learning and other activities

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To achieve these objectives, the senior resident must develop the ability to:

1. Demonstrate continuing evaluation of their own capabilities and limitations.2. Develop techniques for continuous improvement, information acquisition and information handling and





Professional


To achieve these objectives, the senior resident must develop the ability to:1. Demonstrate personal responsibility to patients by availability, confidentiality and respect for each

patient's physical and emotional comfort.2. Demonstrate adherence to the best available practice, including referral to other qualified practitioners

when appropriate.3. Demonstrate meticulous accuracy in reporting clinical and scientific information.4. Demonstrate knowledge of the ethical problems of human organ procurement for the purposes of

transplantation.5. Demonstrate a working knowledge of provincial and federal laws and regulations related to the

practice of medicine in general and urology in particular.6. Demonstrate an understanding and appreciation for patients' legal rights in matters related to informed

consent, delegated consent and informed decision making.7. Understand medical protective procedures and the role of the Canadian Medical Protective

Association in areas of patient-physician dispute.8. Be aware of their own feelings and biases and recognise any personal reactions which may be

detrimental to physician-patient relationships because of these feelings or biases and explore and willingly accept possible ways of changing detrimental or prejudicial feelings.


PGY 4 Urology

ROTATION SPECIFIC OBJECTIVESSecond 4 MONTHS


The following is a listing of disease entities, diagnostic and surgical skills that are commonly included in the specialty of urology. This list is not meant to be inclusive but an example of the knowledge and skills that the senior resident should be able to demonstrate by the completion of the second 4 month rotation.

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Cognitive Skills

Trauma

Ureteral TraumaVesical TraumaUrethral TraumaExternal Genital Trauma




Recipient selectionRelevant transplantation immunology

Andrology

Male Sexual Function and DysfunctionFertility and Male factor Infertility

Urological Oncology

Cancer of the kidney: Renal adenocarcinoma - etiology (including von Hippel Lindau syndrome)Wilm's Tumor Transitional Cell Carcinoma of Renal Pelvis and UreterAngiomyolipoma

Cancer of the bladder:Transitional Cell Carcinoma Squamous Cell Carcinoma Other Tumors

Cancer of the prostate:Adenocarcinoma Other tumors


Cancer of the adrenal: Pheochromocytoma "Incidentaloma"


Urinary incontinence (including stress urinary incontinence, urgency incontinence, total incontinence)Voiding dysfunction due to neurological disease EnuresisFunctional Voiding Disorders

Adrenal Diseases

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DIAGNOSTIC SKILLS

Imaging Studies

intravenous excretory urographyvoiding cystourethrography


kidneybladderprostate (including transrectal ultrasonography)scrotal contents Doppler studies of renal, gonadal and penile vessels


renal imaging (including function studies)voiding cystogramstesticular scansbone scans for staging of malignant diseasescans for localization of inflammatory lesionsscans for adrenal localization


Urodynamic Studies

cystometrogramuroflowmetryvoiding pressure studiespelvic floor electromyographyvideourodynamic studies

Histopathology

testis tumors - including germ cell tumors, (seminoma and non-seminoma), functional tumors of the testis (Leydig tumors), Sertoli tumors inflammatory lesions of the kidney - xanthogranulomatous pyelonephritis, tuberculosis, chronic pyelonephritis inflammatory lesions of the lower urinary tract - interstitial cystitis, cystitis cystica, cystitis glandularis, cystitis follicularis, prostatitis

SURGICAL SKILLS

Endoscopic Procedures:Transurethral biopsy of bladder and urethraTransurethral resection of prostateTransurethral resection of bladder tumorsManipulation and extraction of calculi including litholopaxy, basket extraction

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Ureteroscopy and lithotripsy of ureteric calculi

Open Surgical Procedures:CircumcisionSuprapubic catheterizationFulguration of venereal warts, biopsy of penile lesionsScrotal surgery - hydrocele, epididymal cyst, epididymectomy, simple orchidectomyInguinal surgery - varicocele, herniotomy, orchidopexy Radical orchidectomyRepair of testis torsionPelvic lymphadenectomy Nephrectomy

PGY4 Urology Pediatric Urology Rotation at CHEOThe overall goal of this mandatory two month rotation in Pediatric Urology is a

concentrated experience of pediatric urologic problems in ambulatory clinics and in the operating room.

