Surgical Residency Program Rotation Goals and Objectives


Urology Residency Rotation - Specific Goals and Objectives

PGY-1 Resident Responsibilities and Objectives

  1. Knowledge and experience in documenting preoperative history and physical examinations, operative notes, in-patient progress notes and discharge summaries.
    Goals and objectives/competency: Patient care
    Documentation: Faculty evaluations
  2. Routine and intensive care management of surgical patients including:
    a. Bowel preparation
    b. Antimicrobial prophylaxis and therapy
    c. Antifungal prophylaxis and therapy
    d. Pain management
    e. Wound care
    f. Enteral nutrition
    g. Parenteral nutrition
    h. Renal dysfunction dose adjustments
    i. Postoperative diet advancement
    j. Postoperative fever assessment
    k. Postoperative nausea assessment
    l. Postoperative hypoxia assessment
    m. Postoperative hypotension assessment
    n. Fluid / electrolyte management
    o. Acid / base management
    p. Blood product utilization / transfusion
    q. Intravenous line/injection
    r. Intramuscular injection
    s. Foley catheter placement
    t. Removal/placement of drains
    u. Removal/placement of skin staples
    v. Nasogastric tube placement
    w. Electrocautery use and safety considerations
    x. Surgical gown and glove technique
    y. Sterile surgical technique
    z. Technique for draping surgical site
    aa. One-hand knot tying
    bb. Two-hand knot tying
    cc. Instrument knot tying
    dd. Surgeons knot
    ee. Running closure
    ff. Interrupted closure
    gg. Mattress closure
    hh. Purse-string closure
    ii. Reducing use of unnecessary therapies and testing/Cost containment.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Technical Skill
    Documentation: Faculty Evaluations, Morbidity and Mortality Reports
  3. Experience and skill at preoperative assessment of patient risk factors, determination of special evaluations that should be performed to optimize patient cardiopulmonary status prior to an anesthetic.
  4. Knowledge and experience with the prophylactic measures utilized to prevent complications such as:
    a. Wound infections
    b. Atelectasis
    c. Acute GI bleed
    d. Deep venous thrombosis
    e. Pulmonary embolus
    f. Delirium tremens
    g. Bacterial endocarditis.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care
    Documentation: Faculty Evaluations, Morbidity and Mortality Reports
  5. Radiological evaluation of acutely ill patients.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care
    Documentation: Faculty Evaluations
  6. Emergency evaluation of surgical patients.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Technical Skill
    Documentation: Faculty Evaluations
  7. Familiarity with the art of collegiality and interaction between surgeons of various specialties, and doctors in other fields and specialties who collaborate with us in the total care of patients.
    Goals and Objectives/Competency: Professionalism, Patient Care
    Documentation: Faculty Evaluations
  8. Knowledge of general surgical instruments and retractors, electrocautery safety, laser safety and precautions for preventing the spread of blood-borne illnesses.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Technical Skill
    Documentation: Faculty Evaluations

PGY-2 Resident Responsibilities and Objectives
Administrative Responsibilities

  1. Distribute, collect and submit to Program Coordinator the attendance sign-in sheets for all conferences.
    Goals and Objectives/Competency: Institutional Requirement, Professionalism
    Documentation: Program Coordinator's Receipt of Attendance Records.
  2. All residents are required to pass parts II and III of the USMLE.
    Goals and Objectives/Competency: Medical Knowledge, Institutional Requirement
    Documentation: Report of USMLE test results
  3. All residents must apply for and receive a state of Georgia medical license to progress from the PGY2 year.
    Goals and Objectives/Competency: Institutional Requirement
    Documentation: Georgia Composite State Board records

GHSU Junior Resident Rotation (6 months)

