Waisanen Kyle, Hennig Finn, Lutnick Ellen, Parmar Gaganjot, Baetzhold Daniel, Iskhakov Nathaniel, Saade Kiana, Peterson Matthew, Nader Nader D, Chevli Kent
Department of Urology, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, United States.
University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, United States.
Can Urol Assoc J. 2024 Jul;18(7):E212-E219. doi: 10.5489/cuaj8639.
Our goal was to compare the perceived readiness of graduating urologic residents and fellows to program directors (PDs) in U.S.-based postgraduate training programs. Additionally, we set out to assess the impact of COVID-19 on postgraduation plans to pursue fellowship training.
Graduating residents, fellows, and PDs of accredited residency/fellowship programs in the U.S. were surveyed. The ranked preparedness of trainees to perform common urologic procedures was measured using a Likert scale from 1 (not comfortable) to 5 (fully proficient). The impact of COVID-19 was measured using a three-point Likert scale. Chi-squared and Kruskal-Wallis analyses were used to compare the groups.
From 93 responders, 21 were residents, 19 were fellows, 24 were residency PDs, and 29 were fellowship PDs. The median levels of comfort for trans-urethral resection of the prostate, hydrocelectomy, vasectomy, and urethral sling were at or above (≥3) moderate for both PDs and trainees. PDs were more likely to report underperformance for hypospadias repair (60% vs. 39%), penile prosthesis implantation (39% vs. 26%), and orthotopic neobladder formation (57% vs. 18%) than the trainees. Fifty-three (57.0%) of the surveyors felt that COVID-19 did not impact the trainees' comfort in performing general urologic procedures. COVID-19 influenced trainees' decision to pursue a fellowship or opt to practice as general urologists (p=0.002).
Our study suggests there may be a self-reported discrepancy between graduating trainees and their PDs regarding trainees' comfort levels performing general urologic procedures.
我们的目标是比较美国研究生培训项目中即将毕业的泌尿外科住院医师和研究员与项目主任（PD）对其准备情况的认知。此外，我们还着手评估新冠疫情对毕业后继续深造接受专科培训计划的影响。
对美国经认可的住院医师/专科培训项目中即将毕业的住院医师、研究员和项目主任进行了调查。使用从1（不舒服）到5（完全熟练）的李克特量表来衡量学员执行常见泌尿外科手术的准备程度排名。使用三点李克特量表来衡量新冠疫情的影响。采用卡方检验和克鲁斯卡尔-沃利斯分析来比较各组。
在93名受访者中，21名是住院医师，19名是研究员，24名是住院医师项目主任，29名是专科培训项目主任。对于前列腺经尿道切除术、鞘膜积液切除术、输精管切除术和尿道悬吊带术，项目主任和学员的舒适度中位数均处于或高于（≥3）中等水平。与学员相比，项目主任更有可能报告在尿道下裂修复（60%对39%）、阴茎假体植入（39%对26%）和原位新膀胱形成（57%对18%）方面表现不佳。53名（57.0%）受访者认为新冠疫情并未影响学员执行一般泌尿外科手术的舒适度。新冠疫情影响了学员继续深造接受专科培训或选择成为普通泌尿外科医生的决定（p=0.002）。
我们的研究表明，即将毕业的学员与其项目主任之间在学员执行一般泌尿外科手术的舒适度方面可能存在自我报告的差异。