Objectives

Medical Expert/Knowledge-based and procedural-based competenciesThe resident will demonstrate an understanding and a thorough knowledge of the following problems as they relate to the practice of urology


A. Kidney and Uretera. Cystic Diseases of the Kidneyb. Horseshoe Kidney and Other Renal Anomaliesc. Duplication, Retrocaval ureter and Other Anomalies

B. Bladder and Urethraa. Vesicoureteral refluxb. Epispadias and Extrophyc. Hypospadias and chordee

C. External Genital Anomaliesa. Intersexb. Undescended Testisc. Scrotal and External Genital Anomalies


A. Obstructive Uropathy, Hydronephrosis and Obstructive Renal Failure B. Ureteropelvic Junction Obstruction


A. Posterior urethral valvesB. Functional Obstruction secondary to Neurological Disorders

Pediatric Oncology

A. Wilm’s TumorB. NeuroblastomaC. Mesoblastic Nephroma

Imaging Studies

A. Pediatric ultrasound of abdomen and pelvisB. VCUG

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C. Radioisotope scans

Open Surgical SkillsThe resident will have an understanding of the following open surgical procedures although not necessarily be able to perform independently.

CircumcisionOrchidopexyRepair of testicular torsionHypospadius repairUretero-neocystostomyOpen pyeloplastyPartial nephrectomyAugmentation cystoplasty

Communicator

Establish therapeutic relationships with patients and parents (as well as primary care givers).Obtain and synthesize relevant history from patients, families and communities.Listen effectively.Discuss appropriate information with patients and families and the health care team.Residents must demonstrate the knowledge, skills and attitudes relating to gender, culture and ethnicity pertinent to urology.

Collaborator

Consult effectively with other physicians and health care professionals.Contribute effectively to other interdisciplinary team activities.Interact effectively with patients from all varying lifestyles, socioeconomic backgrounds and value systems.

Manager

Utilize personal resources effectively to balance patient care, learning needs and outside activities.Work effectively and efficiently in a health care organization.Utilize information technology to optimize patient care and life-long learning and other activities.

Health Advocate

Identify the important determinants of health affecting patients with urological disease.Recognize and respond to those issues where advocacy is appropriate.

Scholar

Develop, implement, and monitor a personal continuing education strategy to ensure life-long professional growth.Critically appraise sources of medical information and demonstrate the use of data bases for literature searches and reviews.

To use information technology to optimize patient care, life-long learning and other activities

Professional

Deliver highest quality care with integrity, honesty and compassion.Exhibit appropriate personal and interpersonal professional behaviours with children and their parents.

PGY4 Urology

ROTATION SPECIFIC OBJECTIVES

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THIRD 4 MONTHS


The following is a listing of disease entities, diagnostic and surgical skills that are commonly included in the specialty of urology. This list is not meant to be inclusive but an example of the knowledge and skills that the senior resident should be able to demonstrate by the completion of the third 4 month rotation.

Cognitive Skills


External Genital Anomalies Intersex Undescended Testis Scrotal and External Genital Anomalies


Bacterial (complicated and uncomplicated) and non-bacterial cystitis and urethritis Pyelonephritis and other renal infections

Prostatitis including ProstatodyniaSexually transmitted diseasesOther Genital Infections (including Fournier’s gangrene)




Immunosuppresion (including principles of management of rejection)Management of Surgical Complications of Renal Transplantation

Urological Oncology


Cancer of the adrenal: Pheochromocytoma NeuroblastomaAdrenal adenoma and adenocarcinoma "Incidentaloma"Other tumors

Adrenal Diseases




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DIAGNOSTIC SKILLS


prostate (including transrectal ultrasonography)scrotal contents Doppler studies of renal, gonadal and penile vessels

