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UPJ INSIGHT Practice Readiness? Trends in Chief Resident Year Training Experience Across 13 Residency Programs

By: Zachary Corey, BS, Pennsylvania State University College of Medicine, Hershey; Erik Lehman, MS, Pennsylvania State University College of Medicine, Hershey; Gary E. Lemack, MD, University of Texas Southwestern Medical Center, Dallas; Marisa M. Clifton, MD, John Hopkins University School of Medicine, Baltimore, Maryland; Adam P. Klausner, MD, Virginia Commonwealth University School of Medicine, Richmond; Akanksha Mehta, MD, MS, Emory University School of Medicine, Atlanta, Georgia; Humphrey Atiemo, MD, Henry Ford Hospital, Detroit, Michigan; Richard Lee, MD, MBA, Weill Cornell Medical Center, New York, New York; Mathew Sorensen, MD, MS, FACS, University of Washington School of Medicine, Seattle; Ryan Smith, MD, University of Virginia School of Medicine, Charlottesville; Jill Buckley, MD, University of California San Diego School of Medicine; Houston Thompson, MD, Mayo Clinic, Rochester, Minnesota; Benjamin N. Breyer, MD, MAS, University of California San Francisco School of Medicine; Gina M. Badalato, MD, Columbia University Vagelos College of Physicians and Surgeons, New York, New York; Eric M. Wallen, MD, FACS, University of North Carolina School of Medicine, Chapel Hill; Jay D. Raman, MD, FACS, Pennsylvania State University College of Medicine, Hershey | Posted on: 18 Mar 2024

Corey Z, Lehman E, Lemack GE, et al. Practice readiness? Trends in chief resident year training experience across 13 residency programs. Urol Pract. 2024;11(2):430-438.

Study Need and Importance

Urology residency must prepare trainees for independent practice. However, the optimal operative chief resident year experience to prepare for practice is undefined. We analyzed the temporal arc of cases residents complete during their residency compared to their chief year in a multi-institutional cohort.

What We Found

From a sample of 479 resident graduates, we found a total of 1,287,433 cases were logged, including 375,703 during the chief year (29%). Urologic oncology cases had the highest median percentage completed during chief year (56%) followed by reconstructive urology (27%), general urology (24%), endourology (17%), and pediatric urology (2%). Across the study period, all categories of cases had a downward trend in median percentage completed during chief year except for urologic oncology. However, only trends in general urology (slope of −0.68, P = .013) and endourology (slope of −1.71, P ≤ .001) were significant (Figure).

Figure. Percentage of cases completed during chief year. * indicates a significant change in median cases logged per year.


Our study is limited as the Accreditation Council for Graduate Medical Education case logs utilized are self-reported by residents. This can lead to errors in the accuracy of case logs and may lead to reporting bias.

Interpretation for Patient Care

Our findings provide information that may aid residency training programs in their quest to optimally prepare trainees for independent practice.