In compliance with the ACGME minimum program requirements, the Urology Residency Program
at the Medical College of Georgia at Augusta University requires its residents to
obtain competencies in the 6 areas listed below to the level expected of a new practitioner:
Patient Care that is compassionate, appropriate, and effective for the treatment of health problems
and the promotion of health
Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological
and social-behavioral) sciences and the application of this knowledge to patient care
Practice-Based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and
assimilation of scientific evidence, and improvements in patient care Interpersonal and Communication Skills
that result in effective information exchange and teaming with patients, their families,
and other health professionals
Professionalism, as manifested through a commitment to carrying out professional responsibilities,
adherence to ethical principles, and sensitivity to a diverse patient population
Systems-Based Practice, as manifested by actions that demonstrate an awareness of and responsiveness to the
larger context and system of health care and the ability to effectively call on system
resources to provide care that is of optimal value.
While these competencies have always been a part of residency training, their delineation
as requirements has mandated specific competency-directed activities and careful documentation.
Toward this end, the following knowledge, skill, and attitude requirements, as well
as additional urologic surgery technical ability and institutional requirements, have
been defined.
Responsibilities and Objectives for All Residents on All Rotations
All residents will maintain a full-time position as surgical resident in the Section
of Urology. All residents will be responsible for the year-specific job description
described hereafter. Goals and Objectives/Competency: Institutional Requirement Documentation: Graduate Medical Education Office Resident Rolls
Upon receiving and reviewing this handbook, all residents should sign the last page,
certifying receipt of the handbook, tear out the page, and turn it in to the Program
Coordinator, Kim Maddox. Goals and Objectives/Competency: Institutional Requirement Documentation: Receipt of signed certification page by Program Coordinator
All residents will engage in the care of patients on the urology in-patient service
and the outpatient clinic as well as in the operating room. Residents act as a team
under the guidance of the attending surgeon to manage all patient care issues, from
the preoperative, perioperative, and postoperative time intervals. Goals and Objectives/Competency: Patient Care, Professionalism, Interpersonal and Communication Skills Documentation: Global Resident Competency Rating Form, Observed Patient Encounter Rating Form, 360
Degree Rating Form by Peers, Nursing Staff, and Anesthesia Evaluations.
All residents will prepare for, attend, and participate actively in all teaching conferences
(Campbell's review, journal club, faculty didactic lectures, AUA update series review),
morbidity and mortality conference, urodynamics conference, radiology conferences,
Rinker-Witherington symposium, and any additional lectures and course instruction
deemed mandatory by the faculty. Residents on medical leave, annual leave, or called
to see a patient for a matter than cannot be delegated to the physician assistant
wait until the conclusion of the conference will be excused. Goals and Objectives/Competency: Medical Knowledge, Practice-Based Learning and Improvement, Interpersonal and Communication Skills Documentation: Record of Attendance, Global Resident Competency Rating Form, In-Service Examination
Scores, Presentation score cards
All residents will prepare for and take the annual in-service examination sponsored
by the American Board of Urology. Goals and Objectives/Competency: Medical Knowledge Documentation: In-Service Examination Scores
Residents are responsible for all histories and physicals as well as obtaining preoperative
consent under the supervision of the attending urologist. Attending notes are added
to comply with the laws of Medicare/Medicaid/Tricare. The residents are to write daily
notes and orders, operative notes and orders. A discharge note and complete orders
are to be on the chart on the day of discharge prior to beginning daily duties, such
as clinic or operations. Discharge summaries and consultations are to be sent to referring
physicians. Rounds with faculty responsible for individual in house patients will
occur on a daily basis with the exception of weekends. Residents are to contact the
appropriate faculty member regarding any patient management questions. Goals and Objectives/Competency: Patient Care, Professionalism Documentation: Global Resident Competency Rating Form, Observed Patient Encounter Rating Form
For surgical cases in which the resident is the only resident and/or is the primary
surgeon, residents are expected to: a. Have familiarized themselves with the patient and their history, discuss any questions
with attending b. Done the appropriate reading prior to any operation c. Have all necessary radiographic studies in the O.R. and hanging on the light box
(or displayed on the monitor in the case of digital images) prior to the start of the cased. d. Dictate operative reports within 24 hours. If not dictated in 48 hrs, residents
will lose O.R. privileges. e. Write post-operative admission orders or outpatient orders including prescriptions
f. Promptly enter cases into their own personal and the ACGME Resident Case Log System.
To access the online:
If you do not have an ID and password, contact the Program Coordinator, Kim Maddox
(email: kimaddox@augusta.edu or office (706) 721-2519). You can download a copy of the instruction manual for the Resident Case Log System
at:
A list of CPT codes to help expedite entries can be downloaded from:
For problems with the system, call the ACGME Help Desk at contact the ACGME Help Desk
312-755-7464 or email oplog@acgme.org.