Urodynamic Studiesvideourodynamic studies

Therapeutic Technologies

Lasers in urology - carbon dioxide, Nd/YAG, Holmium-YAG, etc. Transurethral prostatic hyperthermia/thermotherapy and other alternative modalities used in the

management of patients with benign prostatic hyperplasiaLaparoscopic Procedures

SURGICAL SKILLS

Endoscopic Procedures:Transurethral biopsy of bladder and urethraTransurethral resection of prostateTransurethral resection of bladder tumorsTransurethral resection/ incision of ureteroceleManipulation and extraction of calculi including litholopaxy, basket extractionUreteroscopy and lithotripsy of ureteric calculiPercutaneous renal surgery including nephrolithotomy with ultrasound / electrohydraulic / laser lithotripsy

Open Surgical Procedures:CircumcisionSuprapubic catheterizationMeatal Repair for glanular hypospadiasScrotal surgery - hydrocele, epididymal cyst, epididymectomy, simple orchidectomyInguinal surgery - varicocele, herniotomy, orchidopexy Radical orchidectomyRepair of testis torsionOrchidopexy for undescended testisInsertion testis prosthesisVesical neck suspension and procedures for stress urinary incontinenceUretero-neocystostomyAugmentation cystoplastyRadical cystectomy and anterior pelvic exenterationProcedures for renal, ureteral and bladder trauma repairPelvic lymphadenectomy Simple retropubic prostatectomyRadical prostatectomyPyeloplasty for ureteropelvic junction obstructionNephrectomyNephroureterectomyCorrection of proximal hypospadias and epispadias

PGY 5 Urology

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The following is a listing of disease entities, diagnostic and surgical skills that are commonly included in the specialty of urology. This list is not meant to be inclusive but an example of the knowledge and skills that the chief resident should be able to demonstrate by the completion of the first 4 month rotation.Cognitive Skills

Congenital and Developmental AbnormalitiesHypospadias and chordee

INTERSEX, AMBIGUOS GENETALIA IN THE NEWBORN

Obstructive Disease of the Lower Urinary TractPosterior Urethral Valves

Urinary and Genital Infections, and Sexually Transmitted DiseaseOther Genital Infections (including Fournier’s gangrene)

Renovascular HypertensionSurgically Correctable Hypertension

Renal TransplantationOrgan donationRecipient selection

Urological OncologyRenal Cell Carcinoma - etiology (including von Hippel Lindau syndrome)Angiomyolipoma Squamous Cell Carcinoma bladderPheochromocytoma Neuroblastoma

Adrenal DiseasesAdrenal cysts, hyperplasiaAdrenal hyperfunction and hypofunction and associated syndromes

Diagnostic Studies

Angiography of the kidneys and pelvic vesselsLoop-o-graphyCT scanning and MRI Scanning of the urinary tractCoordination of video-urodynamics

SURGICAL SKILLS

Endoscopic Procedures: Percutaneous renal surgery with ultrasound / electrohydraulic/laser lithotripsy

Open Surgical Procedures:Vasovasostomy Vesical neck suspension and procedures for stress urinary incontinenceProcedures for renal, ureteral and bladder trauma repairSimple retropubic prostatectomyNephrectomyNephroureterectomy

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Communicator


To achieve these objectives, the chief residents must develop the ability to:3. Record accurately and succinctly data collected from patients, laboratory tests and radiological studies and




e. management plans to other health care personnel in a way that ensures their effective participation;

f. steps necessary for problem management when acting as a consultant for otherphysicians, particularly in the situation of an intra-operative consult.

Collaborator


To achieve these objectives, the chief resident must develop the ability to:2. Interact effectively with:

a. personnel in community service agencies,b. other health care personnel, for example, attending in discharge planning

2. Accept responsibility for participation in activities that foster good patient care, including contributions to the administration of patient care facilities.


Manager


To achieve these objectives, the chief resident must develop the ability to: 3. Access appropriate urological diagnostic and therapeutic technology in a timely and efficient manner to

benefit all of their patients, for example, running of the chief residents clinic. 4. Organize a priority list for patients waiting surgery.5. Organize the resident schedule 6. Maintain a sytematic program of self directed learning suitable for life long learning.

Health Advocate

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To achieve these objectives, the chief resident must develop the ability to:3. Participate with community based patient support groups such as the prostate cancer support group.4. Understand the role and function of the Canadian Urological Association and related urological societies in

support of urologists and the urological care in Canada and internationally.

