Practice Readiness? Trends in Chief Resident Year Training Experience Across 13 Residency Programs.

Urology residency prepares trainees for independent practice. The optimal operative chief resident year experience to prepare for practice is undefined. We analyzed the temporal arc of cases residents complete during their residency compared to their chief year in a multi-institutional cohort.

Accreditation Council for Graduate Medical Education case logs of graduating residents from 2010 to 2022 from participating urology residency programs were aggregated. Resident data for 5 categorized index procedures were recorded: (1) general urology, (2) endourology, (3) reconstructive urology, (4) urologic oncology, and (5) pediatric urology. Interactions were tested between the trends for total case exposure in residency training relative to the chief resident year.

From a sample of 479 resident graduates, a total of 1,287,433 total cases were logged, including 375,703 during the chief year (29%). Urologic oncology cases had the highest median percentage completed during chief year (56%) followed by reconstructive urology (27%), general urology (24%), endourology (17%), and pediatric urology (2%). Across the study period, all categories of cases had a downward trend in median percentage completed during chief year except for urologic oncology. However, only trends in general urology (slope of -0.68, P = .013) and endourology (slope of -1.71, P ≤ .001) were significant.

Over 50% of cases completed by chief residents are urologic oncology procedures. Current declining trends indicate that residents are being exposed to proportionally fewer general urology and endourology cases during their chief year prior to entering independent practice.

Urology practice. 2023 Dec 29 [Epub]

Zachary Corey, Erik Lehman, Gary E Lemack, Marisa M Clifton, Adam P Klausner, Akanksha Mehta, Humphrey Atiemo, Richard Lee, Mathew Sorensen, Ryan Smith, Jill Buckley, Houston Thompson, Benjamin N Breyer, Gina M Badalato, Eric M Wallen, Jay D Raman

Department of Urology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania., Department of Public Health Science, Pennsylvania State University College of Medicine, Hershey, Pennsylvania., Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas., Department of Urology, John Hopkins University School of Medicine, Baltimore, Maryland., Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, Virginia., Department of Urology, Emory University School of Medicine, Atlanta, Georgia., Department of Urology, Henry Ford Hospital, Detroit, Michigan., Department of Urology, Weill Cornell Medical Center, New York, New York., Department of Urology, University of Washington School of Medicine, Seattle, Washington., Department of Urology, University of Virginia School of Medicine, Charlottesville, Virginia., Department of Urology, University of California San Diego School of Medicine, San Diego, California., Department of Urology, Mayo Clinic, Rochester, Minnesota., Department of Urology, University of California San Francisco School of Medicine, San Francisco, California., Department of Urology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York., Department of Urology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.