Background: The traditional endourology fellowship model encompasses advanced training in minimally invasive surgery (MIS) for both benign disease/kidney stones and oncology.
However, we have anecdotally observed that many former endourology fellows subspecialize within their practices. Recently the Endourology Society-accredited fellowship paradigm has been modified to allow for emphasis on benign disease/kidney stones or laparoscopy/robotic surgery, which is heavily weighted toward oncology. In this study, we sought to assess the practice patterns of former endourology fellows to evaluate the utility of various fellowship models.
Methods: Email addresses for 320 of the 327 graduates of endourology fellowships between 2001 and 2010 identified by the Endourological Society (EUS) were obtained. These were cross referenced with the American Urological Association (AUA) member database to maximize the yield of valid addresses. A 20 question electronic survey (SurveyMonkey Inc. Palo Alto, CA) was sent to this group. Eleven addresses were invalid and 24 recipients opted out of the survey.
Results: Responses were received from 121 of 285 former fellows with active email addresses who did not opt out of the survey (42.5%). Of respondents, 86% had completed fellowships in North America, and 71% completed one year fellowships. Among respondents in academic practice (46%), 44% reported a "mixed" benign and oncology-based practice, compared to 68% of non-academicians (p=0.009). Among academic practitioners, 33% practice predominantly MIS for benign disease, and 24% practice predominantly MIS for oncology, versus 23.1% (p=0.3) and 9% (p=0.04), respectively, of non-academicians. Most fellows had stability of clinical interests (benign vs. malignant disease) pre- and post-fellowship.
Conclusion: Fellowship-trained endourologists who work in an academic setting are more likely to have a subspecialized practice. A subset of private practice endourologists also have focused practices in benign disease. While the traditional fellowship model will be useful for some graduates, subspecialized tracts may improve the efficiency of the training model.
Written by:
Dagrosa LM, Pais V, Assimos D, Hyams ES. Are you the author?
Dartmouth Hitchcock Medical Center, Urology, One Medical Center Dr., Lebanon, New Hampshire, United States, 03756.
Reference: J Endourol. 2014 Jul 7. Epub ahead of print.
doi: 10.1089/end.2014.0403
PubMed Abstract
PMID: 25000513
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