1. Medical Knowledge and Patient Care Effectively and efficiently perform a history and physical examination that is appropriate for evaluation of a surgical patient Identify factors important in perioperative surgical patient such as: concomitant diseases involving organ systems (cardiac, endocrine, hepatic, infectious, pulmonary, renal, and psychiatric) Identify factors which are important conditions affecting the perioperative patient such as: extremes of age, immunosuppression, metabolic disorders, pregnancy, substance abuse Develop appropriate differential diagnosis and management plans Write daily inpatient notes in an appropriate format Write concise clinic notes in an appropriate format Write routine orders for admission, discharge, post-operative Maintain medical records in a legible and legally appropriate professional manner 2. Systems-Based Practice Identify barriers to access to health care Use the electronic medical record appropriately Adhere to policies of the Department of Urology, Office of Clinical Affairs, and the UMHS Become familiar with the principles of patient safety and patient safety practices of the UMHS and JCAHO including: improving accuracy of patient identification, improving the effectiveness of communication between healthcare providers, eliminating wrong-site, wrong-side surgery, implementing a time-out during operative cases Reducing the risk of health care-acquired infections Describe the roles of various health care providers 3. Practice-Based Learning and Improvement Demonstrate self-directed and lifelong learning skills Demonstrate the ability to access, analyze, and use sources available to ascertain scientific knowledge Be proficient with computer applications such as word-processing, spreadsheets, databases, and electronic presentations Become proficient in the EMR for patient care 4. Interpersonal Skills and Communication Listen actively with cultural, ethnic, gender, racial and religious sensitivity Communicate effectively with patients, families, and professional colleagues Be able to educate and advise patients with sensitivity, compassion, and concern Discuss medical errors or professional mistakes honestly and openly in ways which promote learning and improve patient care Convey important information accurately to the transition team to ensure appropriate care Give accurate, clear, and concise oral presentations Appreciate and be able to discuss sensitive issues with patients, including death and dying, substance abuse, health maintenance Identify a faculty mentor 5. Professionalism Adhere to local and institutional code of conduct, demeanor, behavior and attire Demonstrate respect to patient, families and other healthcare providers Use discretion in private and public communications which include electronic communication devices in accordance to HIPAA policies Demonstrate an awareness of one’s limitations Accept feedback appropriately and implement critiques effectively for self-learning and improvement Describe the principles of informed consent Become familiar to the principles of medical ethics Demonstrate time management skills appropriately in order to balance personal and professional responsibilities Demonstrate a strong work ethic, and consistently and dependably carry out one’s duties with honesty and integrity Demonstrate collegiality and a collaborative approach with other members of the health care team Be punctual Attend required conferences By the end of the PGY-1 year, the resident will be able to: a) Conduct proficient preoperative evaluations of general surgical patients. b) Provide postoperative care for general, urology, vascular, transplant and trauma patients. c) Master techniques of insertion and evaluation of invasive monitoring of postoperative or critically ill patients. d) Assist or perform surgical procedures in general, urology, vascular, transplant, trauma; develop surgical skills in minor procedures, and opening and closing surgical wounds. e) Evaluate knowledge base in surgery based on in-service exam. f) Initiate personal surgical log of cases. g) Will work effectively with support personnel in pre-operative, operative, and post-operative settings. 1. Medical Knowledge and Patient Care Obtain foundation of knowledge in urologic disease, including basics of renal physiology, adrenal physiology, neurourology and urodynamics, infertility, embryology, and oncology Learn basic skills of endoscopy of the lower urinary tract 2. Systems-Based Practice Demonstrate self-directed and lifelong learning skills Demonstrate the ability to access, analyze, and use sources available to ascertain scientific knowledge Be proficient with computer applications such as word-processing, spreadsheets, databases, and electronic presentations Become proficient in the EMR for patient care Become familiar with “lean technique” to problem solve 3. Practiced-Based Learning and Improvement Evaluate fund of basic urologic knowledge through the in-service exam with expected performance above 50th percentile national average. Mid –year retesting and focused study plans to be determined by PD as necessary. Yearly mock oral boards 4. Interpersonal Skills and Communication Refine interpersonal skills with support personnel. 