  1. Obtain and document appropriate genitourinary history.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge
    Documentation: Global Resident Competency Rating Form, Observed Patient Encounter Rating Form, 360 Degree Rating Form
  2. Perform and document appropriate genitourinary examination.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge
    Documentation: Faculty Evaluations
  3. Select, obtain and review appropriate laboratory and imaging studies.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge
    Documentation: Global Resident Competency Rating Form, Observed Patient Encounter Rating Form, 360 Degree Rating Form
  4. Integrate clinical information to develop differential diagnosis and most likely diagnosis.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge
    Documentation: Global Resident Competency Rating Form, Observed Patient Encounter Rating Form, 360 Degree Rating Form
  5. Present interesting or challenging imaging cases selected by the chief resident or a faculty member at Radiology conference.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form
  6. Compile the patient list of scheduled surgical cases for weekly pre-op conference (administrative staff available to transcribe written/dictated list), request charts or print out preoperative history and physical from electronic medical record, request radiology studies, and select and display the appropriate radiographic studies to accompany the presentation of preoperative cases by chief resident.
    Goals and Objectives/Competency: Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form
  7. Round at least twice daily and write progress notes on all adult urology patients in the intensive care unit at GHSU and, with the supervision of the chief resident and faculty, manage acute and chronic health issues and develop plans for transfer.
    Goals and Objectives/Competency: Patient Care
    Documentation: Global Resident Competency Rating Form, Observed Patient Encounter Rating Form
  8. Develop Urologic surgical skills including demonstration of understanding of anatomy, indications and risks, familiarity with instrumentation, speed and lack of complications for the following:
    a. Perform stent placement (also demonstrate knowledge of fluoroscopic equipment, appropriate stent placement, appropriate selection of guidewire type and stent diameter and length);
    b. Perform transurethral bladder biopsy (also demonstrate appropriate choice of irrigating fluid, location and depth of biopsies, appreciation of bladder over-distention, appropriate use of electrocautery);
    c. Perform transrectal needle biopsy of the prostate (also demonstrate correct interpretation of images and appropriate location and number of biopsies);
    d. Opening and closing scrotal incision;
    e. Orchiopexy for torsion;
    f. Intracorporal injection;
    g. Suprapubic tube placement;
    h. Flexible cystoscopy;
    i. Stent removal;
    j. Rigid cystoscopy;
    k. Retrograde pyelograms;
    l. Simple and radical orchiectomy;
    m. Adult hydrocele repair;
    n. Varicocelectomy/ligation;
    o. Spermatocelectomy;
    p. Circumcision/dorsal slit;
    q. Excision of genital skin lesions;
    r. Vasectomy;
    s. Urethral dilation.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Technical Skill
    Documentation: Morbidity and Mortality Reports, Global Resident Competency Rating Form, Operative Performance Rating Form.
  9. Read the Ethic module assignments � Module 1-2.
    Goals and Objectives/Competency: Medical Knowledge,
    Professionalism,System-based practice.
    Documentation: 360 Degree Rating form, Global Resident Competency Rating form.

VA Junior Resident Rotation (6 months)

