There is a specific inflection point that many recently graduated physicians experience: the moment when the scale tips from the elation of matching to the fear of not being prepared to take on the responsibility of being a resident.

I am no exception to this rule. Like many friends and colleagues, I was committed to being the best medical student I could be, specifically for urology subinternships and away rotations. My feeling of mastery over the content at the medical student level has since faded away into questioning, well, everything.

When news of the AUA Intern Academy arrived in my inbox, I could only hope that I would have the opportunity to attend. I was fortunate enough to be starting residency at the site chosen for this year’s course, Cleveland Clinic’s campus in Cleveland, Ohio, and to have the program offer attendance to its junior residents.

The course began with an introductory lecture from Drs Sammy Elsamra and Ahmed Ghazi. Then, we proceeded to the first of 6 hands-on skills sessions. Each rotation was scheduled for 2 hours. There were 3 assigned for the first day, with the remaining 3 on day 2.

Endoscopy: The endoscopy station was set up with 2 main goals: (1) to practice cystoscopy and complete a cannulation and stent removal, and (2) to practice ureteroscopy and to basket a stone. Both stations had ample instruction from our faculty and vendor representatives. It was an excellent opportunity to work with endoscopy equipment and practice the dexterity required to do some of the most common urologic procedures.

Catheterization: The catheterization station began with education on troubleshooting difficult catheterizations and hands-on practice for bladder irrigation. The second portion was practice with difficult catheterizations using 3D printed models of different anatomical impediments. We had hands-on scope experience at this station, which was affirming after our prior training in the endoscopy station.

Communication skills: This station was one of the most surprising. While not directly related to surgical skills, it was a chance to dynamically experience medical decision-making, communication, and their consequences. Each group worked through a series of case studies via role play. Discussion and improvisation were encouraged. It was a very thought-provoking station.

Ultrasound: This station covered transrectal ultrasound as well as ultrasound of the bladder and kidney. The transrectal ultrasound portion covered the different types of probes and prostate biopsy methods and offered us a chance to ultrasound a model prostate and take a biopsy. This was a great first experience for many of us who had not done this before. The kidney station was designed to practice getting percutaneous access to the kidney. This excellent experience brought to light many of the challenges and solutions to gaining percutaneous access. The bladder station covered the different types of probes—when they should be used, how to calculate bladder volume, and suprapubic tube placement using ultrasound guidance.

Priapism: The priapism station had one of the best simulation models I have worked with (from Dr Ghazi’s lab, see Figure). The model was anatomically correct, with cavernosal bodies that could be continuously filled with fake blood. In this station, we discussed the etiology and management of priapism before practicing aspiration, irrigation, and shunts on the model.

Figure. Priapism model from the lab of Dr Ghazi.

Surgical skills: I have always loved surgical skills, so my expectation for this station was high. Like the other blocks, I was happily surprised by the breadth and depth of content. We began by discussing the different types of suture material and needles. We then practiced knot tying and various suture styles. There was 1 faculty member per table of 6 trainees, and this ratio was optimal for timely feedback, challenges, and discussion. This was a real treat compared to what is possible in a typical workday.

After the 2 days of hands-on training, getting to know peers and faculty from across the country, and asking as many questions as needed, I felt much more prepared for the upcoming year. Each faculty member was kind and approachable, with a trove of knowledge and a love of teaching. The equipment and representatives were second to none. It was an invaluable experience to have this amount of hands-on practice before working with patients.

While intern year remains daunting, the AUA Intern Academy did an excellent job preparing us for what is to come.