Curriculum

Educational Program

The UConn Program in Urology strives to create an educational environment that allows residents to attain the technical and intellectual skills necessary to become professionally trained urologists and the educational skills that foster a career of lifelong learning. The program provides each resident with a core knowledge base in each of the domains of urology including: andrology, male infertility, impotence, calculus disease, urinary obstruction, endourology, extracorporeal shock wave lithotripsy, neuro-urology, urodynamics, female urology, pediatric urology, infectious diseases, transplantation, adrenal disorders, trauma and oncology. Through a series of structured rotations, the program provides training for each resident in basic office and operative skills needed to become a proficient urologist. This includes training in endoscopic surgery, open pelvic surgery, flank surgery, laparoscopic and robotic surgery. Through journal clubs, grand round presentations and topic oriented seminars, the program fosters an environment that encourages the search for new information and that teaches the skills necessary for continuous self-improvement.

The long-term goal of the program is to prepare individuals to be competent and compassionate urologists who can compete successfully for additional fellowship training or pursue practice in a community setting. The program also strives to expose residents to the research environment with the hope of stimulating some to enter the field of academic urology and encouraging those entering clinical practice to participate in clinical research.

To accomplish these goals the residency consists of a preliminary year in general surgery followed by four years of training in urology. During the general surgery year the resident is trained in basic surgical skills and gains knowledge and experience in the care of patients in the pre and post operative environment. Rotations include general surgery, trauma, intensive care management and outpatient care.

The urology education program is divided into two 2-year segments: junior rotations and senior rotations. Both of the junior and senior rotations are divided into five 10-week blocks. Every resident will rotate through these blocks twice at both the junior and senior level before their education is completed. Each of the hospital rotations has specific goals and objectives along with milestones that must be completed before the resident can advance from junior to senior status or from the senior status to graduation.

The didactic component of the residency consists of three core conferences usually conducted on Thursdays. Thursday mornings begin with grand round presentations. These are followed by topic specific seminars drawn from the urology core curriculum. One evening per month is devoted to journal club which focuses on basic statistical and epidemiologic concepts and trains the resident to critique medical literature. During the summer months residents receive intensive instruction in radiology, pathology, statistics and epidemiology in lieu of grand round conferences.

Pre-Urology Resident Education

A preliminary year of training in general surgery is offered by the UConn program in general surgery. During this preliminary year the resident is expected to become familiar with basic surgical principles and attitudes. Didactic teaching consists of a weekly surgical conference. Practical surgical skills are taught during rotations concentrating on general surgery, vascular surgery, cardio-thoracic surgery, trauma, and the intensive care unit. While on these rotations, the first year resident is expected to become proficient in the management of patients in the inpatient setting. This includes the preoperative evaluation, postoperative care and the management of patients in an acute health care delivery setting such as the emergency room or the surgical intensive care unit. Operative assignments include basic surgical procedures such as hernia repair, abdominal incisions, and appendectomy.

Urology Education

During the first two years of training the urology resident is expected to become familiar with common urological problems, terminology, procedures and diagnostic studies. This is accomplished by having residents rotate twice through five 10-week rotations. During the first rotation the resident is expected to become familiar with the key milestones associated with each module. After completing the second rotation, the resident is expected to have mastered these key milestones. Mastery of the milestones allows the resident to progress to the next level of training. Each of the two junior years of training will include one 10-week rotation each at UConn John Dempsey Hospital, Connecticut Children’s Medical Center, Saint Francis Hospital and two 10-week rotations at the Hartford Hospital.

During the second two years of training the urology resident is expected to function at a senior level. At this level the resident is expected to master complex surgical procedures and be familiar with perioperative care and the management of outpatient urological problems. Once again residents rotate twice through five 10-week rotations. During the first rotation the resident is expected to become familiar with the key milestones associated with each module. After completing the second rotation, the resident is expected to have mastered both clinical and surgical skills so that the resident can provide proficient urological care in an unsupervised setting.

Specific goals and objectives for each of the urology ten-week rotations

Urology Junior Years – Expectations at All Five Rotations

  • Perform a detailed and comprehensive history and physical examination.
  • Demonstrate a familiarity with basic diagnostic tools utilized in urology such as cystoscopy, rectal ultrasound, bladder scan, and diagnostic radiology including a CT examination, renal and scrotal ultrasound examinations, MRI examinations and nuclear medicine studies.
  • Demonstrate a familiarity with urological pathology.
  • Demonstrate a familiarity with urological trauma and urological emergencies such as renal colic, hematuria, testicular torsion, blunt and penetrating renal trauma, pelvic fracture, urinary retention, and urinary infections of the bladder, kidney, testis and prostate.
  • Demonstrate a familiarity with outpatient urological problems such as urinary obstruction, urinary frequency, urinary tract infections, hematuria, renal and ureteral stone disease, prostate problems including an elevated serum PSA, sexually transmitted diseases, impotence, prostatitis, renal cysts, renal masses, spinal cord injury and psychic conditions.

