Core competencies in surgery: evaluating the goals of urology residency training in Canada

In Canada and the United States, the relevance and utility of training objectives as perceived by practising surgeons is rarely examined. We sought to determine if urology residency training objectives reflect the broad realities of urologic practice. Methods: A survey, based on the Royal College of Physicians and Surgeons of Canada training objectives for urology, was designed and validated. All 418 full-time practising members of the Canadian Urological Association were surveyed. Results: The overall response rate was 63%. Many specialized clinical areas of urology that receive little emphasis in the training objectives were rated as useful by the majority: laparoscopic surgery (92%), percutaneous renal access (86%), transrectal ultrasonography (84%), pediatric urology (81%), extracorporeal shockwave lithotripsy (70%), urethral reconstruction (66%) and adrenal surgery (62%). Microsurgery and transplantation were perceived as less useful (54% and 22% respectively). Virtually all nonsurgical training objectives were regarded as useful components of training; however, in the opinion of the majority of respondents residency did not prepare them for many of these: the challenges of office and hospital administration (91% and 89% not prepared [NP]), building a referral base (67% NP), time management (60% NP) and providing care under financial constraints (60% NP). Conclusion: The study results support the current training objectives and indicate areas requiring increased emphasis.