Urology PGYIII

Description of Rotation or Educational Experience

This two-week rotation will be with board certified urologists in the outpatient setting during the PGYIII year. The purpose of the rotation is to provide the family medicine resident with a focused experience in the evaluation and management of a broad range of patients requiring urologic services. It is expected that the resident will obtain clinical knowledge and proficiency in the primary evaluation and initiation of an appropriate management plan for common urologic disorders. The primary teaching method is the evaluation and management of urological problems in the outpatient clinic under the supervision of urology preceptors. The management of patients with urologic conditions will be a continuous longitudinal experience throughout the residency in the continuity clinics of the residents at the FMC, hospital and emergency room settings. The resident will also be responsible for all residency requirements including four half days of clinic at the FMC per week and completion of reading assignments as required by the preceptor.

Goal I: To achieve competence in diagnosing and managing common urological conditions as appropriate for the Family Physician.

Goal II: To achieve competence in recognizing and referring complex urological disorders.

Patient Care

Goal

Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.  Residents are expected to:

Competencies

• Be able to diagnose and treat common urological problems that present to the family practice office.
• Be knowledgeable of basic GU procedures including foley catheter insertion, vasectomy, post void residual assessment, catheterization of urinary bladder, indications for imaging, digital rectal exam, and prostate screening protocol.

Objectives

• At the conclusion of this training, the resident should have the knowledge and skills to manage common urological problems that are seen by Family Practitioners and also recognize the need for proper referral and consultation by a specialist for those that are beyond his/her capabilities.

Medical Knowledge

Goal

Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care.  Residents are expected to:

Competencies

  Objective

• The resident will be able to diagnose and initiate a treatment plan for patients who present with the above problems.

Practice- Based Learning and Improvement

Goal

Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life long learning.  Residents are expected to develop skills and habits to be able to:

Competencies:

• Identify strengths, deficiencies and limits in one’s knowledge and expertise;
• Locate, appraise and assimilate evidence from scientific studies related to their patients’ health problems

Objectives

• The resident will be able to facilitate the treatment of the patient with urological problems.
• The resident will  utilize resources in the office, literature, and electronic resources to accomplish this treatment.

Systems Based Practice

Goal

Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.  Residents are expected to:

Competencies

• Work effectively in various health care delivery settings and systems relevant to their clinical specialty
• Understand the costs associated with urological procedures.

Objectives

The resident will:

• Gain knowledge of the delivery of care to the urology patient in the in-patient and outpatient setting. 
• Demonstrate an understanding of the resources necessary to treat different types of urological problems.
• Understand and discuss the costs, risks, and benefits of the following:
  • Prostrate screening
  • Erectile dysfunction
  • Incontinence

Professionalism

Goal

Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.  Residents are expected to demonstrate:

Competencies

• Accountability to patients, society, and the profession

Objectives

• The residents are exposed to patients from a diverse patient population during their urology rotation.  They are expected to recognize needs and expectations of the patients in the urology environment.  This is measured by direct observation of resident clinical interactions by the supervising physician and is reported on the end of month evaluation.
• The resident will demonstrate sensitivity towards patients with potentially embarrassing diagnoses, for example, erectile dysfunction and incontinence.

Interpersonal and Communication Skills

Goal

Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information with patients, families, and colleges.  Residents are expected to:

Objectives

• The resident, while working with the urology preceptor, will learn the role and function of the consultant and the importance of communication with patients, their families, and the primary care physician.

Teaching Methods

One on one teaching with the urology preceptor.

At the conclusion of each resident rotation, the residency coordinator sends a formative-type, rotation-specific performance evaluation form to the rotations’ supervising physician.  When the completed evaluation is returned, the resident physician and the resident’s faculty advisor review the evaluation and attest to reviewing it by signing/initialing the form.  Next, the program director reviews and attests to the document.  Once all three have reviewed and attested the evaluation, it is included in the resident’s permanent file. 

Each resident is asked to evaluate the rotation and supervising physician(s) at the end of the rotation.  The resident’s faculty advisor and program director review the evaluation and attest to reviewing it by signing/initialing the form. These evaluations are filed together by resident year

The urology preceptor.

Educational Resources

Textbook purchased by the residency and entrusted to each resident while participating on the rotation is as follows:

Handbook  of Urology:  Diagnosis and Therapy – Siroky, Oates & Babayan; Edition 3, 2004

On Line Resources:

UpToDate

DynaMed