  1. Obtain and document appropriate genitourinary history.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge
    Documentation: Global Resident Competency Rating Form, Observed Patient Encounter Rating Form, 360 Degree Rating Form
  2. Perform and document appropriate genitourinary examination.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge
    Documentation: Global Resident Competency Rating Form, Observed Patient Encounter Rating Form, 360 Degree Rating Form
  3. Select, obtain and review appropriate laboratory and imaging studies.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge
    Documentation: Global Resident Competency Rating Form, Observed Patient Encounter Rating Form, 360 Degree Rating Form
  4. Integrate clinical information to develop differential diagnosis and, most likely, diagnosis.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge
    Documentation: Faculty Evaluations
  5. Present interesting or challenging imaging cases selected by the VA senior resident or a faculty member at Radiology conference.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form
  6. Compile the patient list of scheduled surgical cases for weekly pre-op conference, print out history, request radiology studies and display appropriate radiographic studies to accompany the presentation of cases by VA senior resident.
    Goals and Objectives/Competency: Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form
  7. Round at least twice daily and write progress notes on all urology patients in the intensive care unit at VA and, with the supervision of the VA senior resident, chief resident and VA faculty, manage acute and chronic health issues and develop plans for transfer.
    Goals and Objectives/Competency: Patient Care
    Documentation: Global Resident Competency Rating Form, Observed Patient Encounter Rating Form, 360 Degree Rating Form
  8. Develop urologic surgical skills including demonstration of understanding of anatomy, indications and risks, familiarity with instrumentation, speed and lack of complications for the following:a. Perform stent placement (also demonstrate knowledge of fluoroscopic equipment, appropriate stent placement, appropriate selection of guidewire type and stent diameter and length);
    b. Perform transurethral bladder biopsy (also demonstrate appropriate choice of irrigating fluid, location and depth of biopsies, appreciation of bladder over-distention, appropriate use of electrocautery);
    c. Perform transrectal needle biopsy of the prostate (also demonstrate correct interpretation of images and appropriate location and number of biopsies);
    d. Opening and closing scrotal incision;
    e. Intracorporal injection;
    f. Suprapubic tube placement;
    g. Flexible cystoscopy;
    h. Stent removal;
    i. Rigid cystoscopy;
    j. Retrograde pyelograms;
    k. Stent placement;
    l. Placement of ostomy appliance;
    m. Simple and radical orchiectomy;
    n. Adult hydrocele repair;
    o. Varicocelectomy/ligation;
    p. Spermatocelectomy;
    q. Circumcision/dorsal slit;
    r. Excision of genital skin lesions;
    s. Vasectomy;
    t. Urethral dilation;
    u. Periurethral injection of bulking agents;
    v. Assist during ureteroscopy and percutaneous renal surgery;
    w. Shock wave lithotripsy.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Technical Skill
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form, Operative Performance Rating Form, Morbidity and Mortality Reports
  9. Read the Ethic module assignments � Module 3-4.
    Goals and Objectives/Competency: Medical Knowledge,
    Professionalism,System-based practice.
    Documentation: 360 Degree Rating form, Global Resident Competency Rating form.

PGY-3 Resident Responsibilities and Objectives
Administrative/Rotation Independent Responsibilities

  1. The PGY-3 resident serves as the urology consultant for the other specialties in the institutions, including the Level I Trauma Center. After initial evaluation and treatment recommendations, the resident continues to follow these patients throughout their hospitalization.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  2. Obtain clearance at Doctors hospital, University and Surgical Center for female rotation. See Kim Maddox.

GHSU Senior Resident Rotation (3-month block, 2-month block, one month)

  1. Interpret history and clinical data, and propose initial treatment/evaluation plans for infertility, female incontinence, priapism, Peyronie's disease, pelvic pain syndromes, impotence, uncomplicated UTIs and uncomplicated nephrolithiasis.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form by Staff, Peer, and Patient Evaluations
  2. Provide appropriate staging evaluation of newly-diagnosed neoplasms.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care
    Documentation: Global Resident Competency Rating Form
  3. Provide appropriate metabolic evaluation of stones, hypogonadism and adrenal masses.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  4. Provide initial triage and evaluation of the trauma patient.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care
    Documentation: Global Resident Competency Rating Form
  5. Interpret postoperative data and, from that data, recommend and provide appropriate postoperative management of penile implant, female pelvic reconstructive procedures, percutaneous nephrostolithotomy and radical prostatectomy.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  6. Demonstrate surgical skills including demonstration of understanding of anatomy, indications and risks, familiarity with instrumentation, speed and lack of complications for the following (in addition to skills listed under PGY-1 and PGY-2):
    a. Opening and closing flank incision;
    b. Opening and closing chevron or hockey-stick incision;
    c. Transurethral resection of papillary bladder tumor;
    d. Incision of urethral stricture;
    e. PCNL;
    f. Ureteroscopy for stone;
    g. Placement of initial penile prosthesis;
    h. Transurethral incision of the prostate;
    i. Correction of Peyronie's with plication;
    j. Urostomy revision;
    k. Pelvic lymph node dissection;
    l. Simple/donor nephrectomy;
    m. Renal transplantation and transplant nephrectomy;
    n. Cystolithalopaxy;
    o. ESWL;
    p. Placement of initial artificial urinary sphincter;
    q. Holmium laser use;
    r. Assist on urologic procedures on high risk patients;
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Technical Skill
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form, Operative Performance Rating Form, Morbidity and Mortality Reports
  7. Present interesting or challenging cases of residents' choice in Radiology conference.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form
  8. Attend Stone clinic on the first and third Thursday morning of each month.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care
    Documentation: Global Resident Competency Rating Form
  9. Present cases in Nephrology stone conference.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form
  10. Read the Ethic Module assignments � Module 5-6.
    Goals and Objectives/Competency: Medical Knowledge,
    Professionalism,System-based practice.
    Documentation: 360 Degree Rating form, Global Resident Competency
    Rating form.

