Year of Matriculation«
-- Select from the following --
pre-1960
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
Year of Birth«
-- Select from the following --
pre-1930
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
post-1975
Gender«
Approximate total education-related indebtedness upon completion of your residency«
-- Select from the following --
$0-$4,999
$5,000-$14,999
$15,000-$24,999
$25,000-$49,999
$50,000-$74,999
$75,000-$99,999
$100,000-$124,999
Greater than $125,000
Is Urology the specialty you are currently practicing«
[
Yes
]
[
No
]
If no, please indicate your current career and main reason for leaving Urology
Have you completed additional formal training since graduation«
[
Yes
]
[
No
]
If so, please indicate the type and subspecialty of your additional training
Please indicate your type of practice«
If other, please specify
Population size of the immediate community in which you practice«
-- Select from the following --
less than 25,000
25,000-50,000
50,000-100,000
100,000-250,000
250,000-500,000
500,000-1,000,000
greater than 1,000,000
Please indicate the percentage of female patients seen in your practice«
Please indicate the percentage of male patients seen in your practice«
Please indicate the percentage of adult patients seen in your practice«
Please indicate the percentage of pediatric patients seen in your practice«
Please indicate the typical amount of time spent in your practice over a typical week«
-- Select from the following --
less than 50 hours
51-60 hours
61-70 hours
71-80 hours
81-90 hours
91-100 hours
over 100 hours
Please indicate the percentage of time spent in a typical week on the following activities.
Surgery (ambulatory surgery center/hospital)«
Office (patient care)«
Inpatient care«
Inpatient consults«
ER consults«
Administration«
Research«
Teaching (residents, students, fellows, etc.)«
How satisfied are you with the extent to which your urology training program...
Prepared you for your current career type«
-- Select from the following --
Completely satisfied
Satisfied
Mixed
Not Satisfied
Completely unsatisfied
Not applicable
Assisted you in securing the position (job) of your choice after residency«
-- Select from the following --
Completely satisfied
Satisfied
Mixed
Not satisfied
Completely unsatisfied
Not applicable
Helped you to decide whether or not to pursue fellowship or post-residency training«
-- Select from the following --
Completely satisfied
Satisfied
Mixed
Not satisfied
Completely unsatisfied
Not applicable
Prepared you to select a clinical sub-specialty focus«
-- Select from the following --
Completely satisfied
Satisfied
Mixed
Not satisfied
Completely unsatisfied
Not applicable
Please indicate the degree to which you felt prepared by your residency training for each of the areas listed below. If further training was required, please indicate how it was obtained (i.e. CME, outside mentor, partner, fellowship, etc).
Outpatient ambulatory care«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in outpatient ambulatory care«
[
Yes
]
[
No
]
If so, how was it obtained
Inpatient care«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in inpatient care«
[
Yes
]
[
No
]
If so, how was it obtained
General Urology
Care of common adult clinical problems«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the care of common adult clinical problems«
[
Yes
]
[
No
]
If so, how was it obtained
Evaluation of BPH«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the evaluation of BPH«
[
Yes
]
[
No
]
If so, how was it obtained?
Medical management of BPH«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the medical management of BPH«
[
Yes
]
[
No
]
If so, how was it obtained?
Alternative medicine for BPH«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training on alternative medicine for BPH«
[
Yes
]
[
No
]
If so, how was it obtained?
Hematuria evaluation«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in hematuria evaluation«
[
Yes
]
[
No
]
If so, how was it obtained?
Evaluation and treatment of uncomplicated UTI«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the evaluation and treatment of uncomplicated UTI«
[
Yes
]
[
No
]
If so, how was it obtained
Evaluation and treatment of complicated UTI«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the evaluation and treatment of complicated UTI«
[
Yes
]
[
No
]
If so, how was it obtained?