UConn John Dempsey Hospital

  • Residents at UConn John Dempsey Hospital will be expected to demonstrate a familiarity with the ambulatory environment, female voiding dysfunction including a focused pelvic examination, the performance and evaluation of urodynamic studies, and the performance of basic surgical procedures for female voiding problems. Residents should develop familiarity with the evaluation and management of the infertile male. Residents will also demonstrate a familiarity with outpatient procedures such as transrectal ultrasound and biopsy, cystoscopy, and bladder scan.
  • Residents should develop proficiency in the surgical techniques involved with managing renal and ureteral stones

Connecticut Children’s Medical Center

  • Residents at Connecticut Children's will be expected to demonstrate proficiency in the evaluation and management of common outpatient and inpatient pediatric urological problems. This includes exposure to procedures such as urodynamics, hypospadius repair, orchidopexies and ureteral implants. The resident will also be expected to develop a familiarity with basic diagnostic tools utilized in pediatric urology such as cystoscopy, bladder scan, and diagnostic radiology including voiding cysto-urethrogram, CT examination, ultrasound and nuclear medicine studies.
  • Demonstrate a familiarity with pediatric urological trauma and urological emergencies such as flank mass, testicular torsion, blunt and penetrating trauma, and urinary infections of the bladder and kidney.
  • Demonstrate familiarity with common outpatient urological problems such as urinary obstruction, posterior urethral valves, urinary frequency, urinary tract infections, ureteral reflux, hematuria, renal masses, and congenital abnormalities such as meningomyelocele, hypospadius and undescended testis.
  • Demonstrate proficiency in performing common pediatric studies such as cystoscopy and urodynamic studies.

Saint Francis Hospital and Medical Center

  • Residents at Saint Francis Hospital will be expected to demonstrate a familiarity with the following urologic procedures: scrotal surgery and hydrocelectomy, circumcision, transurethral surgery, ureteral endoscopy and lithotripsy, and management of urological trauma. Learning at Saint Francis is done in a less intense and more protected environment allowing for increased one to one mentoring between residents and the attending staff.

Hartford Hospital (Track 1)

  • Residents in track 1 will be expected to demonstrate a familiarity with the following urologic procedures: scrotal surgery and hydrocelectomy, circumcision, transurethral surgery, ureteral endoscopy and lithotripsy, and management of urological trauma

Hartford Hospital (Track 2)

  • Residents in track 2 will be expected to demonstrate a familiarity with minimally invasive surgical techniques including training in the simulation laboratory at the Hartford Hospital.

Key Milestones

At the completion of the first two years of training a urology resident is expected to have achieved the following milestones:

  • Demonstrate proficiency in evaluating and managing patients in an ambulatory setting with the following complaints:
    • Voiding problems among men and women
    • Benign Prostate Hypertrophy
    • Female incontinence
    • Hematuria
    • Bladder cancer
    • Prostate cancer
    • Renal cancer
    • Testis cancer
    • Ureteral and renal stone disease
    • Scrotal pathology such as hydrocele and spermatocele
    • Male infertility
    • Varicocele
    • Renal cysts
    • Urinary tract infections
    • Phimosis and balanitis
    • Pelvic pain syndrome (prostatitis)
    • Impotence
  • Demonstrate proficiency in performing the following surgical procedures:
    • Urethral catheterization including urethral dilation if necessary
    • Placement of a suprapubic tube
    • Cystoscopy
    • Ureteral stent removal
    • Circumcision
    • Hydrocelectomy
    • Varicocelectomy
    • Trans urethral resection of simple bladder tumor
    • Ureteral endoscopy and lithotripsy
    • Extra corporeal shock wave lithotripsy
    • Urodynamics
    • Endoscopic and open procedures to manage female incontinence
    • Assisting at robotic procedures such as prostatectomy

Urology Senior Years – Expectations at All Five Rotations

As a senior resident, each resident will serve as the chief resident at each of the 4 participating hospitals. Emphasis is placed on mastering specific surgical skills that will allow residents to practice independently once they have completed their training. Two senior residents will serve at the Hartford Hospital. One resident will rotate on track 1 which will concentrate training on flank procedures including nephrectomy and nephroureterectomy. The other resident will rotate on track 2 which will concentrate training on pelvic procedures including cystectomy and prostatectomy. Residents are expected to become proficient in open, laparoscopic and robotic techniques. The chief resident at Saint Francis Hospital is expected to participate in all major urological procedures and will gain confidence and proficiency working under the mentorship of the Saint Francis attending physicians. The chief resident at the Connecticut Children’s Medical Center is expected to participate in complex reconstructive procedures, common pediatric procedures such as hypospadius repair, ureteral reimplantation and hydrocelectomy, and more complex outpatient management procedures. The chief resident at UConn John Dempsey Hospital receives training in flank procedures such as nephrectomy, pelvic procedures such as cystectomy and prostatectomy, endoscopic procedures such as percutaneous nephrolithotomy, laparoscopic nephrectomy and transurethral procedures such as resection of the prostate and resection of bladder tumors. In the outpatient setting the chief resident is expected to become proficient in transrectal ultrasonography and biopsy and vasectomy. Finally, the chief resident at UConn John Dempsey Hospital is expected to become proficient at basic organizational and management tasks. This includes tasks such as organizing call schedules, vacation schedules, grand rounds topics, journal club articles and gathering complications for morbidity and mortality conference.

