Urology Residency Program
Curriculum
PGY 1 - Internship Year
The intern year consists of four 1-month General Surgery rotations, including a surgical apprenticeship, surgical intensive care, night float, and vascular surgery. Interns spend the remaining 8 months on the urology service: four months in the department of urology at the Jesse Brown Veterans' Administration Healthcare; two months on the Northwestern Memorial Hospital urology consult service; two months in the department of Pediatric Urology at Childrens Memorial Hospital. During this first year, the intern learns the essentials of patient management as well as the basics in surgical technique. This is a very comprehensive year, and it provides an excellent foundation for future clinical years.
At Children’s Memorial Hospital the intern learns the basics of pediatric urology and the common conditions treated by pediatric urologists. S/he functions as an integral member of the team, reporting to the chief urology resident and working directly with pediatric urology faculty. The resident participates as an assistant in surgery, attends six outpatient clinics per week, and has inpatient responsibilities. During this rotation, the intern is the junior resident, working alongside a senior resident from Northwestern and a senior resident from Loyola University Medical Center. The resident works with six full-time pediatric urologists, and the combination of operative and clinical experience is excellent. This is a tertiary care children's medical center, and there is an abundance of interesting and challenging urologic cases.
The consult resident acts as direct contact to and is the initial evaluator of urology consults requested by both emergency room and inpatient services. Each month, a single Northwestern Memorial Faculty Foundation attending urologist is assigned as the consult attending. The consult resident is responsible for gathering essential information, requesting studies, formulating an initial treatment plan, and presenting this information to the consult attending. The resident and attending then see each consult together on a daily basis until the urologic issues are resolved or the patient is discharged. This arrangement provides a one-on-one experience with the attending for the consult resident. If operative procedure is indicated, this resident is expected to act as first assistant on such cases in order to provide continuity of care.
PGY 2 - Urology
During the second year, the urology resident actually serves as a junior general surgery resident. It is during this year that the resident becomes quite experienced and comfortable with managing trauma patients and sick patients in the intensive care unit. Additionally, much exposure to bowel and open abdominal surgery is available, thus laying a solid foundation for future open urologic cases. During this year broad experience is gained in laparoscopy and endoscopy. With the excellent training obtained in the second year, our residents are able to "hit the ground running" in urology.
In addition to 2 months of general surgery training, the PGY2 residents spend four months at Northwestern Memorial Hospital department of urology, and two months on the Northwestern Memorial Hospital urology consult service. PGY2 urology residents also have the opportunity to participate in four months of electives chosen and designed by the residents based on their interests and educational needs, as part of the new pilot curriculum program. With the direction of the urology program director, residents are encouraged to work with faculty at any of the McGaw institutions, in the various departments.
PGY 3 - Urology
The PGY3 clinical year is comprised of three 4-month rotations: four months on the Northwestern Memorial Hospital academic services; four months at Childrens Memorial Hospital; and four months at the Jesse Brown VA Medical Center.
The PGY-3 on the green service at Northwestern Memorial Hospital learns the basics of urologic oncology, infertility, and erectile dysfunction. The resident rounds on patients daily with a chief resident and is an integral part of the patient care team. S/he also acts as first assistant on minor and some major operative procedures and has half-day clinic responsibility rotating with various attendings on the focused subspecialty areas described above.
The PGY-3 on the red service at Northwestern Memorial Hospital learns the basics of female urology, urological infectious diseases, laparoscopy, and endoscopic surgery. The resident rounds on patients with a chief resident daily and is an integral part of the patient care team. S/he also acts as first assistant on minor and some major operative procedures and has half-day clinic responsibility rotating with various attendings in the focused subspecialty areas described above.
One third of this year is spent at the Veterans' Administration as a junior resident. The PGY-3 resident at the Veterans' Administration focuses strongly on learning and mastering outpatient urological procedures. S/he also acts as an integral member of the patient care team and, under the guidance of the chief resident and attending surgeon, provides the majority of urological consultation to other services at the Veterans’ Administration hospital. S/he also assists the chief resident on major urological procedures and acts as surgeon on minor operative procedures under the supervision of the attending surgeon. This rotation provides a more independent patient care experience than other rotations and is a unique opportunity for continuity of patient care.