5. Professionalism Develop teaching skills to assist in the education of medical students and junior residents Initiate study of clinical research principles Identify one clinical research project for the year (i.e. case reports, review articles and book chapters) By the end of the Urology 1 year, the resident will be able to: a) Demonstrate knowledge of fundamental principles of urologic disease and pathophysiology through didactic lectures and urology curriculum for study. b) Perform cystoscopy, bladder biopsies, and ureteral catheter insertion with supervision of attending staff and senior residents. c) Perform direct vision urethrotomies d) Perform balloon dilation of ureteral strictures. e) Perform both diagnostic and therapeutic ureteroscopy including laser lithotripsy, upper tract biopsy and fulguration. f) Perform transrectal ultrasonography and prostate biopsies under the supervision of attending staff and senior residents. g) Provide pre- and postoperative care for urology patients with emphasis on oncologic surgery. h) Care for inpatients and outpatients at the VA Medical Center under supervision of senior residents and attending staff. i) Increase surgical technical expertise in scrotal surgery, minor urologic surgery, abdominal wound opening and closing, and first assisting in robotic surgery. (See Section VI) j) Continue to work effectively with support personnel. k) Develop intern call schedule 1. Medical Knowledge and Patient Care Continue to increase knowledge of fundamentals of urologic disease and perioperative care Expand surgical experience in endoscopic cases Gain experience in percutaneous endourologic procedures Gain experience in pediatric urology disease evaluation and management Develop basic skills in laparoscopic, robotic and open urologic surgery Become familiar with and able to perform video urodynamics 2. Systems-Based Practice Assist in completing a quality improvement project using “lean technique” 3. Practice-Based Learning and Improvement Evaluate fund of basic urologic knowledge through the in-service exam with expected performance above 50th percentile national average. Mid –year retesting and focused study plans to be determined by PD as necessary. Initiate training in clinical urologic research which includes data analysis and retrieval Initiate two research projects with faculty mentor or other faculty Yearly mock oral boards 4. Interpersonal Skills and Communication Refine interpersonal skills with support personnel Expand your teaching skills to assist the PGY1 and PGY 2 residents Oral presentation at local, regional meeting Complete a manuscript, conducting two research projects during the year (i.e. case reports, review articles and book chapters) 5. Professionalism Develop skills of being a role model for medical students and assist the PGY 1 and 2 with patient care Meet with mentor to discuss initial career plans By the end of the Urology 2 year, the resident will be able to: a) Complete rotation as junior resident on VA inpatient and outpatient services. b) Residents will also perform surgeries and provide patient care at an ambulatory clinic and/or surgery center. c) Perform more complex lower tract endoscopic procedures, such as TUR biopsies of the bladder and prostate. d) Provide primary resident care on endourology service and gain experience with ureteroscopy, percutaneous nephrolithotomy, endopyelotomy, and laser lithotripsy. (See Section VI) e) Develop basic laparoscopic and robotic surgical skills. f) Provide junior resident care on pediatric urology service with particular emphasis on procedures such as orchiopexy. g) Present a research paper at Michigan Urologic Society Meeting. h) Perform surgeries in an ambulatory setting; such surgery includes: SWL, cysto, bladder biopsy, TURBT, ureteroscopy, vasectomy, TRUS/ BX. i) Develop skills in performance of and interpretation of simple and complex urodynamic evaluations. j) Expand clinical research to result in peer-reviewed publication or chapter. k) Evaluate progress of urologic knowledge through in-service examination. l) Present and discuss cases at Urology Grand Rounds. m) Work effectively with support personnel, including administrative aspects. 1. Medical Knowledge and Patient Care Expand depth and scope of knowledge of urologic diseases Develop basic expertise in microsurgery Gain expertise in female urology patient management and surgery Develop problem solving skills for diagnosis of urologic conditions Obtain exposure to clinical medical oncology and radiation oncology of urologic cancers and genitourinary pathology Refine expertise in pediatric urology with a leadership and primary surgical role 2. Systems-Based Practice Learn issues related to private practice of urology (1 month in SJ hospital) and managed care Complete a quality improvement project 3. Practice-Based Learning and Improvement Evaluate fund of basic urologic knowledge through the in-service exam with expected performance above 50th percentile national average. Mid –year retesting and focused study plans to be determined by PD as necessary. Interpret, initiate, and complete a urologic research project Expand understanding of clinical research, including trial design, biostatistics, epidemiology, and outcomes research, conducting two research projects for the year Initiate plans for future careers goals Yearly mock oral boards 