Neuro-urology/Female Urology (2 months)

  1. Interpret history and clinical data and propose initial treatment/evaluation plans for female stress incontinence, pelvic prolapse, pelvic pain syndromes, neurogenic bladder, etc.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  2. Perform pelvic examination, neurologic examination, Bonnie test and grade degrees of prolapse.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  3. Maintain good relationship and team approach with gynecologic colleagues.
    Goals and Objectives/Competency: Professionalism, Interpersonal Communication
    Documentation: Global Resident Competency Rating Form
  4. Demonstrate surgical skills including demonstration of understanding of anatomy, indications and risks, familiarity with instrumentation, speed and lack of complications for the following:
    a. Bladder neck suspension;
    b. Cystocele repair;
    c. Sling procedure;
    d. Superpubic vs vaginal suspension;
    e. Assist with rectocele repair, enterocele repair, vaginal and abdominal hysterectomy.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Technical Skill
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form, Operative Performance Rating Form, Morbidity and Mortality Reports
  5. Read the Ethic Module assignments � Module 13.
    Goals and Objectives/Competency: Medical Knowledge,
    Professionalism,System-based practice.
    Documentation: 360 Degree Rating form, Global Resident Competency
    Rating form.

Pediatric Rotation (1-month rotation)

  1. Interpret history and clinical data, and propose initial evaluation and treatment plans for vesicoureteral reflux, ureteropelvic junction obstruction, recurrent urinary tract infections, undescended testis and hypospadias.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Systems-Based Learning
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  2. See all consults to the pediatric urology service including emergencies.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  3. Follow multidisciplinarypatients in the Spina bifida clinic.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Systems-Based Learning
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  4. Appropriately request, perform and interpret pediatric urodynamic procedures.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Technical Skill
    Focumentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  5. Demonstrate surgical skills including demonstration of understanding of anatomy, indications and risks, familiarity with instrumentation, speed and lack of complications for the following (in addition to skills listed under PGY1 � PGY3):
    a. Orchiopexy;
    b. Pediatric hydrocele repair.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Technical Skill
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form, Operative Performance Rating Form, Morbidity and Mortality Reports
  6. Present interesting or challenging imaging cases of residents' choice or by pediatric urology and/or radiology faculty in pediatric urology radiology conference.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form
  7. Post all pediatric urology surgical cases with the operating room within the time frame mandated, including requests for specialized equipment, blood products and estimates of case duration.
    Goals and Objectives/Competency: Institutional Requirement, Medical Knowledge, Patient Care, Technical Skill
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form by Operating Room Nurse and Anesthesia Evaluations
  8. Compile the patient list of scheduled pediatric urology surgical cases for weekly pre-op conference (administrative staff available to transcribe written/dictated list), review history, request radiology studies and select appropriate radiographic studies for display. Present these pediatric urology surgical cases in weekly pre-op conference.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form

Research Rotation (3 months)
Three months is not intended to be the time allotment to carry a research project from start to finish. Residents are expected to meet with faculty members to discuss projects of interest and read appropriate literature prior to the start of the research rotation, in order for their time to be spent in the actual generation, collection and analysis of data once on the rotation.

