Residency Training Overview

THE FIRST YEAR OF RESIDENCY (PGY1) is spent 6 months with the UCSF Department of Surgery.  Intern rotations focus on maximal exposure to basic open and laparoscopic general surgery procedures, critical care, kidney transplant, trauma, and plastic surgery.  The next five years and 6 months of residency are spent in the Department of Urology.  One year is dedicated entirely to research endeavors and the other four are clinical.

THE FIRST-YEAR UROLOGY RESIDENT (PGY2) continues their training at the VAMC, Mission Bay and the San Francisco General Hospital campus.  Four months are spent at the Bakar Cancer Center at Mission Bay, where two of the months are spent on the Pediatric Urology service.  Objectives for this rotation include broad exposure to urologic oncology surgeries and patient care, robotic surgery, ultrasound skills, and brachytherapy.  Four months are spent at the San Francisco General Hospital where the resident focuses on trauma, general urology, cystoscopy, transrectal ultrasound, and endourology.  Residents begin to develop their ultrasound and robotic surgery skills.

THE SECOND-YEAR UROLOGY RESIDENT (PGY3) begins to develop a deeper understanding of the specialty with 4 month rotations each at the Parnassus and Mission Bay campuses, and the San Francisco General Hospital.  The resident spends two months each on the Endourology/Stones service and subspecialty reconstruction at Parnassus, and two months on the Pediatric Urology service at Mission Bay.   Residents focus on continuity of care from diagnosis to follow up and learn to work in different health systems.

THE THIRD YEAR UROLOGY RESIDENT (PGY4) continues to refine their knowledge of urological procedures with disease processes and spend focused time in all areas of Urologic subspecialty and advance their surgical skills in open, laparoscopic, robotic, endoscopic, and microsurgery.  They spend four months at the Bakar Cancer Center at Mission Bay serving as the senior Oncology resident and eight months at the Parnassus campus.  While at the Parnassus campus, rotations include Endourology/Stones and Urologic subspecialties such as reconstruction, female urology, andrology, infertility, and erectile dysfunction.  On the subspecialty block, residents function as the junior Chief Resident of the Parnassus service.

THE FOURTH YEAR UROLOGY RESIDENT (PGY5) spends one year dedicated to research.  This may include basic science, translational, clinical or outcomes research.  Some residents elect to pursue advanced degrees during this year.  Often residents explore advanced training in statistics, trial design, international and public health depending upon their interests and career goals.  They lead the quality improvement initiative for the department.

THE FIFTH YEAR RESIDENT (PGY6) functions as Chief residents and rotate four months each at the San Francisco General Hospital, the San Francisco VA, and Parnassus/Mission Bay.  This year is dedicated to developing leadership skills, advancing surgical technique, perfecting patient care, and deciding upon future career goals.  Further, the chief resident runs the service at each location, acts as a primary surgeon for major cases and as teaching surgeon for minor cases with junior residents.  They direct management for inpatient and outpatient care and work with an increasing degree of independence throughout the year as they prepare for the transition to fellowship or independent practice.

Weekly

Residents have a protected time each week for their didactic learning sessions. It is done utilizing a flipped classroom teaching approach led by UCSF Faculty with case- and question-based format. High-yield review sessions are also planned to help residents prepare for the in-service examination.

Monthly

Each month, residents participate in the following educational sessions:

• UNIQUE (Urol, Rad, Neph, Path) Conference
• Lifetime Congenital Urology Conference
• Morbidity & Mortality Conference
• Grand Rounds
• Journal Club/Mentor College
• Pediatric Dry Rounds
• Stoller Radiology Rounds

In addition to the weekly and monthly sessions, residents also have quarterly skills lab sessions which allows them to hone their skills through hands-on activities (i.e. robotic/ laparoscopic skills, conduit/neobladder creation and ureteral anastomoses with pig intestines, cadaver lab activities, etc.).

In order to help our residents grow and develop them into leaders both in residency and their future careers, our department created a leadership and wellness curriculum which is designed to supplement residents’ education by focusing on topics outside of urology-centric didactic learning. 

Sample Leadership Topics

• Power at the Podium: Nailing your Presentation from Conceptualization to Delivery
• Philanthropy in Medicine
• Conflict Resolution
• Near Misses

Sample Wellness Topics

The wellness curriculum is built around the 7 pillars of wellness – physical, financial, spiritual, social, occupational, emotional, environmental. 

• Physical: sleep, nutrition, physical fitness, substance abuse
• Financial: loan repayment and financial advice, the business of medicine, retirement planning, disability insurance, philanthropy in medicine
• Spiritual: mindfulness and reflection, resilience and burnout, positive coping strategies, end of life care, medical ethics
• Social: getting the most from your mentors, giving and receiving feedback, conflict management, teamwork and communication
• Occupational: balancing work and family, delivering bad news, dealing with difficult patients, dealing with difficult consultants and staff, time management, interviews & job hunt, academic careers, depositions/medical malpractice, journey to leadership
• Emotional: physician suicide, debriefing traumatic events, dealing with medical errors and shame
• Environment: wellness in the workplace and near misses