Department of Urology

The educational goal of the urology residency program is to train the best physicians to become the best urologists. This goal is met through three objectives:
- First, we strive to instill a sense of scholarship in residents, making self-education a life-long vocation and pleasure. The educational experience of residency should be like that of graduate school: an immergence in the field of urology, where curiosity and excitement fuel discovery about the field. Conferences and grand rounds are only one manifestation of this objective; through the example of scholarship by the faculty, residents see the joy of learning.
- Second, we work very hard to train residents in the craft and discipline of surgery. Initially through example and reduction of each maneuver or operation into its component parts, we provide a graded experience of increased responsibility for each resident. Areas of weakness, uncertainty and ignorance are exposed. The focus is correction. Residents are provided with ample opportunity to hone and refine their surgical skills.
- Third, we place a premium on excellent patient care. By making each senior-level rotation up to six months long, residents are able to see patients in both the peri-operative and longer-term follow-up. Teaching at the bedside, in the context of inpatient consults or rounds, coupled with extensive outpatient clinic experience allow the faculty to provide both examples of excellent patient care and to mentor the residents as they develop into outstanding — and caring — clinicians.

Curriculum

Block Diagram
	4 Months	4 Months	4 Months
PGY-3	VA	PUH	CHP
PGY-4	Lab	Lab	SHY
PGY-5	CHP	SHY	PUH (Magee Chief)
PGY-6	PUH (Admin Chief)	SHY (Chief)	VA (Chief)

Legend:
PUH - UPMC Presbyterian, UPMC Montefiore, and Magee-Womens Hospital of UPMC
SHY - UPMC Shadyside and Hillman Cancer Center
VA - Pittsburgh Veteran's Affairs Medical Center
CHP - Children's Hospital of Pittsburgh of UPMC

Pre-Urology Years

Coordination with the Surgery Department at UPMC has allowed us to structure a pre-urology program that is maximally appropriate for later urologic training.
Typical rotations during the PGY-1 and PGY-2 years include:
- Urology
- General surgery (including the Pittsburgh VAMC & UPMC St. Margaret)
- Trauma
- Surgical Oncology
- GI surgery
- Plastic surgery
- Pediatric surgery
- Vascular
- Thoracic
- ER
- Anesthesia
- Transplant (PGY-2 yr)
- SICU (PGY-2 yr)

Urology Years

Time during the PGY-3 through PGY-6 years is divided between the operating room, rounds, conferences and outpatient clinics.
Operative experience
- High case volume in major urologic procedures ensures outstanding surgical training at UPMC.
- Residents graduating in 2005 were over the 90th percentile for number of prostatectomy and renal cases done as primary surgeon during their residency. These cases are the staple of surgical urologic practice today.
  - Other major cases over the 50th percentile include:
    - Pelvic lymphadenectomy
    - Retroperitoneal lymphadenectomy (RPLND)
    - Percutaneous renal surgery
    - Radical cystectomy
    - Transurethral resection bladder tumor (TURBT)
    - Ureteroscopy
    - Urinary diversion, all types
    - Laparoscopy
Conferences
- Multiple activities are specifically designed for resident education. Conferences for Urology residents at UPMC include:
  - Urology Grand Rounds
  - Urology Morbidity & Mortality Conference
  - Visiting Professor Days
  - Pediatric Radiology Conference
  - Pediatric Didactic Conference
  - Pathology Conference
  - Journal Club
  - Campbell's Club
  - Tumor Board
  - Radiology Conference
  - PUH/MUH Preop Conference
  - UPMC Shadyside Preop Conference
  - VA Preop Conference
  - CHP Preop Conference
Curriculum
- The educational program is designed to cover the breadth of urology over a 2-year time period and then repeat so each resident is exposed to each topic as both a junior and senior level resident. When possible, topics are coordinated between Pathology, Radiology, and Campbell's Club conferences. The topics include:
  - Kidney
    - Anatomy
    - Physiology
    - Pathology
    - Kidney stones, formation and pathophysiology
    - Pyelonephritis, renal abscess
    - Renal trauma, blunt and penetrating
    - Laser physics and safety
    - Kidney stones: location-dependent management
    - Kidney stones: long-term management
    - Renal Cell Carcinoma
    - Post-obstructive diuresis
    - Renal Transplantation: immunosuppression
  - Adrenal
    - Anatomy
    - Physiology
    - Pathology
    - Pheochromocytoma
    - Adrenal adenomas
    - Hormonally active adrenal tumors
    - Adrenal cortical carcinoma
  - Ureter
    - Anatomy
    - Physiology
    - Pathology
    - Ureteral obstruction, pathophysiology
    - Ureteral strictures, acquired and congenital
    - Ureteral trauma
  - Bladder
    - Anatomy
    - Physiology
    - Pathology
    - Bladder Trauma
    - Hematuria: gross, microscopic
    - Urinary tract infection
    - Cystitis: hemorrhagic, interstitial, contracted, acute, chronic
    - Neurogenic Bladder
    - Urinary retention
    - Incontinence: stress, urge, overflow, continuous
  - Prostate
    - Anatomy
    - Physiology
    - Pathology
    - Trauma
    - Benign prostatic hyperplasia
    - Prostatitis: acute, chronic, prostatic abscess
    - Prostate Cancer
  - Urethra
    - Anatomy
    - Physiology
    - Pathology
    - Trauma
    - Diverticulum
    - Strictures
    - Carcinoma
  - Urethra
    - Anatomy
    - Physiology
    - Pathology
    - Trauma
    - Peyronie's Disease
    - Priapism: low flow, high flow, chronic
  - Testes and Scrotum
    - Anatomy
    - Physiology
    - Pathology
    - Trauma
    - Infertility
    - Fournier's Gangrene
Research
- 8-month block during the PGY-4 (URO-2) year
- The Laboratory Research rotation provides an initial exposure to basic urological research with opportunities for study in a variety of areas, including oncology, neurourology, and immunology. With a large number of faculty researchers in the department as well as many well-equipped laboratories, the research rotation provides significant exposure to many common research techniques, such as cell culture, small animal dissections, and molecular biology. Finally, this educational experience provides a focused time to develop analytical and critical cognitive skills in reading basic and clinical scientific literature, understanding and implementing good experimental design and effectively reporting one's findings.
- Residents who have papers accepted to national meetings are strongly encouraged to go and present their work with departmental sponsorship.