During the course of the urology residency program, the individual resident will have a variety of responsibilities including, but not limited to, patient care, preparation for conferences, teaching, and research. Each responsibility will be shared with other individuals including fellow residents, urology faculty, attending physicians and surgeons from other services. In each instance, the resident's share of responsibility will be commensurate with the level of experience of that resident. The individual urology resident should always initiate communication between the chief resident in urology and the faculty to assure that involvement and input from all responsible parties is maintained. Clear communication between these individuals is the key to optimal patient care and a valuable learning experience.
In-service exams provide the faculty information about cognitive advancement in comparison to peers. Residents' participation is mandatory and exceeding 50 percentile of peer group is required. Failure to do so may result in academic probation, suspension of operating room privileges, withdrawal from national, regional or local meetings or other remediation as determined by the faculty. Mock oral and written exams are administered in addition to the formal In-Service exam given in the fall of each year.
Residents will rotate through two clinical services in three-month intervals. One service is responsible for Drs. Schwartz, McKenna and Köhler and covers Laparoscopy, Endourology, Pediatrics and Andrology. The other service covers Drs. Gorbonos, Grampsas and Wilson covering Oncology, Incontinence, General Urology and Research. Rotation through these services exposes the residents to a variety of practice settings and to patients from two different referral bases. The resident will have dedicated time with the attending urologists in the outpatient clinic setting, will be assigned to perform initial hospital consultations and will assist in the operating room. Assigned responsibilities will be commensurate with level of training and experience.
The outpatient clinical experience in which patients are evaluated and managed is necessary for residency training and accreditation and is a key element of urology training. The resident outpatient experience will be one in which the residents are given appropriate responsibilities and an opportunity to make diagnostic and therapeutic decisions concerning the need for surgery. They will have the opportunity for continuity of care outside of the hospital for those patients who have had surgery.
Each resident will have their own personal half day clinic every week under the supervision of a faculty member. This clinic includes experience in outpatient procedures such as cystoscopy and transrectal ultrasound-guided biopsy of the prostate. Each resident is responsible for the care of patients in their clinics, including promptness in attendance, evaluation and management of clinical problems, follow-up of laboratory and imaging studies, scheduling surgery and follow-up appointments and communication with referring physicians. Specific disease states can be discussed with the representative faculty specialist. Clinics will be organized in a way that residents will be able to follow their patients throughout their residency, giving them the opportunity to manage patients over an extended period of time. The faculty providing oversight may change but resident involvement will be consistent.
The resident is expected to be available when the patient is taken to the operating room. When the patient enters the operating room, the resident should be available to arrange pertinent x-rays in the view box, to help position the patient and to be present during the induction of anesthesia. The resident should oversee the prepping and draping of the operative field. The resident will have read about the anatomy and technique of the operative procedure prior to entering the operating room. In addition, residents who participate as the operating surgeon should have chart documentation of participation and understanding of the preoperative work up.
The chief resident has the option to choose cases on any of the services. Exceptions include resident clinic patients and faculty decisions. The resident assigned to a service where the chief resident is the operating surgeon will be present during the operation, and will be responsible for the postoperative care. It is expected that the chief resident will be available to all of the residents for advice and help with the care of all patients, especially in those cases in which he or she served as the operating surgeon.
The ACGME has established a required minimum number of cases in each of the index categories and procedures to maintain program accreditation. Therefore, it is important to maintain an accurate accounting of surgical cases. Residents at all levels are required to log their operative cases onto the ACGME web site on a daily basis. Failure to do so may result in suspension of operating room privileges.
As professionals, mutual respect for other physicians is important for patient care. If medical consultation from another service is requested on our patients, direct verbal communication with the physician is required. Physician-to-physician contact is mandatory and mere written physician orders are not acceptable. Direct physician-to-physician contact communicating the assessment and plan is mandatory. Failure to do so may result in loss of operating room privileges.
Each resident is expected to participate in at least one SIU committee.