Goals and Objectives/Competency: Patient Care, Technical Skills, Institutional Requirements, Delinquent Dictation Reports from Medical Records Documentation: Global Resident Competency Rating Form, Resident Case Logs
All residents are to adhere to the 80 hour work week policy described in the “Policy
on Duty Hours” portion of this Handbook. Residents will complete online One45 Duty
Hours accessed at:
and log on using the ID and password generated for you by the residency coordinator.
More detailed instructions for the completion of the on-line Duty Hours are available
in the “Policy on Duty Hours” section of this Handbook. Additional assistance can
be obtained by contacting: Diana Duva at 706-721-2423 or by email dduva@augusta.edu. If the duty hour limit is reached, the resident should notify the chief resident
and/or supervising faculty member, sign-out his or her pager, and leave the facility. Goals and Objectives/Competency: ACGME/Institutional Regulations, Patient Care Documentation: Duty Hour Logs, Institutional Duty Hour Log Audit Reports
All residents are responsible for monitoring their level of fatigue. If a resident
feels as if his or her level of fatigue is compromising their ability to provide patient
care, the resident should notify the chief resident and/or supervising faculty member,
sign-out his or her pager, and go to an appropriate call bedroom (or home if near
the end of shift and the resident is not too compromised to drive) and sleep. The
resident may return to duty after a nap if he or she feels sufficiently rested and
the shift is not completed or the 80 hour work week limits have not been reached.
If a resident is judged to be too fatigued to adequately provide patient care by the
chief resident and/or supervising faculty, even if the resident does not agree, the
same protocol applies. Goals and Objectives/Competency: Patient Safety Documentation: Global Resident Competency Rating Form, 360 Degree Rating Form by peers
All residents will read assigned chapters in Campbell's Urology Ninth Edition and
other reading assignments as part of their personal home study routine. At Reading
Assignment Review Conferences, all residents will be asked questions at random, such
as from the Campbell's Urology Study Guide, about the assigned chapters and any incorrect
or unclear answers reviewed by supervising faculty assigned by area of expertise. Goals and Objectives/Competency: Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning Documentation: Attendance Record, Minutes of Meeting
All residents will read articles in Journal of Urology or other articles in journals
(e.g., Urology, BJU, Prostate, Endourology, Andrology, NEJM, JAMA) assigned by the
faculty as part of their personal home study routine. At monthly Journal Club, all
residents will be asked at random to summarize articles and/or will be asked to categorize
the methodology of the study (e.g., case series, controlled, blinded, etc.), appropriateness
of the statistical analysis, and alternative study designs that might better answer
the hypothesis presented by the authors. Questions from any CME questions published
with the assigned articles may also be asked. Any incorrect or unclear answers reviewed
by supervising faculty assigned by area of expertise. A subscription to Journal of
Urology (as part of resident membership in the AUA) is required. Goals and Objectives/Competency: Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning Documentation: Attendance Record, Global Resident Competency Rating Form
All residents should demonstrate understanding of socioeconomic issues impacting upon
the practice of urologic surgery including but not limited to the awareness lack or
limits of individual patient Medicare, Medicaid, Peach Care, HMO or other insurance
coverage; frugal use of expensive tests and medications; and familiarity with social
services available to assist patients in need. Goals and Objectives/Competency: Systems-Based Practice, Professionalism Documentation: Attendance (either live or on-line) and adequate score on posttest for GME Core Competency
Lectures related to Socioeconomic Issues, Attendance at urology section didactic lectures by practice CEO/coding office/hospital
legal counsel, Clinical Examination Evaluation, Faculty Evaluations
All residents are expected to demonstrate sensitivity to patient diversity issues
including but not limited to race, gender, cultural/religious beliefs, sexual orientation,
career choice, socioeconomic status, and educational/intelligence level. Goals and Objectives/Competency: Professionalism Documentation: Attendance (either live or on-line) and adequate score on posttest for GME Core Competency
Lectures related to Ethics, Attendance at urology section didactic lectures by hospital
legal counsel, Clinical Examination Evaluation, Evaluations from Faculty, Nursing Staff, Administrative Staff,
Peers
All residents are expected to develop and demonstrate values consistent with the highest
ethical practice of medicine. Goals and Objectives/Competency: Professionalism Documentation: Attendance (either live or on-line) and adequate score on posttest for GME Core Competency
Lectures related to Ethics, Attendance at urology section didactic lectures by hospital
legal counsel, Clinical Examination Evaluation, Evaluations from Faculty, Nursing Staff, Administrative Staff,
Peers, Patients
During clinic, inpatient rounds, surgical procedures, and conferences, residents are
expected to take part in the teaching of students, interns, and more junior residents
