PGY-1

Training goals: Gain a broad knowledge of surgical principles, learn skills of pre-operative evaluation, peri-operative care, management of surgical patients and learn basic surgical techniques (e.g., suture tying, wound care, acute and emergency resuscitation).

Broken into four-week blocks, rotations for first-year residents include:

• 6 blocks of urology
• 2 blocks of urogynecology
• 4 blocks of core general surgery (acute general surgery, surgical oncology, surgical ICU and surgical night float)
• 1 non-general surgery rotation (diagnostic and interventional radiology)

PGY-2

Training goals: Begin the experiential learning process in the diagnosis, treatment and surgical management of urological diseases under direct supervision of urology faculty.

Second-year residents complete alternating two-month rotation blocks at the VCU Medical Center and the Richmond VA Medical Center, in both inpatient and outpatient services. In addition, a two-month block is devoted to our mentored andrology, infertility and robotics (AIRs) rotation and a two-month block is devoted to emergencies and consults.

PGY-3

Training goals: Academic achievement and refinement of decision-making, endoscopic and surgical skills.

Third-year residents have four months dedicated to research, a four-month pediatric urology rotation at the Children’s Hospital of Richmond at VCU and four months divided into an AIRS and consult rotation.

Residents must meet with the research director to discuss topics at least three months prior to the start of the research rotation. The research resident will remain in the call pool and maintain their surgical skills with an expectation to operate, on average, one day per week.

PGY-4

Training goals: Assist the chief resident in overseeing the care of inpatients and all major adult operations, teach junior-level residents and medical students and manage inpatient consults under the supervision of an attending urologist.

The fourth year of training is divided into alternating four-month blocks: one at VCU, one at the Richmond VA Medical Center and one as the mentored urology specialty experience (MUSE) rotation, which incorporates two months of urogynecology and two months of a customized mentored elective, chosen by the resident and faculty members.

PGY-5

Training goals: Master surgical skills and clinical decision-making through operative experience and teaching, serve as a role model in teaching of junior residents and medical students.

As chief residents, fifth years are involved in a wide variety of complex oncology and robotic/laparoscopic surgeries, as well as open surgery. Residents at this level switch hospitals every six months and have administrative duties that prepare them for independent practice after training. Fifth-year residents supervise the consult service run by the senior residents and are expected to teach junior-level residents and medical students.

Specific responsibilities include:

• Manage inpatients and oversee the consult and pediatric services
• Supervise and oversee residents and rotating students in the clinics, wards and operating rooms
• Function as an advisory mediator and faculty liaison for any junior resident concerns, critiques or comments regarding any aspect of the program
• Engage in ongoing education, both formally and informally, of residents and rotating students during rounds, cases and other teaching opportunities
• Provide informal feedback to junior residents and rotating students and serve as a liaison to the program director regarding required duties as well as expected skills and functions
• Arrange weekly calendar listing expected cases with assignment of residents
• Provide written notification to program director, residency coordinator, site directors and surgical scheduling coordinator regarding leave and foreseen resident staffing issues
• Manage and present monthly Q&A, pathology and radiology conferences
• Assign and oversee administrative responsibilities, including preop list creation and presentations for indications conference
• Organize chief call schedule and oversee all schedules with notification of all elective leave at least one month in advance

Conferences and lectures

Each week, the Department of Urology holds lectures and conferences to supplement resident and faculty education.

Weekly conferences
6:30 – 7 a.m. – Rotating class meeting (PGY1-5) with the program director
7 – 7:30 a.m. – Indications conference to highlight notable imaging and complex cases
7:45 – 8:30 a.m. – Grand Rounds (rotates between AUA guidelines, AUA updates, journal club, guest lectures and M&M)

Fridays
7 a.m. – Strive for Five didactics teaching sessions
9 a.m. – General Urology Tumor Board

Strive for Five

In an effort to ensure that all residents are adequately exposed to the urology knowledge base required to perform well on written urologic examinations such as the annual in-service examination as well as the urology boards, we have developed Strive for Five, an in-house curriculum to keep up with the latest advances in urology. This curriculum is largely based on the AUA core curriculum, in addition to the AUA guidelines and AUA updates.

The general idea is that residents will strive to read an average of five pages every day. Each resident is assigned a monthly topic and will work to develop interactive weekly didactic sessions to teach their fellow residents and faculty. The curriculum is designed so that the core urology knowledge base is covered in its entirety over the course of two years.

Examples of topics include:

• Oncology: Adrenal neoplasms, bladder neoplasms
• Sexual medicine: ED physiology, pathophysiology, medical treatment and surgical treatment
• Uroradiology: Computed tomography, conventional radiology, MRI
• Female pelvic medicine and reconstructive surgery: Fecal incontinence evaluation and treatment, pelvic organ prolapse evaluation and treatment