Scholar

General Requirements:Develop, implement, and monitor a personal continuing education strategy to ensure life-long professional growth.Critically appraise sources of medical information.Facilitate learning of patients, housestaff/students and other health professionals.Contribute to the development of new knowledge.To use information technology to optimize patient care, life-long learning and other activities

To achieve these objectives, the chief resident must develop the ability to:9. Demonstrate continuing evaluation of their own capabilities and limitations.10. Develop techniques for continuous improvement, information acquisition and information handling and





Professional


To achieve these objectives, the chief resident must develop the ability to:10. Demonstrate personal responsibility to patients by availability, confidentiality and respect for each patient's

physical and emotional comfort.11. Demonstrate adherence to the best available practice, including referral to other qualified practitioners

when appropriate.12. Demonstrate meticulous accuracy in reporting clinical and scientific information.13. Demonstrate knowledge of the ethical problems of human organ procurement for the purposes of

transplantation.14. Demonstrate a working knowledge of provincial and federal laws and regulations related to the practice of

medicine in general and urology in particular.15. Demonstrate an understanding and appreciation for patients' legal rights in matters related to informed

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consent, delegated consent and informed decision making.16. Understand medical protective procedures and the role of the Canadian Medical Protective Association in

areas of patient-physician dispute.17. Be aware of their own feelings and biases and recognise any personal reactions which may be detrimental

to physician-patient relationships because of these feelings or biases and explore and willingly accept possible ways of changing detrimental or prejudicial feelings.


PGY5 Urology

ROTATION SPECIFIC OBJECTIVESSECOND 4 MONTHS


The following is a listing of disease entities, diagnostic and surgical skills that are commonly included in the specialty of urology. This list is not meant to be inclusive but an example of the knowledge and skills that the chief resident should be able to demonstrate by the completion of the second 4 month rotation.

Cognitive Skills

TraumaRenal TraumaUreteric TraumaTesticular Trauma

Renal TransplantationManagement of complications after renal transplant

Urological OncologyPenile CancerUrethral Cancer

Metastatic Cancers to Genito-urinary Tract



Diagnostic Studies

Ultrasound of scrotal contents Doppler studies of renal, gonadal and penile vessels Radioisotope StudiesUnderstanding of the radio-pharmaceuticals in renal imaging (including function studies)scans for adrenal localization

SURGICAL SKILLS

Endoscopic Procedures:Use of Lasers in urology - carbon dioxide, Nd/YAG, Holmium-YAG, etc Percutaneous renal surgery with ultrasound / electrohydraulic/laser lithotripsyLapaoscopic skills, diagnostic ie intrabdominal testicle

Open Surgical Procedures:

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Cavernosal shunting procedures for priapismTestis biopsy

Procedures for renal, ureteral and bladder trauma repairRadical retropubic prostatectomyNephroureterectomyCystectomy with urinary diversionRPLNDOpen urethroplasty

PGY 5 Urology

ROTATION SPECIFIC OBJECTIVESTHIRD 4 MONTHS


The following is a listing of disease entities, diagnostic and surgical skills that are commonly included in the specialty of urology. This list is not meant to be inclusive but an example of the knowledge and skills that the CHIEF resident should be able to demonstrate by the completion of the third 4 month rotation.

TraumaVesical TraumaUrethral TraumaExternal Genital Trauma

Renal TransplantationRelevant transplantation immunologyImmunosuppresion (including principles of management of rejection)

Urological OncologyWilm's Tumor Transitional Cell Carcinoma of Renal Pelvis and UreterAdenocarcinoma of the prostate Germ cell (including seminoma and non-seminoma )Non-germ cell tumors of the testes

Diagnostic Studies

angiography of the kidneys and pelvic vesselsvenography (including vena cavography)Coordination and interpretation of video-urodynamics antegrade pyelography

Surgical Skills

Open Surgical Procedures:

Cavernosal shunting procedures for priapism Insertion testis prosthesis Procedures for correction penile curvature and Peyronie's Disease Insertion of penile prosthesis Penectomy Urethrectomy

Insertion artificial sphincter Augmentation cystoplasty

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Repair of urinary fistulae - involving bladder, urethra, ureter, kidney Urinary diversion procedures - continent, orthotopic and conduits Radical cystectomy and anterior pelvic exenteration Radical prostatectomy Pyeloplasty for ureteropelvic junction obstruction Partial nephrectomy Retroperitoneal node dissection for carcinoma testis Inguinal lymphadenectomy for carcinoma penis Renal transplantation Cadaveric and live donor renal harvesting for transplantation Transplant nephrectomy Vena cava resection and retrieval of atrial thrombus for carcinoma kidney

PGY 5 Enrichment rotation

On April 1, the official duties of the chief urology resident would be transferred to the senior urology resident. The senior resident would then carry out these duties for the remainder of the academic year:

· administrative duties (scheduling, etc.)

