Curriculum
Educational Philosophy, Goals and Objectives Heading link
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.
Curriculum Heading link
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PG1 Year
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.
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PG2 Year
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.
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PG3 Year
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.
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PG4 Year
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.
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PG5 Year
The PG5 rotation is divided in two 6-month blocks, one at UIH and one at OSF little company of Mary. 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 OSF little company of Mary. The local program director is Dr. Ronald Bonaguar, 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.
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PG6 Year
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.
Rotation Schedule Heading link
| 6 Months | 6 Months | |
|---|---|---|
| **The Pediatric Urology rotation includes the following hospitals: | University of Illinois Medical Center at Chicago | Lurie Children’s Hospital |
| (Jan-June or July-Dec) | (Jan-June or July-Dec) | |
| PGY1 | Urology/General Surgery | |
| PGY2 | Mount Sinai Hospital | University of Illinois Medical Center at Chicago |
| PGY3 | University of Illinois Medical Center at Chicago | **Pediatric Urology |
| PGY4 | Research | Research |
| PGY5 | University of Illinois Medical Center at Chicago | Little Company of Mary |
| PGY6 | University of Illinois Medical Center at Chicago (Chief) | SINAI (Chief) |
Conferences Heading link
Embark on a journey of knowledge and collaboration within the realm of urology through the vibrant array of conferences.
Weekly Conferences
- AUA Update Conference: Each week the residents and a faculty member with expertise in the topic review the content and study questions for each lesson of the AUA Updates. This is performed in an informal setting fostering critical appraisal of the review as well as potential for application of the information toward quality and process improvement of the department.
- Core curriculum: Medical Knowledge
- Multidisciplinary Tumor Board Conference: This is a weekly hospital-wide conference attended by medical oncology, radiation oncology, diagnostic and interventional radiology, pathology, and surgical oncologists from several disciplines. Cases are submitted to the University of Illinois at Chicago tumor registrar by the faculty caring for the patient. Dr. Abern represents Urology at this conference. Each relevant aspect of the case is presented by the appropriate specialty, and the group makes consensus management decisions including any appropriate open clinical trials that the patient may qualify for.
- Pediatric Urology Conferences: During their six month rotation at Children’s Memorial Hospital, residents participate in the conference schedule held by all faculty at this highly academic and busy clinical site. In addition, a monthly hourly conference at the University of Illinois at Chicago attended by all residents is conducted by a faculty member assigned to the University of Illinois at Chicago from Children’s Memorial Hospital. Residents present pediatric cases, and literature appropriate to the applied pediatric patient care is discussed.
- Core competencies: Practice-based Learning and Improvement, Medical Knowledge and Patient Care.
- Pre-Op Indications Conferences: These are weekly meeting. Residents from each service present interesting patients whose surgical treatment is either upcoming or ongoing, and discuss the proposed operative and postoperative management plan with the faculty. Particular emphasis is placed on selection of operative technique, treatment alternatives, and the identification of hypothetical pitfalls and means to avoid them.
- Core competencies: Practice-based Learning and Improvement, Medical Knowledge and Patient Care.
Monthly Conferences
- Journal Club: The intent of this monthly conference is to educate residents in the integration of patient care with utilization of the world literature in the modern electronic era. Based on a particular topic that is aligned with the AUA Core Curriculum, each resident selects a recent and relevant journal article by a PubMed search, and analytically reviews and presents the case and the associated journal article to the residents and attending urologists. Emphasis is placed on the evidence-based approach the journal article applies to the corresponding case. Selection of the journal articles are reviewed and approved by faculty.
- Core competencies: Practice-based Learning and Improvement, Medical Knowledge and Patient Care
- Morbidity/Mortality/Ethics Conference: The intent of this monthly conference is to educate residents in the reflection of patient care with undesired outcomes by reviewing literature applicable to the administered medical and surgical therapies which resulted in morbidity or mortality, but also by considering ethical issues such as judgment in selecting therapy and considering quality of life issues. Morbidity and mortality cases for all hospitals in the training program are included in the conference, and attendance is mandatory for all residents and full time and voluntary faculty. The resident responsible for the management of each case presents a summary of the evaluation, treatment plan, surgical procedure(s), adverse outcome and a topical and pertinent literature review to describe past experience with the adverse outcome encountered during therapy. The responsible faculty member then reviews the case from her or his perspective, and the attendees discuss the case in detail, emphasizing clinical judgment in the approach taken, and the associated ethical and quality of life issues. The treating resident and faculty member then summarize the discussion and present recommendations to prevent adverse outcomes in similar future cases.
- Core competencies: Patient Care, Practice-based Learning and Improvement, Professionalism, Communication and Interpersonal Skills and Medical Knowledge
- Chapter Club: The intent of this monthly two hour conference is to systematically review the core urological knowledge within the Campbell’s Urology textbook. A single faculty moderates the conference, where the assigned chapters are first thoroughly reviewed, and then questions and answers selected from past AUA Self Assessment Study Programs pertaining to the chapters are discussed. An average of four chapters is covered per conference session so that the entire textbook is reviewed during a two year period, and as a result each resident covers the entire text twice during her or his residency. When appropriate, supplemental reading such as journal articles pertinent to the text is assigned and discussed.
- Core competency: Medical Knowledge
- Case Conference: At this conference the residents from each hospital bring their current most difficult or interesting diagnostic and treatment problems for presentation to other residents and faculty. The cases are presented as unknowns and are read by the junior residents. The problems are then dissected by the more senior residents and faculty and a consensus on management is reached by the group.
