Assessing urinary diversion experience in urologic residency programs-are we adequately training the next generation?

Area of Science:

• Urology
• Surgical Education
• Patient Outcomes

Background:

• Surgical volume is linked to improved patient outcomes.
• Residency training is crucial for developing surgical skills.
• Mastery of complex operations requires adequate training experience.

Purpose of the Study:

• To evaluate the current urological residency experience in performing adult urinary diversion.
• To assess resident exposure to continent and incontinent urinary diversions.

Main Methods:

• Analysis of Accreditation Council for Graduate Medical Education-Residency Review for Urology Operative Log Reports from 2000-2004.
• Identification of urinary diversion procedures using CPT codes.
• Comparison of resident logs by training year and diversion type.

Main Results:

• Total urinary diversions increased from 2,259 to 4,017 between 2000-2004.
• Mean/median urinary diversion cases per resident remained constant.
• Graduating residents in 2003-2004 had a mean of 6.7 continent and 9.5 incontinent diversion cases.

Conclusions:

• Urology residents have limited exposure to urinary diversion, particularly continent types.
• Residency programs may lack sufficient volume for comprehensive urinary diversion training.
• Alternative strategies are needed to ensure adequate resident training in urinary diversion.