The Urology Residency Program in Israel-Results of a Residents Survey and Insights for the Future

Abstract

Objective: Urology practice has undergone several changes in recent years mainly related to novel technologies introduced. We aimed to get the residents' perspective on the current residency program in Israel and propose changes in it.

Methods: A web-based survey was distributed among urology residents.

Results: 61 residents completed the survey out of 95 to whom it was sent (64% compliance). A total of 30% replied that the 9 months of mandatory general surgery rotation contributed to their training, 48% replied it should be shortened/canceled, and 43% replied that the Step A exam (a mandatory written certifying exam) in general surgery was relevant to their training. A total of 37% thought that surgical exposure during the residency was adequate, and 28% considered their training "hands-on." Most non-junior residents (post-graduate year 3 and beyond) reported being able to perform simple procedures such as circumcision and transurethral resections but not complex procedures such as radical and laparoscopic procedures. A total of 41% of non-junior residents practice at a urology clinic. A total of 62% of residents from centers with no robotics replied its absence harmed their training, and 85% replied they would benefit from a robotics rotation. A total of 61% of residents from centers with robotics replied its presence harmed their training, and 72% replied they would benefit from an open surgery rotation. A total of 82% of the residents participated in post-graduate courses, and 81% replied they would engage in a clinical fellowship.

Conclusion: Given the survey results we propose some changes to be considered in the residency program. These include changes in the general surgery rotation and exam, better surgical training, possible exchange rotations to expose residents to robotic and open surgery (depending on the availability of robotics in their center), greater out-patient urology clinic exposure, and possible changes in the basic science period.

Figure 1. Degree of Confidence in Independently Performing Common Urologic Procedures Among Residents in Post-graduate Year 3 (PGY3)

Confidence measured on a scale of 1 to 5 (1, not confident; 5, very confident). RPP, retropubic prostatectomy; SPP, suprapubic prostatectomy; TUR-BT, transurethral resection of bladder tumor; TUR-P, transurethral resection of prostate.

Figure 2. Degree of Confidence in Independently Performing Simple Urologic Procedures Among Residents in Post-graduate Year 3 (PGY3) and beyond

Confidence measured on a scale of 1 to 5 (1, not confident; 5 very confident). PGY, post-graduate year; RPP, retropubic prostatectomy; SPP, suprapubic prostatectomy; TUR-BT, transurethral resection of bladder tumor; TUR-P, transurethral resection of prostate.

Figure 3. Degree of Confidence in Independently Performing Complex Urologic Procedures among Residents in Post-graduate Year 3 (PGY3) and beyond

Confidence measured from 1 to 5 (1, not confident; 5, very confident).