Assessing the goals of urology residency training: perceptions of practicing urologists in British Columbia

In an effort to evaluate the perceived utility of specific Royal College of Physicians and Surgeons of Canada (RCPSC) urology residency training objectives we conducted a survey of the practicing urologists of British Columbia (BC).

A two page semi-structured survey was designed. Validity was evaluated for clarity, content and ease of completion. The survey was mailed-out to all 61 practicing urologists in BC. The survey population was divided into urban, rural, and academic according to location of practice.

Survey response rate was 79% with varying subgroup rates: urban-69% (20/29), rural-94% (17/18) and academic 86% (12/14). Specific clinical components of training were rated as "useful" by the majority of all respondents: pediatric urology (93%), laparoscopy (88%), TRUS (77%), percutaneous renal access (74%), urethral surgery (72%), microsurgery (62%). Renal transplantation was rated "not useful" by 74% of respondents. TRUS, percutaneous renal access and adrenal surgery were perceived as useful by the majority of those practicing in rural and non-academic urban centers compared to those in academic centers where the majority rated these skills as "not useful". Virtually all non-clinical components of training were rated as "useful". The majority of respondents felt that residency training prepared them for the following challenges: accepting responsibility for patient care, assessing scientific literature, ethical decision-making and communication. The majority of respondents felt that residency did not prepare them for the following challenges: time and office management, hospital administration and providing care within a constrained system.

Specific clinical and non-clinical areas of training have high perceived utility in all settings of practice. Certain clinical components of training have high perceived utility only in specific settings of practice. There are many non-clinical components of practice, which are perceived to be important, but for which BC urologists feel inadequately prepared for by their residency training programs. If consistent across Canada, these findings may facilitate a rational approach to the modification of the objectives for urology residency training.