Longitudinal Changes in the Operative Experience for Junior Urology Residents
Ezra J Margolin1, Daniel Schoenfeld1, Caleb H Miles2
1Department of Urology, Columbia University Irving Medical Center, New York, NY.
Urology
|July 3, 2023
Summary
Urology residency training shows a decline in major surgical case exposure for junior residents, with a simultaneous rise in endoscopic procedures. This shift may impact surgical preparedness for new urologists.
Area of Science:
- Urology
- Surgical Education
- Medical Training
Background:
- Growing concerns exist regarding urology residents' preparedness for independent practice.
- This perceived deficit may stem from reduced exposure to complex surgical cases early in residency.
Purpose of the Study:
- To analyze longitudinal trends in surgical case volume among junior urology residents.
- To investigate changes in major and endoscopic case exposure during urology residency.
Main Methods:
- Retrospective analysis of deidentified case logs from 244 urology residency graduates across 12 US academic medical centers (2010-2017).
- Primary outcome: change in major case volume for first-year urology residents (URO1).
- Negative binomial regression used to measure trends in case volume.
Main Results:
- A total of 391,399 cases were logged.
- Median major cases for URO1 residents decreased from 64 to 49 (2010-2017), a trend primarily in oncology.
- Median endoscopic cases for URO1 residents increased from 85 to 194, disproportionately more than for senior residents.
Conclusions:
- A significant shift in case distribution is observed among junior urology residents.
- There is a decrease in major case exposure and an increase in endoscopic surgery for URO1 residents.
- Further research is required to assess the impact of these trends on surgical proficiency.
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