The Washington University School of Medicine Urology Residency program is a program with a rich history, having achieved and maintained ACGME-accreditation since 1966. Our program has grown through the years, to now include 20 urology residents (4 residents per year, 5 year program) working alongside faculty who are fellowship-trained in every subspecialty of Urology. Our residents have the opportunity to learn and practice urology at many sites, to care for both adult and pediatric populations, and to work with different patient demographics across the greater St. Louis area.
Our residency program upholds the following values:
- Teamwork. Our residents and faculty support each other both in and out of the hospital.
- Innovation. Our residents and faculty implement the most up-to-date urologic practices today and are also conducting research and seeking ways in which to improve the care of tomorrow’s urology patients. Quality improvement is an ongoing iterative process.
- Pursuit of Excellence. We demand excellence of ourselves and of each other at all times, which requires integrity, respect, and accountability.
Our Urology Residency Program is a 5 year experience.
First Year / PGY-1
PGY-1 Urologic Surgery residents spend 6 months on the Inpatient Urology Service at Barnes-Jewish Hospital (BJH) and 6 months on other surgical rotations at BJH. These other surgical rotations can include Colorectal Surgery, Transplant Surgery, Trauma Surgery, Critical Care Medicine (Surgical ICU), Vascular Surgery, Surgical Oncology, Pediatric Surgery, and Plastics/Reconstructive Surgery. This offers graded responsibility with the primary emphasis on pre- and postoperative patient care. This set of rotations enables the PGY-1 resident to achieve the following goals:
- Develop skill in obtaining medical histories and performing physical examinations
- Learn all aspects of routine pre- and post-operative management of surgical patients
- Learn management of acutely ill patients in the ICU
- Learn basic surgical techniques
Second Year / PGY-2
During the second year of Urologic Residency, residents rotate in three-month blocks at Barnes-Jewish Hospital (BJH), the Center for Advanced Medicine (CAM) (Ambulatory rotation). St. Louis Children’s Hospital (SLCH), and the St. Louis VA Medical Center (VAMC).
While at BJH, the second year resident works closely with the chief resident and a third year resident. They are responsible for the Urology Consult Service at BJH (inpatient and Emergency Department consultations). Through this rotation, they will be learning basic inpatient and outpatient urological care as well as minor urological procedures including circumcision, orchiectomy, cystoscopy, retrograde pyelography and bladder biopsy. In addition, the resident receives training in bedside procedures like the insertion of Foley urethral catheters, insertion of suprapubic tubes, use of urethral dilators, and performance of flexible cystoscopy in the Emergency Room and intensive care units. While on the BJH rotation, the second year resident takes call on average one weeknight per two weeks (which is in-house call covering BJH and SLCH) and one weekend per month (which is home call covering BJH).
While on the Ambulatory rotation, the resident spends time with our adult urology faculty in the outpatient/ambulatory setting, primarily at the CAM at our main medical campus. The resident learns the management of common urologic concerns, such as lower urinary tract symptoms, voiding dysfunction, incontinence, erectile/sexual dysfunction, infertility, urolithiasis, prostate cancer, kidney cancer, and bladder cancer. The resident also gains proficiency in office-based procedures such as cystoscopy and prostate biopsy. While on the Ambulatory rotation, the second year resident takes call on average one weeknight per two weeks (which is in-house call covering BJH and SLCH) and one weekend per month (which is home call covering BJH).
At SLCH the second year resident works with a fourth year resident. The second year resident is responsible for inpatient pediatric urologic care as well as seeing pediatric patients in the outpatient area with the attending physicians. The resident is exposed to common urological procedures performed in children such as circumcision, orchiopexy, inguinal hernia/hydrocele repair, hypospadias repair, and cystoscopy/ureteroscopy. While at SLCH, the second year resident takes call on average one weeknight per two weeks (which is in-house call covering BJH and SLCH) and every other weekend (which is home call covering only SLCH).
At the VA, the second year resident works with a third year, fourth year, and fifth year (Chief) resident. The second year resident is responsible for learning inpatient and outpatient urological care. The second year resident’s operative training includes all minor cases such as circumcision, orchiectomy, cystoscopy, catheter manipulation, urethral dilation and office-based procedures such as prostatic ultrasonography and biopsy. The resident takes call from home every third night and/or one out of every three weeks.
Third Year / PGY-3
The third year consists of three-month rotations at BJH on the Main Service, BJH on the Endourology Service, Barnes-Jewish West County Hospital (BJWC), and the VAMC.
The third year resident on the BJH Main Service has responsibilities for general inpatient care and participates with the Main Chief Resident in managing cases in the clinic, operating room, hospital inpatient floors and consults. Additionally, the third year BJH Main resident has responsibilities as needed in the Emergency Room. The third year BJH resident takes call on average one weeknight per two weeks (which is in-house call covering BJH and SLCH) and one weekend per month (which is home call covering BJH).
The third year resident on the BJH Endourology Service works alongside the fourth year Endourology Senior Resident. The third year Endourology resident is responsible for all aspects of general inpatient care and specifically is expected to master skills appropriate to open urological surgery and endoscopic surgery. The resident also assists with consults in the hospital and in the Emergency Room, and also assists the COH Chief Resident in the COH Urology Clinic, which is held weekly on Friday. The third year Endourology resident takes call on average one weeknight per two weeks (which is in-house call covering BJH and SLCH) and one weekend per month (which is home call covering BJH).
