Second-year residents rotate through all of the three clinical services at DHMC. Continuity of care occurs by seeing new patients in clinic, operating on and caring for the same patient post-op, and then seeing patients return to clinic for followup. Every three months they rotate to another team. During the pediatric block, residents also participate with the transplant team. While assigned to a particular team, residents attend clinic and operate with the team's attendings.
During the pediatric urology block, the resident spends a half-day per week going to transplant clinic, where they are involved in the workup of new patients and the followup of patients on whom they have operated. They participate in donor nephrectomy and in transplantation, particularly the neocystotomy.
- Obtain foundation of knowledge in urologic disease, including basics of renal physiology, adrenal physiology, neurourology and urodynamics, infertility, embryology, pediatric urology, female urology, stone disease, general male urology, and oncology with emphasis on office urology and diagnostic procedures.
- Gain experience in pediatric urology disease evaluation and management.
- Learn basics skills of endoscopy of the lower urinary tract.
- Gain experience in abdominal and flank cases.
- Gain experience in percutaneous endourologic procedures.
- Attend the elevated PSA clinic that is held three to five mornings per month to assess new patients and perform transrectal ultrasounds and prostate biopsies.
- Begin to learn how to perform and interpret urodynamics by participating in an adequate number of urodynamic studies.
- Develop teaching skills to assist in the education of medical students and interns.
- Initiate study of clinical research principles.
- Refine interpersonal skills with support personnel.
- Demonstrate knowledge of fundamental principles of urologic disease and pathophysiology through didactic lectures and self study.
- Perform cystoscopy, bladder biopsies and ureteral catheter insertion.
- Perform urethral dilation and direct vision urethrotomies.
- Perform more complex lower urinary tract endoscopic procedures, such as TUR biopsies of the bladder.
- Gain experience with ureteroscopy and laser lithotripsy.
- Obtain experience and technical expertise in scrotal, inguinal, vaginal and other minor urologic surgery. Perform abdominal and flank wound opening and closing, and as the year progresses, perform an increasing amount of the case in major abdominal or flank cases.
- Develop basic laparoscopic and robotic surgical skills such as instrument handling and knot tying.
- Gain experience in pediatric urology with particular emphasis on procedures such as orchiopexy and hernia repair.
- Provide pre- and post-operative care for urology patients.
- Obtain skill in urologic trauma care, including the evaluation, monitoring, surgical care and post-operative care of acute trauma.
- Identify and plan a clinical research project for the third year.
- Evaluate progress of urologic knowledge through in-service examination with expected performance above the 50th percentile nationally.
- Present a lecture at Urology conference.
- Present and discuss cases at Radiology rounds, M&M conference and Tumor Board.
- Work effectively with support personnel in urology.
- Become familiar with the biology of histocompatibility.
- Learn the process of donor and recipient selection, renal perfusion and preservation, and the procedure of transplantation.
- Evaluate pre- and post-transplant patients in the transplant clinic.
- Perform donor nephrectomy and ureteroneocystotomy under the supervision of the transplant surgeon.