Sunday, February 3, 2013

Urology workforce shortage and teaching residents at private hospitals

Hello, friends.
It's been awhile since I've posted, so sorry for the hiatus.

We have just released a paper in the journal Urology about teaching residents laser prostatectomy in the private practice setting.

Pubmed Citation for Paper

There is a serious shortage of urologists in America.  To compound the issue, there are only 225 or so urology residents graduating per year - well short of what this country needs.  Medicare dollars are also getting squeezed which means that the graduate medical education (GME) environment will only be more challenging (Medicare pays for the bulk of graduate medical education currently in this country).  Going forward, this means that the paradigm of the academic medical center being the sole nexus of surgical education may have to change.

In our paper, we show that residents can be taught cutting edge surgical techniques in a private hospital, in this case laser prostate surgery, without any change in the safety profile or surgical outcomes.  The only difference in cases with a resident was a slight increase in operative time (57 vs. 46 minutes).

More urologists need to be trained in the future to tackle the needs of our population.  Since GME dollars are fixed and are surely going to be tightened up in the future, institutions need to be creative about training opportunities.  High quality private practices can be a great resource to train the next generation of urologists.  In the future, I also see more private institutions creating their own residencies outside the confines of a Medicare system.

Our paper received an editorial...which was a great compliment to the impact of our article.

Pubmed citation for editorial

We composed an editorial reply please find a link below:

Our editorial reply (Pubmed citation)

I hope to continue posting with some regularity....though the periodicity is uncertain at this time.  It has been difficult in the past few months balancing family, my MBA program - only 2 classes left!, research, and a busy clinical practice.  However, there's a bunch of stuff going on in my urologic mission so I want to continue to share and educate.  Any words of encouragement and support are greatly appreciated!

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