The third year BJWC resident has an opportunity to learn general urology and female urology in the office evaluating patients, in the urodynamics laboratory and in the operating room. Additionally, the BJWC resident has responsibilities as needed in the Emergency Room and consults in the hospital, and also assists the COH Chief Resident in the COH Urology Clinic, which is held weekly on Friday. The third year BJWC resident takes call at BJH on average one weeknight per two weeks (which is in-house call covering BJH and SLCH) and one weekend per month (which is home call covering BJH).
The third year VAMC resident enhances skills in evaluating patients in the clinical setting as well as developing operative skills with more sophisticated endourology and endoscopic procedures such as transurethral resection of the prostate, ureteroscopy, percutaneous stone manipulation and other upper tract endoscopic procedures. The third year VAMC resident is also exposed to laparoscopy and robotic surgery at the VAMC. They are also responsible for consults and Emergency Room coverage. The resident takes call from home every third night and/or one out of every three weeks.
Fourth Year / PGY-4
During the fourth year, the residents spend three months at the VAMC, three months at SLCH, three months at Christian Hospital Northeast (CHNE), and three months on an elective rotation.
While at the VA, the fourth year resident further enhances skills in evaluating patients in the clinical setting as well as developing operative skills with more sophisticated endourology and endoscopic procedures such as transurethral resection of the prostate, ureteroscopy, percutaneous stone manipulation and other upper tract endoscopic procedures. The fourth year resident is also exposed to laparoscopy and robotic surgery at the VAMC. They are also responsible for consults and Emergency Room coverage. The resident takes call from home every third night and/or one out of every three weeks.
At SLCH, the fourth year resident participates in more sophisticated open, endoscopic, laparoscopic/robotic pediatric urologic surgical procedures. The fourth year resident participates in a clinic two to three times per week to gain exposure to the process of evaluating children in an outpatient setting, selection of children for surgical procedures and postoperative follow-up. This includes exposure to urodynamics testing, especially in the multidisciplinary Spina Bifida Clinic. The fourth year resident is also responsible for covering the Emergency Room and in-house consults. While at SLCH, the fourth year resident takes call on average one weeknight per two weeks (which is in-house call covering BJH and SLCH) and every other weekend (which is home call covering only SLCH).
The CHNE Senior resident is responsible for covering the urology service at Christian Hospital Northeast. The resident will spend time mostly in the OR but also one day per week in clinic. The surgeries performed at CHNE primarily include General Urology, Endourology, MIS, Oncology, and Reconstructive Urology (including IPP placement). This rotation is intended to build the operative skills of senior residents. The fourth year CHNE resident takes call on average one weeknight per two weeks (which is in-house call covering BJH and SLCH) and every third weekend (which is home call covering only BJH as back-up to a more junior resident).
The Elective Rotation allows a PGY4 resident to consider their own educational needs, in light of the skills they have developed thus far in residency and considering what their plans are post-residency. Examples of clinical foci for the Elective Rotation include Urogynecology, BPH therapy (like HoLEP and PVP), and Infertility/Male Health. The Elective Rotation is also an opportunity for residents to emphasize academic endeavors and to complete research projects. On average, the Elective Resident uses 3-4 days per week for their Elective time, and 1-2 days per week the Elective Resident helps to cover more complex surgical cases on the Main Service and Endo Service at BJH that are appropriate for the level of a senior resident. The fourth year Elective resident takes call on average one weeknight per two weeks (which is in-house call covering BJH and SLCH) and every third weekend (which is home call covering only BJH as back-up to a more junior resident).
Fifth Year / PGY-5
Chief resident rotations are four months in length at BJH as the Main Chief, at BJH as the Endourology Chief, and at the VAMC as the Chief resident. All Chief residents are on call from home (second call) as back up to more junior residents. The goals of these rotations are to allow the resident to master all aspects of urological care, including especially clinical judgment when managing an inpatient service line and also operative skills.
The VAMC Chief resident is responsible for running the patient clinic and, with appropriate supervision from the attending, selecting and performing surgery on patients.
The Chief resident of the Main Service at BJH refines their surgical skills in all surgical modalities, with special focus on robotic surgery and Urologic Oncology. The Chief resident at BJH also coordinates the schedules of the residents across the program at different hospitals (minus the VAMC) as the administrative chief resident.
The Endourology Chief resident at BJH is responsible for covering the endourological surgeons who are performing laparoscopic and robotic procedures as well as endourologic surgeries. The Endourology Chief resident also helps to supervise the second year resident responsible for the Consult Service. The Endourology Chief resident helps to oversee the educational conference schedule.
The residents at each hospital have graded responsibility for care of the patients. In general, decision-making is encouraged by residents at all levels with an expectation that residents will discuss their decision-making with more senior and chief residents and, ultimately, the responsible faculty member. Continuity of care is implemented by allowing residents on many of the rotations to see and evaluate patients in the urological outpatients offices preoperatively, in the hospital or operating room (if surgery is to be performed), and postoperatively, as well.
At all of our sites, there are allied health professionals to assist with both inpatient and outpatient care.
The Urology Surgery Residency Training Program follows the Residency Review Committee (RRC) guidelines of the Accreditation Council for Graduate Medical Education (ACGME) pertaining to duty hours. Please refer to the ACGME Common Program Requirements, Section VI.F.1.