Urological training in Australasia: perceptions of recent fellows and current trainees

In this study we sought to determine the opinions of recent Fellows and current trainees on the state of urological training in Australasia. Self administered questionnaires were mailed to all urologists in Australia and New Zealand who had obtained their FRACS from 1988 to the present, as well as all current advanced urological trainees. Eight-seven per cent of Fellows and ninety-four per cent of trainees completed and returned the questionnaire. Most Fellows and trainees felt that their training adequately equipped them for subsequent independent practice. At the completion of training and FRACS examination the majority of respondents felt competent in dealing with most urological conditions. However, many did not feel confident with paediatric and specialized or complex adult urology, particularly oncology and reconstruction. Post-Fellowship training, however, appears valuable in overcoming these deficiencies. Several limitations were also noted as a consequence of the fact that training is based entirely in the public hospital system. This created particular difficulties with respect to outpatient or 'office' urology as well as exposure to some non-acute conditions such as urinary incontinence and infertility. The current research requirements of training do not appear to provide trainees with an adequate knowledge of scientific method, with many respondents not feeling equipped to critically appraise urological literature. High levels of competence are also not attained for other important professional skills, particularly communication with other medical practitioners. Despite its importance for learning, feedback on progress is not adequately provided and this was seen as a major problem with current urological training in Australasia. The majority of respondents felt that mentors required specific training to facilitate feedback to trainees.