4. Interpersonal Skills and Communication Present poster or podium presentation at local, regional, or national scientific meeting Complete at least one manuscript and/or chapter 5. Professionalism Continue to develop strategies for career goals after completion of training Refine interpersonal skills with support personnel By the end of the Urology 3 year, the resident will be able to: a) Interpret, initiate, and complete a research project in urology, with a scientific mentor in urology or other University of Michigan researcher with special expertise. b) Learn basic principles of study design and biostatistics through initiation of basic and/or clinical research. c) Obtain greater in-depth knowledge of urologic diseases with study of multiple texts, journals, and articles, such as Campbell’s Textbooks and Journal of Urology. d) Learn fundamentals of genitourinary pathology through participation in GU pathology. e) Submit abstract to national meeting (example, AUA or AACR). f) Submit manuscripts for publication on at least two clinical research topics. g) Present research paper at Michigan Urologic Meeting. h) Evaluate knowledge base by in-service exam. i) Obtain microsurgery expertise at microsurgery course provided by Department of Urology. j) Present and discuss cases at Urology Grand Rounds. k) Develop resident call schedule 1. Medical Knowledge and Patient Care Obtain proficiency in entire spectrum of pathophysiology of urologic disease Continued expansion of knowledge base of urologic disease Expand surgical experience in oncology as senior resident Gain experience in complex reconstructive surgery Use didactic conferences to expand depth of knowledge of urologic disease Coordinate / supervise weekly resident conference Facilitate high yield review sessions prior to ISE Mature in surgical expertise as primary surgeon 2. Systems-Based Practice Organize as the administrative chief the university service and VAH service Use didactic conferences to expand depth of knowledge of urologic disease Learn issues related to private practice (2 months at SJ) of urology and managed care 3. Practice-Based Learning and Improvement Evaluate fund of basic urologic knowledge through the in-service exam with expected performance above 50th percentile national average. Mid –year retesting and focused study plans to be determined by PD as necessary. Finalize future careers goals and conduct one research project during the year Yearly mock oral boards 4. Interpersonal Skills and Communication Be the liaison between fellow residents and faculty regarding resident-oriented issues Refine speaking skills as medical lecturer 5. Professionalism Demonstrate administrative skills and responsibility in organization of the service Assist in organization of the didactic lecture series Assume a leadership role and further refine leadership skills Exhibit traits of a role model for junior residents Refine interpersonal skills with support personnel By the end of the PGY-5 (Uro-4) year, the resident will be able to: a) Be primary resident on female urology service (inpatient and outpatient) with an emphasis on history taking, examination, and evaluation and treatment of women with urologic diseases, including incontinence, pelvic floor strengthening exercises, biofeedback, endometriosis, interstitial cystitis, neurogenic problems, recurrent UTIs, management of urethral diverticula and fistulas, pelvic pain, estrogen replacement therapy, osteoporosis, and urodynamics. b) Be primary resident on male general urology service with emphasis on BPH and andrology, including infertility and impotence. c) Submit at least one abstract to national meeting. d) Complete clinical or research manuscripts or chapters for publication e) Present and discuss cases at Urology Grand Rounds. f) Work effectively in clinical care and administration with support personnel, colleagues and students. g) Evaluate knowledge base by In-service exam. h) Master sophisticated aspects of urologic disease physiology, diagnosis, and decision making in preparation for the qualifying exam (Part I) of the Urology Boards. i) Organize teaching conferences with Associate PD for curriculum and lectures including Urology Grand Rounds, Uropathology Conference, and Monday Didactic Conferences. j) Supervise medical student teaching on urology service. k) Supervise inpatient care as chief of service with delegation of responsibilities to junior residents as appropriate. l) Present paper at Michigan Urologic Society. m) Submit at least one abstract for a national meeting. n) Expand knowledge of evolving knowledge and procedures in Urology by attendance at American Urologic Association Meeting. p) Refine surgical skills (open, laparoscopic and robotic) in most complex cases with a particular emphasis on oncology. (See Section VI) q) Manage VA outpatient and inpatient service as chief resident under faculty supervision. r) Learn comparative aspects of academic, private practice, and system-based practice career opportunities. s) Present and discuss cases at Urology Grand Rounds. t) Gain additional surgical expertise in a private practice setting in both inpatient and outpatient care at St. Joseph’s Hospital
PGY-1 Preliminary (9 mo. General Surgery/3 mo. URO)
PGY-2 (Uro-1)
PGY-3 (Uro-2)
PGY-4 (Uro-3)
PGY-5 (Uro- 4)