Management of elevated PSA«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the management of elevated PSA«
[
Yes
]
[
No
]
If so, how was it obtained
Management of prostatitis«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the management of prostatitis«
[
Yes
]
[
No
]
If so, how was it obtained
Management of STDs«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the management of STDs«
[
Yes
]
[
No
]
If so, how was it obtained
Management of interstitial cystitis«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the management of interstitial cystitis«
[
Yes
]
[
No
]
If so, how was it obtained
ED, Infertility
Erectile physiology and pharmacology of ED; evaluation and management of ED«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in erectile physiology and the pharmacology of ED; evaluation and management of ED«
[
Yes
]
[
No
]
If so, how was it obtained
Evaluation and management of Peyronie's disease and priapism«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the evaluation and management of Peyronie's disease and priapism«
[
Yes
]
[
No
]
If so, how was it obtained
Evaluation and medical and surgical management of male infertility«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the evaluation and medical and surgical management of male infertility«
[
Yes
]
[
No
]
If so, how was it obtained
Endourology, Stones
Non-operative management of acute renal colic«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the non-operative management of acute renal colic«
[
Yes
]
[
No
]
If so, how was it obtained
Metabolic evaluation of stone patients«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the metabolic evaluation of stone patients«
[
Yes
]
[
No
]
If so, how was it obtained
Decision-making regarding the appropriate surgical approaches to stone disease«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in decision-making regarding the appropriate surgical approaches to stone disease«
[
Yes
]
[
No
]
If so, how was it obtained
Evaluation of patients with UPJ obstruction«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the evaluation of patients with UPJ obstruction«
[
Yes
]
[
No
]
If so, how was it obtained
Urinary incontinence, female urology, NGB«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in urinary incontinence, female urology, NGB«
[
Yes
]
[
No
]
If so, how was it obtained
Evaluation of patients with uncomplicated urinary incontinence«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the evaluation of patients with uncomplicated urinary incontinence«
[
Yes
]
[
No
]
If so, how was it obtained
Evaluation of patients with complicated urinary incontinence«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the evaluation of patients with complicated urinary incontinence«
[
Yes
]
[
No
]
If so, how was it obtained
Evaluation and management of patients with NGB due to SCI, Parkinson's, CVA, etc.«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the evaluation and management of patients with NGB due to SCI, Parkinson's, CVA, etc.«
[
Yes
]
[
No
]
If so, how was it obtained
Oncology
Initial evaluation and treatment of localized prostate cancer«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the initial evaluation and treatment of localized prostate cancer«
[
Yes
]
[
No
]
If so, how was it obtained
Follow-up of prostate cancer«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the follow-up of prostate cancer«
[
Yes
]
[
No
]
If so, how was it obtained
Initial evaluation and management of renal mass«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the initial evaluation and management of renal mass«
[
Yes
]
[
No
]
If so, how was it obtained
Follow-up of renal neoplasms«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the follow-up of renal neoplasms«
[
Yes
]
[
No
]
If so, how was it obtained
Initial evaluation and treatment of testis cancer«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the initial evaluation and treatment of testis cancer«
[
Yes
]
[
No
]
If so, how was it obtained
Follow-up of testis cancer«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the follow-up of testis cancer«
[
Yes
]
[
No
]
If so, how was it obtained
Initial evaluation and treatment of localized bladder cancer«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the initial evaluation and treatment of localized bladder cancer«
[
Yes
]
[
No
]
If so, how was it obtained
Follow-up and management of localized bladder cancer«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the follow-up and management of localized bladder cancer«
[
Yes
]
[
No
]
If so, how was it obtained
Evaluation and management of invasive bladder cancer«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the evaluation and management of invasive bladder cancer«
[
Yes
]
[
No
]
If so, how was it obtained
Evaluation and treatment of penile cancer«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the evaluation and treatment of penile cancer«
[
Yes
]
[
No
]
If so, how was it obtained
