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Pediatric Resident Exposure to Urology: More Is Better

Saturday, October 20, 2012
Grand Ballroom A/B (Hilton Riverside)
Gerald Mingin Jr., M.D., Surgery/Urology, Vermont Children's Hospital, Burlington, VT and Sarah Hardy, MD, Pediatrics, Vermont Children's Hospital, Burlington, VT

Purpose: The majority of patients referred to a pediatric urologist are initially seen by pediatricians.  The purpose of the study is to determine the level of exposure of pediatric residents to urology during their residency and to see how these findings compare and contrast with the perceptions of urology program directors.

Materials and Methods: An IRB approved web based survey containing 18 questions was employed. The survey was sent to both chief residents in pediatrics and urology program directors. Seventy one chief residents and 51 urology program directors completed the survey.

Results:   When asked about the availability to rotate on the pediatric urology service only 8.1% of pediatric residents stated that this was possible, while 25% of urology program directors responded affirmatively. Fifty one percent of pediatric residents responded that they were involved in the urology clinic anywhere from 1 day to 1 month. This response differs from urology program directors that stated that only 19.6 % of pediatric residents were involved in clinics. Sixty six percent of residents said that their main form of urologic teaching was through formal didactics or grand rounds; whereas 37.8 %felt that it was through clinical teaching.  More concerning 23% of residents rated their satisfaction with didactics as fair to poor with 25% rating their bedside clinical experience as fair to poor. Sixty percent of pediatric residents wished to see more didactics, and 64% wished improvement in bedside teaching.  Likewise, 51% of urology program directors felt that the overall exposure pediatric residents received could be improved.

Conclusion:   Pediatricians as gate keepers account for a large percentage of a pediatric urologist's referral base. Our findings suggest a disconnect between urologists and pediatric trainees concerning exposure to pediatric urology. More concerning, a significant number of residents felt that their exposure was in adequate and more than 60% were eager for improvement.  Interestingly, 51% of urology program directors felt that there was a need for greater involvement. Given these findings it would seem that improvement in both didactic and clinical interaction with our future colleagues will lead to better communication and care for our mutual patients.