  1. Identify a faculty member/topic of interest and perform literature search, reading and review to develop clinical question/hypothesis/protocol.
    Goals and Objectives/Competency: Medical Knowledge, Practice-Based Learning
    Documentation: Written literature summary/hypothesis, Faculty Evaluations
  2. Review regulations and apply for appropriate institutional approvals for human or animal research. Take course and pass examination for GHSU and VA research compliance. Contact Mary Ann Park, director of clinical research services, phone 721-0193, email mpark@augusta.edu for information and instructions.
    Goals and Objectives/Competency: Professionalism, Medical Knowledge, Interpersonal and Communication Skills, Institutional Requirements.
    Documentation: Submitted protocol application, course completion
  3. Collect and conduct analysis of data, and write abstract/manuscript.
    Goals and Objectives/Competency: Professionalism, Medical Knowledge, Interpersonal and Communication Skills
    Documentation: Abstract/Manuscript
  4. Present research and Rinker and/or Georgia Urology Resident Research Expo. Submit abstract to Southeastern Section of AUA and/or Annual AUA meeting.
    Goals and Objectives/Competency: Professionalism, Interpersonal and Communication Skills
    Documentation: Presentation.
  5. Read the Ethic Module assignments � Module 14-16.
    Goals and Objectives/Competency: Medical Knowledge,
    Professionalism,System-based practice.
    Documentation: 360 Degree Rating form, Global Resident Competency
    Rating form.


PGY-4 Resident Responsibilities and Objectives
Administrative Responsibilities

  1. Organization of resident call schedule monthly with attention to the 80-hour work-week, one day off in seven regulations.
    Goals and Objectives/Competency: Institutional Requirement, Professionalism
    Documentation: Timely submission of call schedule with fair distribution of call nights in compliance with the 80-hour work-week, 1 day off in seven rules.

Pediatric Rotation (6 months)

  1. Interpret history and clinical data, and propose initial evaluation and treatment plans for vesicoureteral reflux, ureteropelvic junction obstruction, recurrent urinary tract infections, undescended testis and hypospadias.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Systems-Based Learning
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  2. See all consults to the pediatric urology service including emergencies.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  3. Follow multidisciplinary patients in the Spina bifida clinic.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Systems-Based Learning
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  4. Appropriately request, perform and interpret pediatric urodynamic procedures.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Technical Skill
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  5. Demonstrate surgical skills including demonstration of understanding of anatomy, indications and risks, familiarity with instrumentation, speed and lack of complications for the following (in addition to skills listed under PGY1 � PGY3):
    c. Ureteral reimplantation for reflux;
    d. Initial pyeloplasty;
    e. Orchiopexy for cryptorchidism with abdominal testis;
    f. Laparoscopy for nonpalpable testis;
    g. Transurethral resection of posterior urethral valves;
    h. Distal hypospadias repair;
    i. Pediatric nephrectomy.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Technical Skill
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form, Operative Performance Rating Form, Morbidity and Mortality Reports
  6. Present interesting or challenging imaging cases of residents' choice or by pediatric urology and/or radiology faculty in pediatric urology radiology conference.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form
  7. Post all pediatric urology surgical cases with the operating room within the time frame mandated, including requests for specialized equipment, blood products and estimates of case duration.
    Goals and Objectives/Competency: Institutional Requirement, Medical Knowledge, Patient Care, Technical Skill
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form by Operating Room Nurse and Anesthesia Evaluations
  8. Compile the patient list of scheduled pediatric urology surgical cases for weekly pre-op conference (administrative staff available to transcribe written/dictated list), review history, request radiology studies and select appropriate radiographic studies for display. Present these pediatric urology surgical cases in weekly pre-op conference.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form
  9. Read the Ethic Module assignments � Module 7-8.
    Goals and Objectives/Competency: Medical Knowledge,
    Professionalism,System-based practice.
    Documentation: 360 Degree Rating form, Global Resident Competency
    Rating form.