· primary operative assistance to Queen’s urological attending staff

· ward consultations

This provides the chief resident with the opportunity to pursue:

· clinical and surgical enrichment activities

· elective clinical rotations

· focused study for the Royal College examinations in urology

· conclusion research projects

CLINICAL AND SURGICAL ENRICHMENT ACTIVITIES

The chief resident would be free to pursue clinical and surgical learning opportunities to fill perceived gaps in his/her knowledge or experience base. These activities could be varied on a daily basis, at the discretion of the chief resident and the relevant clinical staff. Examples might include:

· attending selected urological clinics, both general and specialized

· attending selected non-urological clinics, with the permission of the appropriate attending staff (e.g. gynecology, nephrology, videourodynamics)

· assisting with selected urological operations (e.g. uncommon operations, cystoscopy under local anaesthesia, vasectomy)

· assisting with selected non-urological operations, with the permission of the appropriate attending staff (e.g. gynecology, general surgery, vascular surgery)

· assisting with selected interventional radiology procedures, with the permission of the interventional radiologist (e.g. percutaneous nephrostomy insertion)

· performing and interpreting urodynamic studies

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· providing teaching to junior housestaff and medical students

ELECTIVE CLINICAL ROTATIONS

The chief resident would be free to arrange brief clinical rotations, both in Kingston and at other centres. Examples might include:

pediatric urology

renal transplantation

urogynecology

oncology

community urology

nephrology

infertility

STUDY TIME

An appropriate portion of the enrichment phase would be spent in directed studying for the Royal College examinations in urology. This might include simulated oral examinations from urology attending staff, reading, and practicing for the multiple choice and short answer components of the examination.

RESEARCH PROJECTS

If desired, the chief resident could work on pre-existing research projects or initiate new ones.

Community Elective in Urology


The following is a listing of disease entities, diagnostic and surgical skills that are commonly included in the specialty of urology. This list is not meant to be inclusive but an example of the knowledge and skills that the resident should be able to demonstrate by the completion of the Community Elective in Urology rotation.

Cognitive Skills

The elective should focus on learning skills and acquiring knowledge which are more readily attainable outside of residency training at an academic centre such as Queen's.

The resident should learn the skill of operating without another specialist physician assistant. Normally at a teaching centre there is an attending Urologist. Particular examples where differences in a community setting exist include:-Ureteroscopy-TURP -Inguinal/scrotal procedures-radical prostatectomy-laparcospic procedures including nephrectomyThe resident should familiarize him/herself with what can realistically & safely be accomplished in terms of office procedures eg:-Vasectomies-Neonatal circumcisions-Cystoscopy-TRUS biopsy

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Communicator


To achieve these objectives, the residents must develop the ability to:4. Record accurately and succinctly data collected from patients, laboratory tests and radiological studies and




g. management plans to other health care personnel in a way that ensures their effective participation;

h. steps necessary for problem management when acting as a consultant for otherphysicians, particularly in the situation of an intra-operative consult.

Collaborator


To achieve these objectives, the resident must develop the ability to:1. Interact effectively with:

other health care personnel, Patients from all varying lifestyles, socioeconomic backgrounds and value systems 2. Accept responsibility for participation in activities that foster good patient care,

including contributions to the administration of patient care facilities.

Manager

General Requirements:Utilise personal resources effectively to balance patient care, learning needs and outside activities.Allocate finite health care resources wisely.Work effectively and efficiently in a health care organisation.Utilise information technology to optimise patient care and life-long learning and other activities.