PGY 4/5 - Urology
Residents in the fourth clinical urology year have senior resident responsibilities. In other words, they are the most senior resident on all rotations and therefore they assist with all major operative procedures, make supervised day-to-day management decisions on the inpatients, and perform initial consults.
Four months are spent on the Northwestern Memorial Hospital blue service. On the blue service, the resident functions as senior resident on a busy four-member private urology group. This rotation exposes residents to a community-based, private practice urology setting that sees both routine and complicated general urology disorders. During this rotation, residents must make the transition from junior to senior resident, taking on chief-level responsibilities. The major goals of this rotation reflect a focus on assessing the resident’s pre-operative preparation, surgical skills, and surgical decision-making.
Four months in this clinical year will be spent at the John H. Stroger, Jr. Hospital of Cook County. This rotation provides high level responsibility in all areas of general urology. Responsibilities, while entirely supervised by attending faculty, are broadened as the patient numbers are significant and the residents are depended on to provide an important aspect of patient care. The resident is one of the more senior residents on the urology team composed of residents from the Cook County Urology residency program as well as the Northwestern resident. The residents work as an integrated team, providing both inpatient and outpatient urology care to a varied patient population, often with urological problems unique to a largely indigent and immigrant population, such as rare infections, advanced cancers, and complex trauma. This rotation truly broadens the residents’ exposure to populations and disease states and conditions not often seen at any other of our participating institutions.
PGY 4/5 - Urology (Lab Year)
All residents spend a full year performing research under the supervision of a Northwestern University faculty member. The faculty member is chosen by the resident based upon his/her research interests. Although the research mentor is typically a faculty member in the Department of Urology, this is not a requirement.
During the lab year, the residents have limited clinical responsibilities, consisting of 1 full day of Northwestern Memorial Hospital clinical responsibility per 3 weeks. The majority of their time and efforts are focused on urologic research. The decreased clinical responsibility during the lab year provides opportunity to partake in other learning opportunities not afforded in the other years.
PGY 6 - Chief Year
PGY-6 residents have completed a full year in which they functioned as a senior resident. Four-month rotations on the Northwestern Memorial Hospital red and green service allow them to focus on specific areas of urology in which they have a particular interest or in which they feel a knowledge deficit. The 4-month Veterans' Administration rotation provides an increased level of independence which is valuable in the transition to practice following the residency.
During the Northwestern Memorial Hospital red service rotation, the PGY-6 functions as chief resident, learning advanced skills in the areas of female urology, laparoscopic surgery, urological infectious disease, and endoscopic surgery. S/he is responsible for the day-to-day care of the inpatient service and has half-day per week responsibility in an attending surgeon’s outpatient clinic. The chief also has an independent resident clinic (overseen by an attending faculty member) in which outpatient care plans are determined and implemented by the chief resident. S/he provides continuity of care for patients in this clinic and is involved in any operative procedures they may require.
During the Northwestern Memorial Hospital green service rotation, the PGY-6 functions as chief resident, learning advanced skills in the areas of urological oncology, infertility, and erectile dysfunction. S/he is responsible for the day-to-day care of the inpatient service, and has half-day per week responsibility in an attending surgeon’s outpatient clinic.
The Veterans’ Administration PGY-6 rotation provides chief-level responsibility in all areas of general urology. The resident’s responsibilities, while entirely supervised by attending faculty, are broadened as s/he takes on the added responsibilities of operative case scheduling, review of operative indications (including making changes when necessary), and oversight of junior residents at that facility. Though separate services, chiefs also interact directly with urology resident physicians and attendings from other institutions. They also have 2 full days of clinic responsibility and, in conjunction with an attending physician, oversee junior residents during this clinic. This clinical responsibility is unique to this rotation in the outpatient setting. The chief resident also defines junior resident clinical responsibilities and delegates daily work schedule.
