Educational Philosophy, Goals and Objectives
The program is designed to provide the trainee with broad knowledge of all urologic diseases, their diagnosis, selection of appropriate therapy, and the requisite surgical skills to provide the highest quality of urologic care. The trainee is taught to have ongoing intellectual curiosity such that he/she will strive for continuing urologic education throughout his/her career. These goals are accomplished through a program of graded responsibility for patient care under faculty supervision in three hospital settings (University, Non-Profit and Private), an organized didactic program including a broad range of conferences, visiting professorships and guest lectures, regular evaluation of both resident and faculty performance, resident attendance and participation in local and national urologic meetings, and a dedicated laboratory research year. The latter provides the trainee with appreciation of the investigative process such that he/she should be able to critically evaluate new developments in urology during the course of their careers. This year also provides excellent stimulation for some residents to seek academic careers.
Starting in 2019-20, residents will be under the auspices of Urology and rotate with General Surgery. The PGY1 year will include six months of urology rotations designed to develop competence in basic urological skills, general care of the urology patient both in the in-patient and ambulatory setting, management of urology patients in the emergency department, and a foundation of urological knowledge. The resident will also spend six months under the direction of General Surgery, specifically 3 months in general surgery and 3 months of additional non-urological training.
The residents spend their urological education in the PG2 year in 2 6-month rotations at the University of Illinois Hospital (UIH) and Mt. Sinai Hospital (MSH). The goals at both sites are to learn the fundamentals of performing a urologic history and physical examination, develop a differential diagnosis, recommend the appropriate diagnostic studies, and suggest an appropriate medical and/or surgical therapy. The resident is expected to begin developing urologic diagnostic and surgical skills with emphasis on cystoscopic experience, urethral instrumentation and catheterization, trans-rectal ultrasonography, wound opening and closure, and minor urologic open procedures, all under the direct supervision of the chief resident and/or attending physician. The resident sees patients in the outpatient clinics at each site with the chief resident and attending and follows those patients to the inpatient setting, thus giving opportunity for observing continuity of care. The PG2 has a significant exposure to clinic flexible cystoscopy and TRUS guided prostate needle biopsy under supervision by the attending physician.
The goals and objectives of the PG3 year are to: increase the skills necessary for independence in completing a thorough urologic history and physical examination; to develop facility in performing all urologic endoscopy; to become proficient at performing minor open urologic surgeries and gain the skills necessary for increasing independence in major procedures; and, to acquire a basic knowledge of and surgical skills in the pediatric urologic patient.
The PG3 year is divided into 2 rotations, each of 6-months duration, one on the adult service at UIH and the other on the pediatric urology service at Lurie Children’s Hospital. While assigned at UIH, the resident sees outpatients in the attached offices and follows these patients when admitted. Under the direct supervision of the private urologists, the resident manages the inpatient service including writing admission and post-operative orders. The resident performs all major and minor adult operative procedures (including robotic surgery) as deemed appropriate for his/her level of skill under the supervision of the responsible urologist. Since all postoperative patients are followed in the attached offices, the resident has excellent experience in continuity of care in a private practice setting. UIC medical students rotate on the urology service at this site as well.
The PG3 resident’s experience on the Pediatric Urology Service mirrors that on the adult service. The junior resident is under the direct supervision of the faculty’s pediatric urologist, Dr. Emilie Johnson. In addition to responsibilities at UIC, the resident also spends several days during the week at Lurie Children’s Hospital working with the urologists in those facilities. In the clinic, he/she evaluates new referrals and sees post-operative patients and on the inpatient service, evaluates all new admissions and writes orders and makes rounds on postoperative patients under the direct supervision of the attending. In the operating room the resident is given the opportunity to perform endoscopy (cystoscopy, ureteral catheterization, portions of TUR urethral valves, etc.). He/she opens and closes major cases and will perform all or parts of most procedures (orchiopexy, herniorrhaphy, ureteral reimplantation, nephrectomy, urethroplasty, etc.) with the pediatric urologist. On more complex cases (bladder exstrophy, cloacal dysplasia, etc.) the resident assists under the supervision of the fellow and attending surgeons.
