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Practice Readiness? Trends in Chief Resident Year Training Experience Across 13 Residency Programs.

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Urology chief residents are performing fewer general and endourology cases, with urologic oncology dominating their surgical experience. This trend may impact preparedness for independent practice.

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Area of Science:

  • Medical Education
  • Surgical Training
  • Urology

Background:

  • Urology residency aims to equip trainees for independent practice.
  • The ideal operative experience during the chief resident year remains undefined.

Purpose of the Study:

  • To analyze the temporal trends of surgical case volume completed by urology residents during residency and their chief year.
  • To assess the impact of these trends on preparedness for independent practice.

Main Methods:

  • Data from Accreditation Council for Graduate Medical Education case logs of urology residents from 2010-2022 were aggregated.
  • Five index procedure categories were analyzed: general urology, endourology, reconstructive urology, urologic oncology, and pediatric urology.
  • Trends in case completion during the chief year relative to overall residency training were examined.

Main Results:

  • A total of 1,287,433 cases were logged by 479 residents, with 29% performed during the chief year.
  • Urologic oncology cases constituted the highest proportion (56%) of chief resident cases.
  • Significant downward trends were observed in the median percentage of general urology (-0.68, P=.013) and endourology (-1.71, P≤.001) cases completed during the chief year.

Conclusions:

  • Chief residents are increasingly focused on urologic oncology procedures, exceeding 50% of their cases.
  • Declining exposure to general urology and endourology during the chief year may affect residents' readiness for independent practice.