Goals
The goal for the first year of urologic residency training during the female pelvic floor ambulatory rotation is to develop a working knowledge of urologic terminology, physiology/pathophysiology and anatomy as it pertains to female incontinence, voiding dysfunction, pelvic floor prolapse disorders, pelvic pain syndromes and neurology while developing skills in the history taking, workup, preoperative evaluation and management of patients with these disorders. In addition, the first year resident will acquire fundamental surgical skills and develop an understanding of research principles in the field of pelvic floor disorders, female incontinence and pelvic pain syndromes including biostatistics, data base management and the language of scientific literature. Each of these goals will be accomplished in the highest ethical fashion with attention to the confidentiality of patients and their families while developing communication and professional behaviors that facilitate the delivery of health care by the treating team. Patient care
The resident will demonstrate the ability to interview and evaluate patients in an empathetic and respectful manner using open ended to directed questions which results in the acquisition of an accurate and complete history taking and examination of their pelvic floor disorder.
The resident will perform a thorough physical examination with appropriate focus on the female pelvic floor system.
The resident will provide timely and appropriate medical care ( including successful performance of urethral catheter placement) required for testing and/or management of urologic patients under the supervision of the supervising faculty.
The resident will demonstrate knowledge and competency in the discussion, performance and application of nonsurgical treatment of interstitial cystitis, female incontinence and pelvic prolapse.
The resident will participate in, and document that participation in, the performance of all types of low to moderate complexity ambulatory procedures including (but not limited to) flexible and rigid cystoscopy, endoscopic implantation of various FDA approved periurethral bulking materials for incontinence, chemodenervation, placement of urethral catheters and suprapubic catheters, retrograde pyelograms, insertion of pessary rings and placement of peripheral neuromodulator devices.
The first year resident will routinely second assist in the performance of moderate to high complexity urologic surgical procedures.
The resident will communicate the understanding of risks and benefits, as well as the expected experiences during the recovery period.
The resident will participate in a wide variety of basic and complex urodynamic and videourodynamic procedures and demonstrate an understanding of voiding physiology, an understanding about the urodynamic and uroflow equipment and the ability to interpret the results of these tests.
The resident will be introduced to various devices for suture fixation in female pelvic prolapse repair. Medical knowledge
The resident will demonstrate basic medical knowledge in the physiology of normal bladder function as it relates to normal storage and emptying.
The resident will demonstrate knowledge of the normal female pelvic floor anatomy.
The resident will demonstrate medical knowledge of the pathophysiology of aberrant bladder function, as it relates to, intrinsic sphincter deficiency, overactive bladder, neurogenic bladder, interstitial cystitis/pelvic pain syndromes, stress, urge and mixed incontinence and pelvic prolapse disorders.
The resident will demonstrate an understanding of the various factors involved in female voiding dysfunction, pelvic prolapse and pelvic pain syndromes.
The resident will demonstrate an understanding of the pharmacotherapy for overactive bladder and female stress urinary incontinence.
The resident will demonstrate a basic knowledge of the voiding patterns associated with common neurologic disorders.
The resident will demonstrate knowledge of aberrant female pelvic floor anatomy as it relates to uterine prolapse, cystocele, enterocele, rectocele, urethral diverticula and fistula formation.
The resident will demonstrate knowledge of the AUA Updated: Guidelines for Stress Urinary Incontinence.
The resident will demonstrate a knowledge of the diagnosis and management of interstitial cystitis and related pelvic pain syndromes.
The resident will demonstrate a knowledge of the evaluation and management of neurogenic voiding dysfunction.
The resident will demonstrate knowledge of the role of recurrent urinary tract infections in the female patient population, as it relates to vaginal atrophic changes, incomplete bladder emptying and other pelvic floor relaxation disorders.
The resident will demonstrate knowledge of the effect of the postmenopausal state and the effects of estrogen replacement therapy as it relates to female pelvic floor disorders and female urinary incontinence.
The resident will demonstrate knowledge of pelvic floor strengthening exercises, pelvic floor stimulation and biofeedback therapy and their application to the management of female pelvic floor, voiding dysfunction and incontinence disorders.
The resident will demonstrate knowledge and competency in the discussion, performance and application of nonsurgical treatment of interstitial cystitis, female incontinence and pelvic prolapse.