The PG4 year is a full-time research assignment. At the end of the PG3 year the resident meets with Dr. Craig Niederberger, Dr. Carol Podlasek and Dr. Gail Prins, Director of Urologic Basic Science Research, and settles on a research problem for study in the PG4 year. The resident will also select a clinical faculty mentor with whom he/she can carry out a simultaneous clinical research project if so desired. The resident spends full time in research activity for the entire year but is required to attend all department clinical and didactic conferences and will occasionally (average of 10 times in 1 year) perform significant cases and staff clinics with critical learning opportunities during the daytime, to fill in for vacationing fellow residents. The resident is required to attend the weekly Research Conference and to present their research work at a department Grand Rounds at the end of the academic year.
The research residents have the opportunity to work in our prostate cancer basic science laboratories with renowned scientists; in the University’s unique inter-college Innovation Center, where faculty from the colleges of engineering, medicine, business, and architecture, design and the arts collaborate on projects including medical device design from inception to commercialization; or pursue a master’s degree in the University’s School of Public Health, which is consistently rated in the top 20 in the United States. Most residents will present their work to at least 1 national urologic meeting and many will have at least one peer reviewed publication at the end of the year. The goals and objectives of this year are to leave the resident with an understanding of research methods, including study design and implementation, analysis of data, and statistical techniques. For the resident destined for community clinical practice this should provide the skills to critically evaluate future developments in the field as well as the intellectual curiosity to stay abreast of new knowledge. For those interested in an academic career the experience should act as a foundation for future investigation and make the individual a competitive candidate for fellowship training.
The PG5 rotation is divided in two 6-month blocks, one at UIH and one at St. Francis Hospital in Evanston. The goals of the PG5 year are to sharpen the resident’s diagnostic and surgical skills in adult urology and to begin the process of developing the confidence necessary for increased independence as a Chief Resident. At UIC, the PG5 is an active participant in laparoscopic renal surgery. The PG5 will also begin his/her robotic surgical experience including bedside assistance as well as performing portions of operations as the console surgeon. The PG5 will guide the PG2 resident through endoscopic and minor open surgical procedures and will have primary responsibility for performing complex endoscopic procedures.
A second 6-month rotation is done at St. Francis Hospital. The local program director is Dr. Allen Chernoff, who supervises the training provided by four board-certified Urologists. The PGY5 resident performs daily in-patient and out-patient surgery in order to develop advanced surgical skills and decision making. This includes endoscopic, open, and robotic procedures. The PG5 develops advanced skills in peri-operative care of surgical patients. He or she gains experience with decision making for Urological emergencies while developing critical thinking skills through educational presentations at quarterly M&M conferences.
The goals and objectives of this final year are to provide an atmosphere in which the Chief resident can manage all aspects of the urological care (evaluation, diagnosis, surgical intervention, and pre- and post-operative management) of his/her patients in an independent fashion. This is done with sufficient faculty oversight to assure proper education and patient safety.
PG6 residents are Chief Residents. They rotate for 6 months each at the University hospital and Mt. Sinai Hospital. Chief residents are expected to have significant independence in the evaluation and management of their patients. At each institution they are given the responsibility of managing the inpatient and outpatient services. They function as “junior attendings” and have direct responsibility for instructing and supervising the junior residents and medical students (M3, M4) assigned to the urology service. At the University they have their own clinic where they have responsibility for the evaluation and treatment of patients. The clinic is supervised by a faculty member who is present to oversee and consult but allows the Chief to make independent decisions.
At Mt. Sinai Hospital, Dr. Simone Crivellaro serves as the local program director. While assigned here, the resident sees outpatients in the hospital clinic and follows these patients when admitted. Under the direct supervision of the urologists at MSH, the resident manages the inpatient service including writing admission and post-operative orders. The resident performs all major and minor adult operative procedures as deemed appropriate for his/her level of skill under the supervision of the responsible urologist. Since all postoperative patients are followed in the attached offices, the resident has excellent experience in continuity of care in a community hospital.