The worldwide urological community is heavily invested in the education of the next generation of urologists, as evidenced by the abstracts presented on surgical education during the AUA Annual Meeting in April 2023 in Chicago, Illinois. Fifty-two abstracts were presented across the “MP25: Education Research I” moderated by Drs Pareek, Taylor, and Richstone; “PD30: Education Research II” moderated by Drs Elsamra and Wang; and “MP66: Education Research III” moderated by Drs Hung and Takacs. These sessions focused on numerous topics related to medical and urological education, training, and clinical practice. Significant themes emerged including: (1) Residency Management, (2) Technical Skills Training, (3) Well-being, (4) Scholarship, and (5) Simulation (see Figure).

Figure. Themes for surgical education research abstracts AUA 2023.

Within the theme of Residency Management, abstracts addressed subtopics of application rates and trends, preference signaling, fellowship case trends, virtual interviews, practice readiness, and surgical bootcamps. Corey et al analyzed case distribution and exposure of chief residents in 13 institutions during their entire residency using Accreditation Council for Graduate Medical Education case logs from 2010-2020 and found that 30% of all cases were completed during chief residency year, with the highest median percentage of cases in urologic oncology (57%), followed by reconstructive urology (31%), general urology (31%), endourology (23%), and pediatric urology (12%). Across the study period all categories of cases had a downward trend in median percentages completed during chief year except urologic oncology. Passarelli et al reported on a single-institution survey of applicants with a 36% response rate on what factors are influencing applicant rank lists and their perceptions on virtual interviews. They found 30% of participants identify goodness of fit within the program, 28% program location and 23% resident happiness as the most important factor in ranking decisions. Calvo et al examined trends in genitourinary reconstructive surgeons’ fellowship case logs from 2014-2022 and found that case volumes have increased in urethral reconstruction, male sexual health, genital reconstruction, and abdominal reconstruction while they have decreased in female case volume.

Within the theme of Technical Skills Training, abstracts addressed topics such as modern tools for study such as digital flashcards, mixed/virtual reality, artificial intelligence, feedback, and skills training on procedures such as prostate biopsy, percutaneous renal access, and transurethral resection of bladder tumors. Saxton et al carried out evaluation of mixed reality (MR) technology for remote guidance during ultrasound-guided percutaneous renal access simulation by randomizing 12 residents into MR using “smart” glasses transmitting audio and merged surgical fields vs in-person (IP) trainings. The MR group had greater improvement in attempts, time, and score. After crossover training, only the MR group improved in these same outcomes. However, while 68% of trainees found MR training similar to IP for usefulness and clarity, only 8% preferred MR to IP. As such, despite improved performance and equivalent delivery with MR technology, trainee perception towards remote/MR training remains skeptical. Alargkof et al assessed the learning curve of robotic assisted transperineal MRI/ultrasound fusion–guided prostate biopsy through single-institutional technical training of robotic assisted transperineal MRI/ultrasound fusion–guided prostate biopsy among chief and first-year residents and experts measuring time, accuracy, performance, workload, and complications and demonstrated a learning curve of 13 procedures for transition point of workload reduction, with probe placement and time to biopsy identified as the most difficult skills.

Within the theme of Well-being, abstracts addressed topics such as complications, finances, burnout, parental leave, and safety in the workplace. Klimowich et al analyzed the 2019 AUA Census comparing symptoms of burnout, depersonalization, and emotional exhaustion between postgraduate year (PGY) 1-3s and PGY 4-5s. They found that all symptoms were higher among PGY 1-3 and recommended changes to improve work life were meal plans, on-call quarters, and time for health appointments. Farooq et all applied actual methods to estimate financial compensation related to coresident parental leave call workload using the 2019 AUA Resident Census based on data showing 7% of residents have a child per year and modeling every fourth call and a 6-week parental leave. Estimated annual allocation of resources to fund resident parental leave is $7,224, which are data that programs, program directors, and residents can use with sponsoring institutions and health care systems to facilitate supporting parental leave.

Within the theme of Scholarship, abstracts addressed topics such as assessing “spin” in manuscripts, ethics, publication rates, indexes for clinical scholarship, and rates of female authorship. Wu et al assessed spin or language manipulation of results in 5 top urology journals from 2019-2021, and of 3,500 studies spin was found in 76% of studies, 46% of abstracts, and 48% of main text conclusions. Common spin strategies were obscuring statistical nonsignificance or primary outcome, focusing on statistically significant secondary results, and emphasizing trends despite nonsignificant results. Orji et al quantified nonclinical academic contributions in a single-institution weighted framework as a clinical scholar index to assess academic work to identify ways to support career development and promote faculty growth.

Within the theme of Simulation, abstracts addressed topics such as surgical gestures, 3D-printed organs, and virtual reality. Lee et al assessed the viability and efficacy of a multi-institutional skills-based bootcamp for junior urology residents for New York City programs on urethral catheterization, cystoscopy, renal and bladder ultrasound, and robotic simulation. Twenty of 23 trainees strongly agreed the course provided high-yield overview and was engaging and effective in residency preparation. As such, leveraging resources across programs in collaborative educational endeavors can be feasible and effective in training junior residents.

As evidenced by these highlighted projects and many others, the urological community is deeply engaged in training and education, and the take home message is that despite the challenges of pandemic and the complexity of modern medicine, urologists dedicate themselves to advancing and innovating the education and development of the next generation of urologists.