Additionally, the resident will acquire a working knowledge base about the physics of each of the imaging modalities and therefore successfully apply that knowledge to the use of these modalities in the diagnosis and treatment of patients.
The resident will demonstrate a complete knowledge regarding the technique of the above procedures, an understanding of the technology and be capable of determining the risks and benefits of all approaches.
The resident will demonstrate knowledge of the various materials, techniques, methods of insertion and associated risks and benefits of each alternative FDA approved method for midurethral slings, suspensions and biologic materials (autografts, allografts , xenografts and synthetics) applicable to lower urinary tract reconstruction.
The resident will demonstrate an understanding of the role and technique of intraurethral injection therapies.
The resident will demonstrate an understanding of appropriate patient selection, implantation techniques and the role of neuromodulation (sacral) for overactive bladder, urge incontinence, retention and voiding dysfunction.
The resident will demonstrate a fundamental knowledge on sacral nerve stimulation programming.
The resident will demonstrate knowledge of equipment names and function, as well as the pertinent urologic anatomy.
The resident will demonstrate a basic knowledge of vaginal and abdominal approaches for female pelvic prolapse repair.
The resident will demonstrate basic knowledge of common complications associated with surgical procedures addressing female prolapse and incontinence, including postoperative voiding dysfunction and obstruction and demonstrate there immediate diagnosis and management in the postoperative period.
The resident will regularly attend research conferences and interact successfully with both basic science and clinical investigators.
The resident will demonstrate familiarity with the ongoing work of the Incontinence Research Foundation.
The resident will demonstrate familiarity with the ongoing work and recommendations of the International Consultations on Interstitial Cystitis.
The resident will demonstrate knowledge on ongoing data and literature published on overactive bladder, stress urinary incontinence, pelvic prolapse and pelvic pain disorders.
The resident is expected to explore the inconsistencies in diagnostic criteria and appreciate the lack of standardization in measuring treatment outcomes, especially when attempting to compare techniques and procedures in the management of female incontinence and pelvic floor disorders. Practice-based learning and improvement
The resident will demonstrate an understanding of the magnitude and etiology of overactive bladder and voiding dysfunction in the aging population.
The resident will have a baseline understanding of the strengths and limitations of current available therapies for the management of overactive bladder and voiding dysfunction.
The resident will demonstrate an understanding of the limitations of pharmacotherapy for voiding dysfunction in the geriatric population.
The resident will demonstrate knowledge of the AUA Updated: Guidelines for Stress Urinary Incontinence.
The resident will demonstrate the ability to acquire basic knowledge about female pelvic floor and incontinence disorders and apply the physiologic and pathophysiologic background of these conditions by attending conferences and through independent reading of standard textbooks, including Campbell’s Textbook of Urology and other such books as determined in conjunction with the faculty.
During this ambulatory rotation the resident will demonstrate independent reading skills and interact in a professional and organized manner with the supervising faculty member such that the resident acquires the required understanding of the pathophysiology, evaluation and treatment of pelvic floor disorders, female urinary incontinence and voiding dysfunction as outlined above.
The resident will demonstrate knowledge and competency in the discussion, performance and application of nonsurgical treatment of interstitial cystitis, female incontinence and pelvic prolapse.
The resident will attend regular urologic radiology conferences and demonstrate the ability to accurately interpret urologic urography, US, CT and MRI scans.
The resident will acquire the ability to abstract medical records and to collect appropriate information into clinical data bases.
The resident will successfully manage one Filemaker Pro database for the year will professional interactions with the Senior Data Assistant in the Department of Urology.
The resident will regularly attend research conferences and interact successfully with both basic science and clinical investigators.
The resident will attend scheduled lectures on biostatistics and demonstrate the ability to perform low complexity analyses such as Chi Square and Student’s T tests on de- identified data.
The resident will interact effectively with at least 1 research mentor and produce a research project which is presented in abstract form at one research meeting.
It is not expected that the first year resident would routinely attend the national or international meetings. However, in select circumstances an individual resident could function as an integral part of a research project and be chosen to present that research.
The resident will demonstrate familiarity with the ongoing work of the Incontinence Research Foundation.
The resident is expected to explore the inconsistencies in diagnostic criteria and appreciate the lack of standardization in measuring treatment outcomes, especially when attempting to compare techniques and procedures in the management of female incontinence and pelvic floor disorders.
The resident will have the opportunity to submit and present peritent research projects and compete for research grants through the Society for Female Urology and Urodynamics.