- Core competencies: Practice-based Learning and Improvement, Medical Knowledge and Patient Care
- Research and Education and Practice Meetings: These monthly meetings are part of the administrative function of the Department of Urology, and two resident delegates attend to give direct input into the educational and practice-oriented operation of the department. The monthly Research and Education meeting addresses all educational and research efforts within the department, and the Practice Meeting attends to clinic practice oriented issues involved in the running of the department. Residents are considered equal partners in the administration of the department at these meetings, contributing ideas and collaborating in problem solving.
- Core competencies: Practice-based Learning and Improvement, Systems-based Practice and Communication and Interpersonal Skills
Occasional Conferences
As the occasion arises, residents will meet with members of the radiology and pathology departments for an interdisciplinary conference fostering collaboration across fields.
Pelvic Floor Conference: This is an interdisciplinary conference involving our urology and OB/GYN residents. The monthly conference is run by either Dr. Ervin Kocjancic, Dr. Anders Mellgren, or Dr. William Kobak. The entire spectrum of the anatomy, physiology and diseases of the pelvic floor and lower urinary tract are covered. The residents have a unique opportunity to get a multidisciplinary approach to common diseases affecting 1.6 million patients in US. The didactic section is very interactive through case presentation and decision making modules.
- Core competency: Practice-based Learning and Improvement, Medical Knowledge and Patient Care
Miscellaneous
Robotics Training Program
Simone Crivellaro, MD, leads a monthly lab teaching all residents the basics in robotic surgery as part of a scored robotics training program. These dry and wet labs train residents in minimally invasive procedures with laparoscopic and robotic skills. Labs also incorporate virtual reality software. All residents must pass a standardized assessment at the end of each year.
Computational Science and Engineering Research Conference
This weekly meeting to review and discuss the Computational Science and Engineering Research laboratory effort is attended by the research resident participating in the laboratory. The resident presents her or his weekly work to the attendees, and subjects it to rigorous analysis and input. This meeting is integral to the scientific education of the participating resident.
External Seminars Heading link
Chicago Urological Society
One year older than the American Urological Association, this monthly meeting held from November to April every year is one of the most active educational venues in urology today. The Chicago Urological Society consists of over 200 practicing urologists in the tri-state area and faculty at all of the academic programs. Academic faculty from all programs give didactic lectures throughout the afternoon followed by direct interaction with residents and academic faculty from all urology residency training programs in Chicago. After dinner, an invited national thought leader in urology gives a lecture on a topic chosen by the participants to be of high educational value. Once a year the residents involved in research in the Chicago urology training programs compete in the Charles Huggins Resident Essay Competition .
National Urology Resident Preceptorship Program (NURPP – Cleveland Clinic)
The Cleveland Clinic received an NIH grant to support this scientific conference. The program’s emphasis is female pelvic medicine and reconstructive surgery (FPM & RS). The format of the meeting includes live surgery, didactic lectures and discussion of research and career opportunities in FPM & RS. The program is held for 3 ½ days. The core competency of Medical Knowledge is directly addressed by the structure of this conference.
National Urology Resident Preceptorship (NURP – Cleveland Clinic)
This didactic program’s emphasis is adult and pediatric reconstructive and prosthetic urologic surgery, and is held for two days at the Glickman Urological Institute of the Cleveland Clinic. The core competency of Medical Knowledge is directly addressed by the structure of this conference.
Basic Science Conference
This week-long conference held at the University of Virginia provides a review of basic science knowledge applicable to urology in the development of treatment methods. It provides an opportunity to compare newly published findings and their impact on medical practice and patient care. Both PG4 residents (URO2) attend this conference. The core competency of Medical Knowledge is directly addressed by the structure of this conference.
Specialty Review in Urology Course
This week-long conference is designed to prepare residents for Part 1 of the American Board of Urology examination. The core competency of Medical Knowledge is directly addressed by the structure of this conference.
Working with Medical Students Heading link
As indicated in the above descriptions of the resident yearly rotations all patients at all sites are seen by the resident staff at the time of initial presentation in the outpatient clinic, on admission to the various hospitals, in the operating room, postoperatively, and again in the clinics following discharge. They are given independence in managing all aspects of patient care commensurate with their level of training and individual progress. This is done under direct supervision of an attending physician who has final responsibility for every patient at every site. The resident is expected to follow all patients through their entire care. When they are off call they report on their patient’s care to the responsible attending and fellow resident and receive progress reports on their return to duty. Patient care is a full time responsibility and although there are defined duty hours residents are expected to remain with sick patients on the floors and in the operating room when necessary to assure continuity of care. The 6 month rotations allow for observation and participation in long term care. When significant care issues extend beyond 6 months the resident receives follow-up at conferences or directly from fellow residents and attendings. For purposes of education, there is no distinction between private and non-private patients at any site.
Program Policy Regarding Supervision. (P.R. V. D.)
All residents at all institutions are supervised by faculty (full time and voluntary) who have final responsibility for patient care. The faculty at all sites report to the program director who ensures that the residents receive appropriate teaching and oversight. The program director evaluates the supervision through frequent feedback both from the faculty and residents.
At the University of Illinois, medical students have the option of a four-week urology rotation during the M3 or M4 year. Residents have a major role in teaching medical students during these rotations including instruction on the workup of patients in the hospital and clinic settings as well as the operating room. Students perform histories and physicals on selected patients and present their work to supervising residents. Residents also assign readings to the medical students and quiz them during clinics, rounds and in the operating rooms.