About the Fellowship

Milestones

The core curriculum of the UTHSC Pediatric Urology Fellowship program is based on the 6 ACGME Competencies:

Patient Care

1. Information Gathering, Pre-operative/Diagnostic Testing, Differential Diagnosis
2. Patient Management/Indications for Surgery/Judgment
   Peri-operative Care (Fluid and Electrolytes, Pain Management)
3. Genital Reconstructive Procedures
4. Open Abdominal/Retroperitoneal Procedures
5. Endoscopic and Percutaneous Procedures of the Upper and Lower Urinary Tract
6. Laparoscopic/ Robotic

Medical Knowledge

1. Appropriate Competency in Core Domains
2. Related Fields of Knowledge (Nephrology, Endocrinology, Radiation Safety, etc.)

Systems-Based Practice

1. Working Effectively Within and Across Health Delivery Systems for the Benefit of Children
2. Cost Awareness and Risk-Benefit Analysis in Patient Care
3. Enhancing Patient Safety

Practice-Based Learning and Improvement

1. Improves via feedback and self-assessment
2. Evidence-based Learning
   

Interpersonal and Communication Skills

1. Communication: Families and Care Givers
2. Communication: Children
3. Communication: Personal Interactions with Physicians, Nurses, Hospital Staff Members, Residents, and Students
4. Use of Technology and Information Sharing Modalities to Facilitate Communication: Hospital EMR; In-patient, Outpatient, and OR
   

Professionalism

1. Work Ethic: Integrity, Altruism, and Teamwork
2. Sensitivity and Responsiveness to Diverse Populations: Gender, Family Structure, Culture, Race, Religion, Disabilities,
3. Respect for Patient Privacy and Autonomy
4. Sensitivity and Responsiveness to Diverse Populations: Gender, Family Structure, Culture, Race, Religion, Disabilities, Sexual Orientation
   

Goals and Objectives

Program

The goals and objectives of the program are to graduate residents trained in all aspects of pediatric urology care, both medical and surgical, no matter how complex, and whether acquired or congenital. The length of training is two continuous years in which clinical training is provided along with opportunities for teaching and research. Surgical experience is ongoing and usually daily. The resident has the choice of which cases in which to participate ensuring experience in the most complex ones. Congenital as well as acquired (tumor, trauma, etc.) diseases are included. Ambulatory care in the Urology Clinic, ED and consultation service provides the opportunity to develop non-surgical and diagnostic skills while under appropriate graded supervision. These skills include but are not limited to imaging modality selection and interpretation, urodynamic performance and interpretation, myelodysplasia, genetics, endocrinology, infectious disease, newborn ICU care, and the management of urologic emergencies and trauma. In the second -year outpatient office experience is acquired which will include performing outpatient lab and performing renal and abdominal ultrasounds. Opportunities for education and research are also provided. Teaching rotating urology residents and medical students will develop teaching skills. Projects are planned and undertaken with the faculty. At least one presentation at a national meeting and one publication per year is expected. Both national meetings are to be attended and expenses will be provided.

Rotation

Year 1

The clinical experience is the primary focus of first year. With a high-volume service at this tertiary institution, the Pediatric Urology Division serves a variety of pathologies. Surgical cases are open, laparoscopic, or robotic. A full spectrum of cases is available from smaller outpatient procedures such as hernias and orchiopexies, to more complex reconstructive cases such as proximal hypospadias, enterocystoplasty, and cloacal abnormalities. Additionally, a dedicated cystoscopy suite is available for all endoscopic surgeries. Ambulatory clinics are available for teaching and outpatient exposure at four different sites. There are also dedicated specialty clinics to optimize management of complex GU patients, including the spina bifida, CAKUT (Congenital Anomalies of the Kidneys and Urinary Tract), and DSD clinics.

Additionally, the first year fellow will be encouraged to participate in clinical research and develop project ideas that can then be carried out into their second year.

Year 2

The second year focuses on research, both clinical and basic science. Staff will assist with development of all research projects. Opportunities for bench research are available and encouraged with well-established/funded projects. While there are still clinical responsibilities, approximately 80% of the fellow’s time will be dedicated to carrying out their research. Options for pursuit of a Master of Science in Epidemiology for clinical investigators are also available.