The resident will attend all scheduled core competency sessions throughout the year including the monthly Department of Urology sessions, the lectures scheduled through the Office of Medical Education and any additional sessions considered necessary by the faculty mentor or program director. Interpersonal and communication skills
The resident will be to communicate these findings effectively to supervising faculty and residents, as well as in the EMR.
The first year resident will function successfully as a member of the house staff in the role of collecting accurate information regarding the status of hospitalized patients and communicate such information in a timely and professional manner to other residents and faculty.
The resident will demonstrate the ability to promptly and accurately document all interactions with patients and their surrogates in the EMR including an understanding of all documentation guidelines for billing and compliance.
During this ambulatory rotation the resident will demonstrate independent reading skills and interact in a professional and organized manner with the supervising faculty member such that the resident acquires the required understanding of the pathophysiology, evaluation and treatment of pelvic floor disorders, female urinary incontinence and voiding dysfunction as outlined above.
The resident will demonstrate knowledge and competency in the discussion, performance and application of nonsurgical treatment of interstitial cystitis, female incontinence and pelvic prolapse.
The resident will expect to receive formative feedback of their performance during this pelvic floor rotation, on a prompt and ongoing basis from their assigned faculty mentor, other faculty and the program director.
The resident will receive summative feedback at the end of each female pelvic floor ambulatory rotation from the faculty supervisor and on a bi- yearly basis with the program director.
The resident will demonstrate an understanding of the established supervisory policy and the grievance policy.
The resident will demonstrate an understanding of the policy regarding promotions and probation.
The resident will communicate suggestions for program change or improvement to the supervising faculty and program director at both scheduled residency discussion meetings and in private conference.
The resident will successfully manage one Filemaker Pro database for the year will professional interactions with the Senior Data Assistant in the Department of Urology.
The resident will regularly attend research conferences and interact successfully with both basic science and clinical investigators.
The resident will interact effectively with at least 1 research mentor and produce a research project which is presented in abstract form at one research meeting.
The resident will expect to be evaluated during role playing exercises, interview sessions with standardized patients and during monthly quality improvement conferences.
The resident will conduct routine self evaluations regarding all manners of clinical and interpersonal experiences and expect to review such evaluations with their faculty mentor.
The resident will learn to employ interview skills such as the use of open ended questions and attain the ability to listen to a patient as they tell their story.
The resident will demonstrate the ability to interview patients with respect and empathy.
The resident will demonstrate the ability to obtain informed consent for the low to moderate complexity urologic procedures.
The resident will learn to employ interview skills such as the use of open ended questions and attain the ability to listen to a patient as they tell their story. Professionalism
During this ambulatory rotation the resident will demonstrate independent reading skills and interact in a professional and organized manner with the supervising faculty member such that the resident acquires the required understanding of the pathophysiology, evaluation and treatment of pelvic floor disorders, female urinary incontinence and voiding dysfunction as outlined above.
The resident will complete HIPAA and IRB training courses and demonstrate an understanding of the ethical and professional considerations for conducting human subjects research.
The resident will demonstrate the ability to interview patients with respect and empathy.
The resident will interact in a professional manner with all nursing and other support staff.
The resident will demonstrate the ability to obtain informed consent for the low to moderate complexity urologic procedures.
The resident will attain the professionalism to deal with challenging social and medical situations. Systems-based practice
The resident will demonstrate the ability to promptly and accurately document all interactions with patients and their surrogates in the EMR including an understanding of all documentation guidelines for billing and compliance.
The resident will demonstrate an understanding of the economic consequences of each treatment modality, as well as the patients experience during the recovery from each of these procedures.
The resident will conduct routine self evaluations regarding all manners of clinical and interpersonal experiences and expect to review such evaluations with their faculty mentor. Evaluations
The resident will expect to receive formative feedback of their performance during this pelvic floor rotation, on a prompt and ongoing basis from their assigned faculty mentor, other faculty and the program director.
The resident will receive summative feedback at the end of each female pelvic floor ambulatory rotation from the faculty supervisor and on a bi- yearly basis with the program director.
The resident will demonstrate an understanding of the established supervisory policy and the grievance policy.
The resident will demonstrate an understanding of the policy regarding promotions and probation.
The resident will communicate suggestions for program change or improvement to the supervising faculty and program director at both scheduled residency discussion meetings and in private conference.
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