Lavi Arnon, Tzemah Sharon, Hussein Anan, Bishara Ibrahim, Shcherbakov Nikolay, Zelichenko Genady, Mashiah Alon, Gross Michael, Cohen Michael
Department of Urology, Haamek Medical Center, Afula, Israel.
Rambam Maimonides Med J. 2017 Oct 16;8(4):e0039. doi: 10.5041/RMMJ.10317.
Urology practice has undergone several changes in recent years mainly related to novel technologies introduced. We aimed to get the residents' perspective on the current residency program in Israel and propose changes in it.
A web-based survey was distributed among urology residents.
61 residents completed the survey out of 95 to whom it was sent (64% compliance). A total of 30% replied that the 9 months of mandatory general surgery rotation contributed to their training, 48% replied it should be shortened/canceled, and 43% replied that the Step A exam (a mandatory written certifying exam) in general surgery was relevant to their training. A total of 37% thought that surgical exposure during the residency was adequate, and 28% considered their training "hands-on." Most non-junior residents (post-graduate year 3 and beyond) reported being able to perform simple procedures such as circumcision and transurethral resections but not complex procedures such as radical and laparoscopic procedures. A total of 41% of non-junior residents practice at a urology clinic. A total of 62% of residents from centers with no robotics replied its absence harmed their training, and 85% replied they would benefit from a robotics rotation. A total of 61% of residents from centers with robotics replied its presence harmed their training, and 72% replied they would benefit from an open surgery rotation. A total of 82% of the residents participated in post-graduate courses, and 81% replied they would engage in a clinical fellowship.
Given the survey results we propose some changes to be considered in the residency program. These include changes in the general surgery rotation and exam, better surgical training, possible exchange rotations to expose residents to robotic and open surgery (depending on the availability of robotics in their center), greater out-patient urology clinic exposure, and possible changes in the basic science period.
近年来泌尿外科实践发生了若干变化，主要与引入的新技术有关。我们旨在了解以色列泌尿外科住院医师培训项目在住院医师中的看法，并提出改进建议。
对泌尿外科住院医师进行了一项基于网络的调查。
在95名被邀请的住院医师中，61人完成了调查（回复率64%）。共有30%的人认为9个月的普通外科强制轮转对他们的培训有帮助，48%的人认为应该缩短或取消，43%的人认为普通外科的A阶段考试（一项强制性的书面认证考试）与他们的培训相关。共有37%的人认为住院期间的手术接触足够，28%的人认为他们的培训是“实践操作型”的。大多数非初级住院医师（研究生三年级及以上）报告称能够进行简单手术，如包皮环切术和经尿道切除术，但不能进行复杂手术，如根治性手术和腹腔镜手术。共有41%的非初级住院医师在泌尿外科诊所实习。在没有机器人手术设备的中心，62%的住院医师表示缺少机器人手术设备对他们的培训有不利影响，85%的人表示他们将从机器人手术轮转中受益。在有机器人手术设备的中心，61%的住院医师表示有机器人手术设备对他们的培训有不利影响，72%的人表示他们将从开放手术轮转中受益。共有82%的住院医师参加了研究生课程，81%的人表示他们将参加临床 fellowship。
根据调查结果，我们建议在住院医师培训项目中考虑一些改进措施。这些措施包括普通外科轮转和考试的调整、更好的手术培训、可能的交换轮转以使住院医师接触机器人手术和开放手术（取决于其所在中心是否有机器人手术设备）、增加泌尿外科门诊接触机会以及基础科学阶段可能的调整。
