Urology Clerkship

Hello, and welcome to Urology!

You have chosen a great elective during your third year Surgery rotation. Most of the students that take this elective course really enjoy themselves and learn more than they thought they would when they signed up for it.

Urology is a specialty that takes care of patients with many different kinds of problems. We see patients with kidney problems including kidney cancer and kidney stones. We also see patients with bladder problems such as bladder cancer and urinary incontinence in men, women, and some children. Although men with prostate cancer are usually cared for by urologists, many men with benign prostatic enlargement and its subsequent symptom of difficult urination are often cared for by urologists as well as their primary care physicians. We also take care of men with erectile dysfunction and male- factor infertility. Lastly, within the specialty of Pediatric Urology, we see boys and girls with all kinds of congenital problems with the kidneys, bladder, penis, and testicles.

The majority of the patients we care for require surgery, but many other patients we see have problems that only require medication or re-assurance. That is why you will be spending half of your time with us in the OR and half of your time seeing patients with us in clinic.

We realize that the majority of you who take this rotation will probably not choose a career in Urology. In fact, we know most of you will probably enter a career in one of the primary care fields; therefore, we have made some changes to our curriculum to better meet your learning needs.

We have a curriculum for medical students that we are really excited about. The American Urological Association (AUA) recently surveyed a broad assortment of physicians around the country and asked them “What do you think every medical student should know about Urology before finishing medical school?” They surveyed Residency Program Directors for Internal and Family Medicine Residencies, Emergency Department Programs, Pediatric Residencies, and Urology Programs.

What was surprising about the results of the survey was the striking similarity in the responses from vastly different specialties. There were 10 topics that all specialties felt were important. These are:

1. Kidney Stones
2. Hematuria
3. Adult UTI’s
4. Pediatric UTI’s,
5. The Acute Scrotum
6. Urinary Incontinence
7. Benign Prostatic Hyperplasia (BPH)
8. Prostate Cancer Management
9. Prostate Cancer Screening
10. Erectile Dysfunction

The survey also showed that most programs thought students should have the skills to insert a Foley catheter and perform a digital rectal exam. Because of these results, we have created a curriculum based on those 10 core topics and two skills. You can find the new curriculum here, on the Department of Urology’s website, in the handbook and on Learn at UW. In addition, you will find links to two videos which demonstrate the proper technique for Foley catheter insertion in men and women as well as a video that illustrates proper technique for performing a female genital exam. There are also links to some patient clinical scenarios that are fun and allow you to do more interactive computer based learning.

In addition to learning through participation in the operating room and seeing patients with us in clinic, there will be several small group learning sessions with the Urology faculty in their offices. Lastly, one or two of the 3:00 General Surgery Core Discussion sessions are mentored by some of the Urology faculty and cover several of the core topics that we and the AUA feel are important for all medical students to learn.

Before you start with us our Residency Coordinator, Barb Lewis, will e-mail you a copy of your schedule with information about where you should be on your first day of the rotation. Stop by her office in 3224 in the UW Medical Foundation Centennial Building (MFCB) to pick up a copy of The Department of Urology Medical Student Handbook for you to use while you are with us. You can keep the handbook to use as a reference after you are done with the rotation. She will also lend you a textbook that will help augment the information in the curriculum. The textbook will need to be returned when your Urology rotation is over. Barb’s number is 263-1363 and her e-mail address is lewis@urology.wisc.edu.

Barb will also meet with you for orientation during your first afternoon with us. She will discuss our learning objectives for you as well as give you a few suggestions and let you know how we provide feedback throughout the rotation.

If there are any concerns during the rotation, please do not hesitate to contact Barb Lewis at 263-1363 or lewis@urology.wisc.edu or me at 265-7000, pager 1358. I hope your rotation in Urology will be useful in your career as a physician.

Urology is a rapidly evolving technological specialty that requires surgical and diagnostic skills. All of us are excited about what we do, and feel privileged to be able to work as Urologists. There is an excellent video from the AUA titled “Why Urology?” We recommend it to all medical students. I hope you have a great time during your rotation with us. I hope you enjoy learning some urology that should be useful in any career you choose.