VA Senior Resident Rotation (Five months)

  1. Compile the patient list of scheduled VA surgical cases for weekly pre-op conference (administrative staff available to transcribe written/dictated list), review history, request radiology studies and select appropriate radiographic studies for display. Present these VA surgical cases in weekly pre-op conference.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form
  2. Interpret admission data and, from that data, recommend and provide appropriate management of infected/eroded penile implant, urosepsis, acute renal failure secondary to obstruction, post-operative small bowel obstruction, patients with metastatic cancer and pain/dehydration/neurologic changes (with attention to patient comfort and patient/family wishes regarding heroic measures to prolong life)
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Professionalism
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  3. Interpret pre-operative staging data and, from that data, propose appropriate treatment plans for newly diagnosed neoplasms, patients failing medical therapy for BPH and impotence, patients with large/complex urinary stone burden, neurogenic bladder dysfunction (with attention to patient support system).
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Systems-Based Learning, Professionalism
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  4. Present interesting or challenging cases of residents' choice in radiology conference.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form
  5. Post all VA surgical cases with the operating room within the time frame mandated, including requesting specialized equipment, blood products, and estimates of case duration.
    Goals and Objectives/Competency: Institutional Requirement, Medical Knowledge, Patient Care, Technical Skill
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form, Operative Performance Rating Form
  6. Present cases in VA pathology conference (administrative staff will compile and transcribe list from urology surgical schedule and clinic specimen log; resident must notify pathology administrative staff if specimens from other services or slides sent from other facilities are to be reviewed as well).
    Goals and Objectives/Competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form
  7. Demonstrate surgical skills including demonstration of understanding of anatomy, indications and risks, familiarity with instrumentation, speed and lack of complications for the following (in addition to skills listed under PGY1 � PGY3):
    a. Simple prostatectomy;
    b. Radical prostatectomy;
    c. Radical nephrectomy;
    d. PCNL with multiple access/concomitant ureteroscopy;
    e. Transurethral resection of large bladder tumor or involving ureteral orifice;
    f. Endopyelotomy;
    g. Bladder neck suspension/PV sling;
    h. Replace/revise artificial urinary sphincter;
    i. Ureteroscopy for upper tract tumor;
    j. End-to-end urethroplasty;
    k. Urethrectomy;
    l. Partial cystectomy/diverticulectomy;
    m. Repair of bladder injury/rupture;
    n. Cystoprostatectomy and conduit;
    o. Vasography;
    p. Laparoscopic nephrectomy;
    q. Female pelvic reconstruction.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Technical Skill
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form, Operative Performance Rating Form, Morbidity and Mortality Reports
  8. Read the Ethic Module assignments � Module 10-11.
    Goals and Objectives/Competency: Medical Knowledge,
    Professionalism,System-based practice.
    Documentation: 360 Degree Rating form, Global Resident Competency
    Rating form.

Transplant Rotation (1-month)

  1. Resident will gain knowledge of diagnosis, management, treatment options (surgical/non-surgical), long term prognosis, postoperative effects, complications, patient risk and cost considerations associated with:
    a. Performinh a complete transplantation exam;
    b. Pre- and post-operative management of kidney transplant patients;
    c. Immunosuppressive drugs - types, indications and dosages;
    d. Complications of transplantation;
    e. Treatment of rejection;
    f. Appropriately use of diagnostic tools, such as ultrasound of a transplanted kidney, renogram, Doppler vascular ultrasound, kidney transplant biopsy.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Systems-Based Learning
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  2. Demonstrate surgical skills including demonstration of understanding of anatomy, indications and risks, familiarity with instrumentation, speed and lack of complications for the following (in addition to skills listed under PGY1 � PGY2):
    a. Operative techniques required for the preparation of the recipient for kidney transplantation;
    b. Learn vascular techniques and reinforce urologic techniques employed during the operative procedure of the recipient and donor for kidney transplantation;
    c. Learn techniques of temporary catheter placement and A � V fistula creation for hemodialysis.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Technical Skill
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form, Operative Performance Rating Form.
  3. Read the Ethic Module assignments � Module 12.
    Goals and Objectives/Competency: Medical Knowledge,
    Professionalism,System-based practice.
    Documentation: 360 Degree Rating form, Global Resident Competency
    Rating form.