Pediatric Urology
Evaluation and management of pediatric emergencies«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the evaluation and management of pediatric emergencies«
[
Yes
]
[
No
]
If so, how was it obtained
Evaluation of UTI in infants and children«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the evaluation of UTI in infants and children«
[
Yes
]
[
No
]
If so, how was it obtained
Evaluation of ureteral anomalies (i.e. VUR, megaureter, UPJ obstruction)«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the evaluation of ureteral anomalies (i.e. VUR, megaureter, UPJ obstruction)«
[
Yes
]
[
No
]
If so, how was it obtained
Evaluation of hypospadias«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the evaluation of hypospadias«
[
Yes
]
[
No
]
If so, how was it obtained
Evaluation and treatment of children with voiding dysfunction (i.e. enuresis, NGB, urinary incontinence, SCI)«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the evaluation and treatment of children with voiding dysfunction (i.e. enuresis, NGB, urinary incontinence, SCI)«
[
Yes
]
[
No
]
If so, how was it obtained
Evaluation of children with intersex«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the evaluation of children with intersex«
[
Yes
]
[
No
]
If so, how was it obtained
Administration/Personal Growth
Financial/business management«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in financial/business management«
[
Yes
]
[
No
]
If so, how was it obtained
Medico-legal aspects of office practice«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the medico-legal aspects of office practice«
[
Yes
]
[
No
]
If so, how was it obtained
Medico-legal aspects of surgical practice«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the medico-legal aspects of surgical practice«
[
Yes
]
[
No
]
If so, how was it obtained
Managed care«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in managed care«
[
Yes
]
[
No
]
If so, how was it obtained
Practice organization«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in practice organization«
[
Yes
]
[
No
]
If so, how was it obtained
Understanding hospital organization and function«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in understanding hospital organization and function«
[
Yes
]
[
No
]
If so, how was it obtained
Billing and coding«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in billing and coding«
[
Yes
]
[
No
]
If so, how was it obtained
Personal financial management (insurance, retirement, estate planning, etc.)«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in personal financial management (insurance, retirement, estate planning, etc.)«
[
Yes
]
[
No
]
If so, how was it obtained
Development of interpersonal skills«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in the development of interpersonal skills«
[
Yes
]
[
No
]
If so, how was it obtained
Development of public speaking skills«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in the development of public speaking skills«
[
Yes
]
[
No
]
If so, how was it obtained
Dictation skills«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in dictation skills«
[
Yes
]
[
No
]
If so, how was it obtained
Maintaining practice responsibilities versus family/personal responsibilities«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in maintaining practice responsibilities versus family/personal responsibilities«
[
Yes
]
[
No
]
If so, how was it obtained
Surgical Experience - Overall
TURP«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in TURP«
[
Yes
]
[
No
]
If so, how was it obtained
Laser TURP«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in laser TURP«
[
Yes
]
[
No
]
If so, how was it obtained
TUNA or other minimally invasive surgical treatments for BPH«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in TUNA or other minimally invasive surgical treatments for BPH«
[
Yes
]
[
No
]
If so, how was it obtained
TRUS/biopsy«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require additional training in TRUS/biopsy«
[
Yes
]
[
No
]
If so, how was it obtained
Flexible cystoscopy with or without biopsy, fulguration, stent removal«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in flexible cystoscopy with or without biopsy, fulguration, stent removal«
[
Yes
]
[
No
]
If so, how was it obtained
Rigid cystoscopy with or without RPG, biopsy, fulguration, stent placement, stent removal«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in rigid cystoscopy with or without RPG, biopsy, fulguration, stent placement, stent removal«
[
Yes
]
[
No
]
If so, how was it obtained
Vasectomy«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in vasectomy«
[
Yes
]
[
No
]
If so, how was it obtained
Penile prosthesis«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in penile prosthesis«
[
Yes
]
[
No
]
If so, how was it obtained
Ureteroscopy semi-rigid (diagnostic or for stone treatment)«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in ureteroscopy semi-rigid (diagnostic or for stone treatment)«
