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SAU Task Forces Make Recommendations to Improve Urology Education

posted: April 15, 2019

The SAU provides academic urologists with a forum to discuss, review, and resolve critical issues in all aspects of academic urology. At the 2019 SAU Program Directors and Coordinators meeting in Houston, Texas, 5 task forces presented recommendations pertaining to a gamut of educational concerns raised at the prior year’s meeting.

The task forces, respective chairs and recommendations were:

Match Violations — Simone Thavaseelan, MD Brown University

A troublesome issue in the urology community for years has been violations surrounding the match process. Applicants continue to complain about being asked unethical questions and being unnecessarily pressured to make verbal commits to programs. This group defined violations, reviewed the present on-line information and determined a comprehensive code of conduct for the SAU Match.

The recommendations included revising the Urology Match guidelines and adapting the National Residency Match Program (NRMP) Code of Conduct which reinforces privacy and confidentiality, restricts illegal or coercive questions, prohibits second visits and post-interview telephone or email communication. The Match Violations Task Force espoused standardizing education for all stakeholders so as to mitigate future violations during and after the SAU Match. Furthermore, the task force recommended electronic attestation of both program directors and applicants to comply with the revised Match Guidelines.

SAU Match Improvements — Blake Hamilton, MD University of Utah

This task force reviewed multiple problems related to the current SAU Match. This included timing of the SAU Match, non-standardized letters of recommendation, and increasing number of applications to each program.

A survey to program directors was returned with a modest response rate (18%). Many of the respondents preferred to 1) move the AUA ISE, 2) limit the number of applications to 40 per applicant, 3) coordinate interviews by region, 4) standardize the LORs, 5) postpone the SAU Match deadline by 1 month and 6) ban all second visits. After significant efforts, the first 4 will require ongoing efforts. Moving the match deadline by one month will be recommended to the membership, as will banning of all second visits.

Recruitment and Retention of Women and Underrepresented Minorities in Urology — Adam Hittleman, MD Yale

Diversity, equity and inclusion are extremely important to the education of all urology trainees. Urology program directors have been concerned for years about the disproportionate number of women and underrepresented minorities (URM) pursuing careers in urology relative to the general population. Ten colleagues diligently reviewed the current literature and determined that, although there are 50.4% women entering medical schools in the US, they only represent 26% of all urology residents. The numbers are worse for URMs. While URMs make up about 30% of the US population, they represent only 16% of matriculating medical students, 11% of all urology residents and fewer than 6% of practicing urologists nation-wide.

Recommendations began with holistic review of all residency applications to improving applicant numbers and matching. Programs are encouraged to appoint a chief diversity officer in their departments and make involvement of URM faculty a priority in the recruitment process. Moreover, It is strongly recommended that each urology program include a diversity, equity and inclusion statement on their websites, one that is discussed with all members of the department and represents a consensus declaration of diversity. The SAU should also partner with the R. Frank Jones Society to improve our education of and recommendations for URMs. Scholarship-based externship programs for URM medical students and research programs targeted at URM and women, could be funded by individual institutions or with assistance from the SAU and/or AUA. These deliberate measures definitely increase exposure to and opportunities for students who might not encounter opportunities favoring them matching in urology.

Common Assessment Tools for PGY-1 Trainees — Robert Sweet, MD University of Washington

This task force reviewed the current literature and available resources for the PGY-1 urology residents. They also analyzed applicable websites. The task force made competency-based recommendations, included adopting all or part of the American College of Surgeons (ACS) American Program Directors of Surgery, Phase 1 and 3 program as part of a spiral 2-year curriculum. The task force also recommended formative assessments (e.g., OSATS, GEARS, CSATS), simulation skills, as well as, critical soft-skills education around professionalism and inter-professional communication skills in TEAM Stepps).

Urology Residency Training in 2030 — Mathew Sorensen, MD University of Washington

The task force acknowledged that future success of urologic training mandates inclusion of a facility with technical (e.g., simulation in open and minimally invasive techniques) as well as soft skills (e.g., communication, leadership, professionalism and well-being). In order to adequately address these two topics, the Curriculum 2030 Task Force recommended a survey of all urology program directors to determine the critical topics and the best mode of information delivery.

Educational standardization would set expectations for learners and improve their knowledge base. Centralization of a core curriculum in wellness, resilience, fatigue mitigation, patient safety, healthcare policy, practice management, leadership and team building would be extremely economical and highly valuable. This task force also suggested that the AUA University core curricula, supplemented by the AUA Guidelines, should be included in every urology program

Conclusions

The SAU is the organization responsible for stewarding academic endeavors in urology. An organized structure that enables and encourages member participation in making change will fulfill this purpose. The above recommendations worked on by our membership based task forces are currently being reviewed the SAU’s Executive Board. Final recommendations will be posted on the SAU and AUA websites after a period of public comment by the SAU members and voted on at the SAU meeting during the Chicago AUA.