To achieve these objectives, the resident must review and understand: 1. Billing procedures via modem, within the provincial health plan2. Billing codes and their acceptable/ethical interpretation3. Billing procedures for un-insured services4. Office computer hardware and software needs5. Office staffing needs (transcription, reception, nursing etc)6. Assessing one's present and future needs when looking for office physical space, and the potential cost

of running an office7. The pros & cons of leasing vs. buying office space8. Accounting/bookkeeping needs

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9. Financing of office equipment for minor procedures10. Cash flow management for personal and professional expenses11. Obtaining professional financial advice for one's personal and professional life12. The pros and cons of incorporation for Physicians13. Maintain a systematic program of self directed learning suitable for life long learning.

Health Advocate


Scholar

General Requirements:Critically appraise sources of medical information.Contribute to the development of new knowledge.To use information technology to optimise patient care, life-long learning and other activities

To achieve these objectives, the resident must develop the ability to:1. Develop techniques for continuous improvement, information acquisition and information

handling and participate in the quality improvement and quality assurance programs of the institutions in which they practice.


3. Demonstrate the use of databases for literature searches and reviews.

Professional


To achieve these objectives, the resident must develop the ability to:1. Demonstrate personal responsibility to patients by availability, confidentiality and respect for each

patient's physical and emotional comfort.2. Demonstrate adherence to the best available practice, including referral to other qualified

practitioners when appropriate.3. Demonstrate meticulous accuracy in reporting clinical and scientific information.4. Demonstrate an understanding and appreciation for patients' legal rights in matters related to

informed consent, delegated consent and informed decision making.5. Demonstrate knowledge of legal requirements of staff privileges6. Demonstrate knowledge of legal responsibility of provincial licensing authorities in the practice of

medicine

Research ObjectivesResident Training Program, UrologyQueen’s University

Research Objectives

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1. To permit residents the opportunity and guidance in preparing a research proposal2. To permit residents the opportunity to develop skills in study design and data analysis3. To permit residents the opportunity to develop the communication skills required to verbally present research

results4. To permit residents to develop the skills necessary in writing a paper for publication5. To help familiarize the resident with the practice of clinical or basic science research in the context of clinical

urologic practice6. To facilitate the residents research potential as it relates to post-graduate studies and possible career choices7. To develop skills of critical appraisal of the literature and aspects of evidence based medicine

Principles of Research Training

1. Residents differ in their motivation and background in order to develop research skills during residency.2. Relevant research skills will need to be assessed individually. Some further research training for residents may

need to be permitted to facilitate completion of projects. (Queen’s or KGH resources can be explored).3. Specific acquisition of research skills include attendance in the Queen’s Research Methodology Course entitled

“Introduction to Research” held in the PGY1 year. As needed, the Grand Rounds schedule can include specific teaching of research skills such as Statistics and Epidemiology.

4. Resident swill be encouraged to attend basic science course such as those offered by the AUA and the University of Toronto.

5. Residents will be encouraged to participate in resident research conferences including SLUG and Upstate New York resident research day as well as national and international Urologic meetings.

6. Understanding of research design and data analysis is an ongoing process and can be acquired outside of a didactic course or ongoing research project, such as through discussion with experts during appropriate learning moments (in clinic/journal club).

7. All residents will be actively encouraged to complete at least one research project during the three years of urology training. This may involve retrospective or prospective clinical research, quality assurance research, medical education research or, in particular circumstances, basic science research.

8. Residents will be encouraged to choose a project early in residency (PGY1-2) in order to allow sufficient time for completion of projects.

9. Ongoing research in the department of urology is abundant and residents will have great opportunity to be involved in several projects; however, if there is a desire to investigate a research endeavor outside of the department it will also be encouraged.

10. Most projects will be completed outside of a specific block of research time as dictated by the specific requirements of training. As circumstances permit, specific blocks of time will be arranged to help facilitate completion of ongoing projects.

11. Progress of resident research as a whole will be evaluated at regular intervals including bi-monthly research rounds and quarterly resident evaluations. The Urology ITER does include consideration of research skills.

12. All residents will be encouraged to present their research to the Urology staff and colleagues in order to help acquire verbal communication skills prior to presenting data for regional, national, or international audiences.

Last revision August 2009

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Documents

Urology resident objectives.doc