[
Yes
]
[
No
]
If so, how was it obtained
Ureteroscopy flexible (diagnostic)«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in ureteroscopy flexible (diagnostic)«
[
Yes
]
[
No
]
If so, how was it obtained
Ureteroscopy flexible (lithotripsy: laser, EHL, basketing)«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in ureteroscopy flexible (lithotripsy: laser, EHL, basketing)«
[
Yes
]
[
No
]
If so, how was it obtained
PCNL«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in PCNL«
[
Yes
]
[
No
]
If so, how was it obtained
Cystoscopy with injection of bulking agents to treat urinary incontinence«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in cystoscopy with injection of bulking agents to treat urinary incontinence«
[
Yes
]
[
No
]
If so, how was it obtained
Pubovaginal sling with any material«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in pubovaginal sling with any material«
[
Yes
]
[
No
]
If so, how was it obtained
Pelvic prolapse surgery«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in pelvic prolapse surgery«
[
Yes
]
[
No
]
If so, how was it obtained
Vesicovaginal fistula (VVF) repair (vaginal approach)«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in VVF repair (vaginal approach)«
[
Yes
]
[
No
]
If so, how was it obtained
VVF repair (abdominal approach)«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in VVF repair (abdominal approach)«
[
Yes
]
[
No
]
If so, how was it obtained
Laparoscopic nephrectomy«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in laparoscopic nephrectomy«
[
Yes
]
[
No
]
If so, how was it obtained
Laparoscopic partial nephrectomy, cyst decortication, pyeloplasty
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in laparoscopic partial nephrectomy, cyst decortication, pyeloplasty«
[
Yes
]
[
No
]
If so, how was it obtained
Hand-assisted partial/complete nephrectomy«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in hand-assisted partial/complete nephrectomy«
[
Yes
]
[
No
]
If so, how was it obtained
RRP«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in RRP«
[
Yes
]
[
No
]
If so, how was it obtained
Robotic prostatectomy«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in robotic prostatectomy«
[
Yes
]
[
No
]
If so, how was it obtained
Open radical, partial nephrectomy«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in open radical, partial nephrectomy«
[
Yes
]
[
No
]
If so, how was it obtained
TURBT«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in TURBT«
[
Yes
]
[
No
]
If so, how was it obtained
Radical cystectomy«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in radical cystectomy«
[
Yes
]
[
No
]
If so, how was it obtained
Ileal loop urinary diversion«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in ileal loop urinary diversion«
[
Yes
]
[
No
]
If so, how was it obtained
Neobladder«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in neobladder«
[
Yes
]
[
No
]
If so, how was it obtained
Orchiectomy for testis cancer«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in orchiectomy for testis cancer«
[
Yes
]
[
No
]
If so, how was it obtained
Pediatric
Pyeloplasty«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in pyeloplasty«
[
Yes
]
[
No
]
If so, how was it obtained
Simple hypospadias repair«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in simple hypospadias repair«
[
Yes
]
[
No
]
If so, how was it obtained
Complex hypospadias repair«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in complex hypospadias repair«
[
Yes
]
[
No
]
If so, how was it obtained
Hydrocelectomy, orchidopexy«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in hydrocelectomy, orchidopexy«
[
Yes
]
[
No
]
If so, how was it obtained
Re-implantation«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in re-implantation«
[
Yes
]
[
No
]
If so, how was it obtained
Pyeloplasty«
-- Select from the following --
Unprepared
Adequately prepared
Over-prepared
Did you require further training in pyeloplasty«
[
Yes
]
[
No
]
If so, how was it obtained
Do you feel the residency training you received at Northwestern provided you with enough confidence to practice urology in the manner in which you wished during your FIRST TWO YEARS following training«
-- Select from the following --
Absolutely yes
Probably yes
Maybe
No
Absolutely no
Unsure
Do you feel the faculty is available for consultation if you have a question regarding a urologic issue«
-- Select from the following --
Absolutely yes
Probably yes
Maybe
No
Absolutely no
Unsure
What was the most POSITIVE aspect of your urology residency experience at Northwestern
What was the most NEGATIVE experience of your urology residency experience at Northwestern
What would you have added to your residency which would have been beneficial to your practice
Please add any comments which you feel might improve the urology residency experience at Northwestern
Fields marked with "«" are required.