Specific Goals and Objectives – All Five Rotations

  • Perform a detailed and comprehensive history and physical examination of complex urology patients. Synthesize the information gathered into a diagnosis and develop an appropriate treatment plan.
  • Master basic diagnostic tools utilized in urology such as cystoscopy, rectal ultrasound, and bladder scan. Develop the ability to interpret diagnostic radiology studies including a CT examination, renal and scrotal ultrasound examinations, MRI examinations and nuclear medicine studies.
  • Master basic urological pathology.
  • Diagnose and manage urological trauma and urological emergencies such as renal colic, hematuria, testicular torsion, blunt and penetrating renal trauma, pelvic fracture, urinary retention, and urinary infections of the bladder, kidney, testis and prostate.
  • Diagnose and manage outpatient urological problems such as urinary obstruction, urinary frequency, urinary tract infections, hematuria, renal and ureteral stone disease, prostate problems including an elevated serum PSA, sexually transmitted diseases, impotence, prostatitis, renal cysts, renal masses, spinal cord injury and psychic conditions.

UConn John Dempsey Hospital

  • Master care in the ambulatory environment including office urology, male and female voiding dysfunction, the performance and evaluation of urodynamic studies.
  • Master outpatient procedures such as transrectal ultrasound and biopsy, cystoscopy, vasectomy and bladder scan.
  • Master surgical techniques involved with managing renal and ureteral stones including percutaneous nephrolithotomy.
  • Master open, laparoscopic and robotic approaches to pelvic and flank surgery.
  • Master surgical procedures related to female urinary incontinence
  • Master surgical procedures related to male infertility and impotence.

Connecticut Children’s Medical Center

  • Master the evaluation and management of outpatient and inpatient pediatric urological problems such as urinary obstruction, posterior urethral valves, urinary frequency, urinary tract infections, ureteral reflux, hematuria, renal masses, and congenital abnormalities such as meningomyelocele, hypospadius and undescended testis.
  • Master procedures such as urodynamics, hypospadius repair, orchidopexies and ureteral implants.
  • Master basic diagnostic tools utilized in pediatric urology such as cystoscopy, bladder scan, diagnostic radiology including voiding cysto-urethrogram, CT examination, ultrasound, nuclear medicine studies and urodynamics.
  • Master the evaluation of pediatric urological trauma and urological emergencies such as flank mass, testicular torsion, blunt and penetrating trauma, and urinary infections of the bladder and kidney.

Saint Francis Hospital and Medical Center

  • Master major flank, pelvic and endoscopic surgical procedures. Learning is done in a less intense and more protected environment allowing for increased one to one mentoring between residents and the attending staff.

Hartford Hospital (Track 1)

  • Master basic open, laparoscopic and robotic techniques used in flank surgery.
  • Master procedures related to impotence.

Hartford Hospital (Track 2)

  • Master basic open, laparoscopic and robotic techniques used in pelvic surgery.

Key Milestones

At the completion of the second two years of training a urology resident is expected to have achieved the following milestones:

  • Demonstrate proficiency in evaluating and managing complex patients in an ambulatory setting with the following complaints:
    • Voiding problems among men and women
    • Benign Prostate Hypertrophy
    • Female incontinence
    • Hematuria
    • Bladder cancer
    • Prostate cancer
    • Renal cancer
    • Testis cancer
    • Ureteral and renal stone disease
    • Scrotal pathology such as hydrocele and spermatocele
    • Male infertility
    • Varicocele
    • Renal cysts
    • Urinary tract infections
    • Phimosis and balanitis
    • Pelvic pain syndrome (prostatitis)
    • Impotence
  • Demonstrate proficiency in performing the following surgical procedures:
    • Flank procedures including nephrectomy and retroperitoneal dissection
      • Open flank incision
      • Laparoscopic and hand assisted approach
      • Robotic approach
      • Percutaneous nephrolithotomy
    • Pelvic procedures including cystectomy and simple and radical prostatectomy
      • Open retropubic incision
      • Laparoscopic and hand assisted approach
      • Robotic approach
      • Perineal approach
    • Trans urethral procedures
      • Ureteral endoscopy and lithotripsy
      • Transurethral resection of the prostate
      • Transurethral resection of bladder tumors
    • Pelvic and scrotal reconstruction
      • Female incontinence procedures
      • Urethral stricture repair
      • Hydrocelectomy
      • Radical orchiectomy
    • Ambulatory procedures
      • Transrectal ultrasound and biopsy
      • Vasectomy
      • Scrotal procedures