Urology Residency Program
Overall Goals of the Residency Program
The primary objective of the Urology Residency Training Program is to ensure that the trainee is competent in all aspects of the care of patients with Urological Disease. The specific objectives will align with the Royal College Objectives of Training in Urology and Specialty Training Requirements in Urology. They are very detailed and will be of use to assess preparedness for the Royal College exams. They can also be used by the resident to evaluate the quality and comprehensiveness of the training program. Specific objectives are available on a rotation-by-rotation basis. The resident should become familiar with the objectives early in the first year of training and seek learning experiences (textbooks, journal articles, computer-assisted simulations and demonstrations) and actual or simulated patient cases, appropriate for the attainment of each objective. The rotation specific objectives of the three years of Urological training will provide more guidance as to self-assessment of progress through the training program.
Urology competencies will align to those elaborated by the Specialty Committee for urology at the Royal College, in alignment with the CanMEDS 2015 Framework .
Residents in the Competency Based Medical Education paradigm, beginning in 2017, will progress through the four CBME stages of Transition to Discipline, Foundations, Core Urology and Transition to Practice. Each of these features well-defined entrustable professional activities (EPAs) with corresponding milestones to meter their achievement and progress. These are available for review and should be known by the CBME cohort residents as part of their training planning.
Urological training involves not only training within the specialty but also a period of core training in general surgery and other specialties which may include vascular surgery, intensive care, nephrology, gynaecology, radiology, emergency medicine, pathology and plastic surgery. When residents undertake these training rotations it is important that there be defined objectives for the rotation, if maximum educational benefit is to be obtained. This document contains objectives for those rotations considered to be important to the urologist. During the early years of training the resident will learn the principles of surgery and will be evaluated in these through the Surgical Foundations Examination of the Royal College, typically at the end of the PGY 2 year (this may move earlier based on the implementation of the Surgical Foundations CBME process from the Royal College.
Objectives are structured to the level of resident training, that is junior, senior, chief resident and the rotations of the resident should reflect this gradation of training. Due to the nature of the program at Queen's, this occurs in a less structured manner. As experience and knowledge progresses, responsibility increases. At four monthly intervals, residents are evaluated according to the set objectives. CBME residents are evaluated in an iterative process to assess their process through the stages and EPAs of the CBME process. It is recognized that residents may vary in the speed with which they gain surgical proficiency and the order of rotation may not reflect their skills. However, it is the prerogative of the consultant to allow the resident assigned to him for any surgical cases to do as much or as little of the case as he considers appropriate for the resident's training.
Organization of the Training Program
The Department of Urology at Queen's University is accredited for full training in the specialty by the Royal College of Physicians and Surgeons of Canada. This requires a total of 5 years of postgraduate training: 2 years of Surgical Foundations and 3 years of Urology. The program is geared toward success in the Royal College examinations upon completion of the program. The training program is acceptable to the American Board of Urology, and residents who have successfully completed the program are permitted to sit the examinations of the American Board of Urology.
The Department sponsors the required training in Surgical Foundations at the PGY I and 2 level, and this will include rotations in general surgery, urology, critical care and emergency medicine; as well as electives such as gynaecology, transplantation and plastic surgery. This will permit the candidate to write the second part of the LMCC examinations. The second surgical foundations year will include rotations in Intensive Care, General Surgery and Vascular Surgery, if not done previously. Other elective rotations taken during these core years include: gynaecology, genitourinary pathology and radiology.
The first two years as a senior urology resident (PGY 3 and PGY 4) include rotations through outpatient clinics, operating rooms, wards and Emergency Rooms at Kingston Health Sciences Center, as arranged at the beginning of the year in consultation with the Program Director. Operative and clinic time will be spent at the Lennox and Addington County General Hospital as well. Elective and/or community urology rotations may be scheduled during this time. The year as Chief Resident (PGY 5) is located primarily at the Kingston General Hospital. He/she will have significant teaching responsibilities, both to his/her fellow residents and to the clinical clerks rotating through the Urology service. As described above, the CBME cohort will progress through the stages of the model (Transition to Discipline, Foundations, Core Urology and Transition to Practice) through the EPAs and their constituent milestones.