including but not limited to discussions of normal genitourinary anatomy, physiology
and embryogenesis; elements of urologic history taking; elements and technique of
urologic physical examination; common urologic signs and symptoms, their implications,
and components of appropriate evaluation; patient disease processes and congenital
anomalies; rationale, indications, and risks of urologic surgical procedures and medical
interventions; and technique of urethral catheter insertion as well as more general
topics such as format and content of preoperative history and physical examinations
and postoperative progress notes, sterile technique, sharps safety, universal precautions,
and perioperative patient care. Goals and Objectives/Competency: Medical Knowledge, Interpersonal and Communication Skills, Professionalism Documentation: 360 Degree Rating Form by peers and students
Residents are expected to participate in academic contributions to the Section of
Urology by seeking opportunities for involvement in research such as questioning existing
data through literature reviews, formulating research questions, and discussing potential
research projects with faculty members. Summarizing the history and course of an interesting
patient in the form of a case report is also acceptable. Residents are required to
understand and comply with the institutional Human Assurance Committee Policies. For
projects approved by the involved faculty member, residents can access data from existing
databases maintained by that faculty member or establish and collect a novel data
set from patient chart reviews. After data analysis and interpretation residents are
expected to present their findings via manuscript admission. Submission of associated
abstracts to scientific meetings is also encouraged. While the current residency rotations
do not allow for dedicated research time with which to perform basic science research,
the clinical portion of such projects, such as serum collection for proteomic analysis, can be
performed in collaboration with one of the basic science faculty. For more in-depth
research exposure, residents are encouraged to apply for funding for a fellowship
position in the Section through the American Foundation for Urologic Disease. Goals and Objectives/Competency: Medical Knowledge, Practice-Based Learning Documentation: Submitted/Accepted Manuscripts and Abstracts
All residents will complete Faculty Evaluations and Program Evaluation annually as
well as Self and Peer Evaluation twice yearly. In order to complete the Faculty, Program
and Peer evaluations, residents should go to:
Follow the detailed instructions for the completion of the on-line Faculty and Program
Evaluations are available in the “Policy on Resident, Faculty, and Program Evaluation”
section of this Handbook. For the Peer Evaluations, residents should complete the
360 Degree Rating Form for each of their fellow residents. Goals and Objectives/Competency: Institutional Requirement, Practice-Based Learning and Improvement, Professionalism Documentation: Completed Evaluation Forms
All residents have access to a VESSL lab and are encouraged in their free time to
utilize this to practice their surgical skills. You may enter the lab via key pad.
The code to enter is 9375 *. If you need any assistance you may contact the coordinator
for the VESSL, at ext. 4202. Goals and Objectives/Competency: Medical Knowledge, Surgical Skill Documentation: Faculty Evaluations
All residents are expected to participate in the teaching of rotating medical students
and interns including assisting students in the completion of their topic checklist. Topics to be discussed with students and interns include but are not limited to: 1. Urologic physical exam 2. Performing and interpreting clinic urinalysis 3. Components of hematuria evaluation (CT or IVP, cysto, cytology, not ultrasound
with normal renal function) 4. Voiding symptoms associated with a. Obstruction (BPH) b. UTI c. Stress incontinence d. Urge incontinence e. Mixed incontinence 5. Presenting symptoms of epididymitis vs testicular torsion 6. Prostate cancer a. Screening (age appropriateness) b. Natural history c. Treatment options d. Basic hormone therapy concepts 7. What patient to treat and not to treat with asymptomatic bacteruria (catheterized,
intestinal diversion, pregnancy, immunocompromised) 8. Precautions with GU implants (prophylactic antibiotics, catheterization) 9. Foley catheter management a. Placement (prep, closed system, French size and coude indications) b. Alternatives (SP tube, CIC) c. Colonization d. Removal approaches (antibiotics, fill and pull) Student teaching is to be performed in a gracious and positive fashion. Students will
be given the opportunity to evaluate residents on their teaching skill. Goals and Objectives/Competency: Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning Documentation: Student Checklists, Evaluation Forms
All residents are expected to follow the goals and objectives on the following pages
regarding the knowledge, skills, progressive responsibility for patient management,
and other attributes of residents for each major rotation and each year of training
(see details on following pages). Along with these goals and objectives, the responsibility
given to residents in patient care will also depend upon each resident's knowledge,
problem-solving ability, manual skills, experience, and the severity and complexity
of each patient's status as determined by the supervising faculty member.
