12 months (Adult)

Expectations

The PGY-1 year is spent in the Department of Surgery and is preliminary to entry into the Urology training program. The goal of the preliminary year is for residents to obtain a firm foundation in the care of critically ill surgical patients and to become skillful in fundamental surgical techniques. 

The six competencies are introduced to residents and specified in the goals and objectives of the Mass General Surgery Residency Program.

Residents begin as a junior member on the Leadbetter, Kerr or O’Neil service in which they are exposed to inpatient and outpatient urology patients. Twelve months are spent as the junior resident on the adult service at Mass General. During this time residents become certified in laser safety and are exposed to the use of lasers in urology. Residents begin skill set training in laparoscopy by using the training modules and attending the laboratory demonstrations. They will have primary responsibility for the day-to-day activities of inpatient care and are trained in the systems of health care to include patient placement and post-discharge home support.

Residents are exposed to all aspects of urologic surgery and become proficient in scrotal procedures and diagnostic endoscopy. They are tutored for one month at the outset of the rotation in outpatient urology by the attendings of different specialties as well as the chief resident and then are assigned patients in the outpatient clinic which they attend one day per week.

Residents will acquire cognitive and clinical skills in the outpatient and inpatient care of urology patients and will be introduced to urologic data collection, i.e. history and physical examination and clinical decision-making. They should be familiar with urologic imaging modalities and will be introduced to urologic diagnostic techniques including the following:

  • Cystoscopy
  • Retrograde pyelography
  • Stent placement
  • Bladder biopsy
  • Transurethral resection of bladder tumors
  • Transrectal ultrasound
  • Biopsy of the prostate

Residents will perform scrotal urologic procedures with proficiency and be exposed to adult abdominal and pelvic surgery by the end of the year.

Residents will cultivate communication, attitudinal and professional skills with ethical standards and will be respectful of patients and their families, obtain informed consent and will demonstrate conduct consistent with a professional. Residents will become knowledgeable about systems-based practice, will be able to work well with the case manager to facilitate proper patient placement in the appropriate facility, as well as provide for patient needs in the home following discharge if that is the destination. Residents will be introduced to quality of care metrics and be capable of effectively accessing the literature to enhance practice. Residents will begin scholarly activities, which will involve literature reviews of clinical or basic science problems. A scholarly paper is the ultimate goal at the conclusion of the residency. Residents participate in weekly chapter reviews and all conferences.

By the end of the 12-month rotation, residents are expected to have become proficient at the following:

Patient Care

  • Demonstrate basic skill in use of laparoscopic instruments and knot tying through simulation
  • Attain laser safety certification
  • Provide effective, routine inpatient care and management
  • Obtain informed consent for most urologic procedures
  • Perform simple procedures in the acute care setting
  • Treat and follow patients in the acute care setting and access diagnostic and referral mechanisms
  • Demonstrate proficiency in scrotal procedures, diagnostic endoscopy and simple cystoscopic procedures
  • Participate in open, laparoscopic and endourologic procedures

Systems-based Practice

  • Determine appropriate patient placement follow-up and home health assistance

Medical Knowledge

  • Demonstrate basic medical knowledge base in urology, assessed by in-service examinations
  • The goal is to be in the 80th or above percentile

Practice-based Learning and Improvement

  • Participate in systematic analysis and use quality improvement methods to enhance quality of care, patient safety, cost effective care and patient outcomes

Interpersonal and Communication Skills

  • Communicate effectively with patients, families, physicians and other health care professionals

Professionalism

  • Carry out professional responsibilities and adhere to ethical principles

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