PGY-5 (Chief) Resident Responsibilities and Objectives
Administrative Responsibilities

  1. Administer the day-to-day logistics of the resident/student schedule including operating room assignments, clinic assignments, rounding times, prompt attendance to conferences and specific elements of conference participation.
    Goals and Objectives/Competency: Patient Care, Professionalism Interpersonal and Communication Skills, Systems-Based Practice
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  2. Supervise (with faculty input) the junior residents in minor procedures.
    Goals and Objectives/Competency: Patient Care, Professionalism, Interpersonal and Communication Skills, Systems-Based Practice
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form, Operative Performance Rating Form, Morbidity and Mortality Reports

GHSU/VA/Chief

  1. Present GHSU adult surgical cases (and pediatric surgical cases when the PGY-4 resident is rotating at the VA) other than emergencies at weekly pre-op conference prior to surgery.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form
  2. Post all GHSU adult surgical cases (and pediatric surgical cases when the PGY-4 resident is rotating at the VA) with the operating room within the time frame mandated including requesting specialized equipment, blood products and estimates of case duration.
    Goals and Objectives/Competency: Institutional Requirement, Medical Knowledge, Patient Care, Technical Skill
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form by operating room nurse and Anesthesia, Operative Performance Rating Form
  3. Prepare written (administrative staff available to transcribe written/dictated text) and oral presentation GHSU adult morbidity and mortality cases (and pediatric surgical cases when the PGY-4 resident is rotating at the VA) monthly.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning, Institutional Requirements
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form
  4. Compile list of selected surgical specimens every two weeks for presentation at GHSU uropathology conference (administrative staff available to transcribe written/dictated list) and submit to pathology for preparation. During uropathology conference, present a brief history of each patient prior to the histologic review.
    Goals and Objectives/Competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning, Institutional Requirements
    Documentation: Attendance record of conferences, Global Resident Competency Rating Form
  5. Interpret history and clinical data, and propose initial evaluation and treatment plans for ambiguous genitalia, female pelvic floor relaxation, cancer patients with recurrent/residual malignancy.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Systems-Based Learning
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form
  6. Demonstrate surgical skills including demonstration of understanding of anatomy, indications and risks, familiarity with instrumentation, speed and lack of complications for the following (in addition to skills listed under PGY1 � PGY4):
    a. Adrenalectomy;
    b. Radical nephrectomy with tumor thrombus;
    c. Partial nephrectomy;
    d. Urethrolysis/revision female pelvic reconstruction;
    e. Segmental ureterectomy;
    f. Salvage prostatectomy;
    g. Bladder augmentation, Mitrofanoff, MACE;
    h. Repair of vesico-enteric fistula;
    i. Pediatric partial nephrectomy;
    j. Female cystectomy/anterior exenteration with conduit;
    k. Cystectomy and continent diversion/bladder substitution;
    l. Laparoscopy/hand-assisted nephrectomy;
    m. Graft urethroplasty;
    n. Retroperitoneal lymph node dissection;
    o. Sentinel/inguinal lymph node dissection;
    p. Correction of Peyronie's with plaque excision and grafting;
    q. Total penectomy with urethrostomy;
    r. Revision pyeloplasty
    s. Ureteral reimplantation for reimplant failures, ureteral disruption, distal ureterectomy.
    Note: The chief resident will operate on major open/challenging cases at either the VA or GHSU at his or her discretion.
    Goals and Objectives/Competency: Medical Knowledge, Patient Care, Technical Skill
    Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form, Operative Performance Rating Form, Morbidity and Mortality Reports
    Read the Ethic Module assignments � Module 9 � GHSU , Module 17 - VA
    Goals and Objectives/Competency: Medical Knowledge, Professionalism, Systems-based practice.
    Documentation: 360 Degree Rating form, Global Resident Competency Rating form.