The Urology Residency at Mayo Clinic’s campus in Rochester, Minnesota, is a five-year categorical postgraduate training program with an optional unaccredited research year in the 4th year of residency training – which for those choosing the research year would result in a six-year program – the first year of surgery rotations (PGY-1) and four years of clinical urology (PGY-2, PGY-3, PGY-4, PGY-5).

Strengths of the program include its preceptorship mentor training model, high surgical volume, exposure to general urology as well as complex subspecialty surgery, and unlimited access to a world-class surgical skills lab and surgical simulators with regularly scheduled simulation training.

Clinical training

During all years of training in the Urology Residency, residents participate in the day-to-day operations of the mentor service, which includes active involvement in the diagnostic evaluation of urologic patients, pre- and postoperative care, and assisting in the operating room with both minor and major open procedures.

• The PGY-1 year is a combined general surgery services and urology services to provides a broad foundation of education to build your urologic training. Six months is spent in general surgery services and include three months rotating in general surgery rotations (general surgery hospital surgical service, trauma surgical critical care, and colon and rectal surgery) and three months rotating in non-urological surgery rotations (transplant surgery, plastic surgery, and surgical ICU). Six months in urology services including rotations as a chief resident junior, general urology service, and pediatric urology.
  
  
• The PGY-2 year of residency is the first full year of urology. You become familiar with urologic diagnosis, endoscopy, urodynamic technique and theory, and management of urologic oncology patients. You also acquire basic operative skills and in-depth experience with both common and uncommon urologic disease processes. This year you will begin acquiring basic skills in endourology and stone disease, urologic oncology, female urology, and general urology.
  
  
• The PGY-3 and PGY-4 years provide intensive training in pediatric urology, endourology, female urology, andrology and infertility, erectile dysfunction, neurourology, trauma and genitourinary reconstruction, and urologic oncology. The rotations in urologic oncology offer significant exposure to patients with prostate, bladder, and renal cancer.
  
  
• The final year of urology PGY-5 consists of hospital and clinical rotations, including senior and chief resident assignments. This experience allows you to mature into a knowledgeable, confident, and skillful urologic surgeon capable of independent thinking and conducting the most difficult operations.

Research project

Residents will complete a minimum of one research project during their residency with a requirement of publication.

The Urology Residency at Mayo Clinic’s campus in Rochester, Minnesota, offers a unique optional protected year of fully funded research during which you would be given the opportunity to pursue basic science, translational, or clinical outcomes research, or a combination thereof. There would be opportunities to take formal courses on statistical methodology. Additionally, the optional research year affords residents the time and opportunity to pursue medical mission trips, solidify decisions on career choices, and the flexibility to explore any aspect of urology (I.e., AUA policies) during this time.

Rotation schedule

Mayo Clinic Urology employs a preceptorship mentor model. Residents will participate in six sequential eight-to-nine-week rotations over the course of an academic year. The following is a typical rotation schedule for the Urology Residency.

Didactic training

Clinical conferences, seminars, small discussion groups, journal clubs, and one-on-one instruction are all integral parts of the Urology Residency.

Daily activities include formal hospital rounds.

Weekly activities:

• Imaging and pathology conferences presented by and for residents and consultants, including case presentations and reviews of excretory urograms, CT scans, ultrasounds, and MRIs
• Academic seminars and consultant lectures in basic science and allied clinical subjects
• Topic Orientation Journal Club
• Radiology, nephrology, and general surgery conferences

Monthly activities:

• Pathology lectures, case presentations, and morbidity and mortality conferences
• Urology based labs and simulations
• Bimonthly genitourinary multidisciplinary cancer conference

Other activities throughout the year: 

• Surgical Quality and Safety Conferences
• Board review sessions leading up to in-Service Exam
• Genitourinary Tumor Board
• Pediatric Urology Conferences
• Journal clubs
• Visit Professor events

Your didactic training also includes periodic reviews of surgical specimens, postmortem findings, instructive cases, and urinary microscopy. You have the opportunity to take courses in laser technique, laparoscopy, microsurgical technique, computer training, and basic cardiac life support.

Call frequency

Call schedule starts the beginning of your PGY-2 year. PGY-1s have the opportunity to shadow in-hospital call prior to taking call independently. Weekday overnight in-hospital call for PGY-2 thru PGY-4 is approximately every 12th night and PGY-5 every fifth night with rotating home call over the weekends. Mayo Clinic follows the recommendations of the Accreditation Council for Graduate Medical Education (ACGME). 

Teaching opportunities

You have the opportunity to teach Mayo Clinic Alix School of Medicine students and visiting students from other medical schools through bedside instruction and formal didactic lectures.

Teaching opportunities continue through residency with regular didactic presentations and simulations. Chief residents work closely with junior residents and serve as their mentors and educators during call, hospital consults, and in the OR.

Leadership opportunities

Residents serve on departmental committees related to education, research, and clinical practice. Urology residents also make up the Residents Affairs Committee, where they discuss concerns related to the program. Issues raised at Residents Affairs Committee meetings are forwarded to the Urology Education Committee for additional input.

Scholarly activities

Residents are encouraged to present their clinical and basic science research/work at national meetings and to publish their work in prominent urology journals. Expense reimbursement support is provided for expenses incurred for presentations and attendance at conferences.

Moonlighting

Extramural employment (moonlighting) for trainees at or above a PGY-2 level with a valid license to practice medicine are eligible to moonlight. Residents are prohibited from moonlighting within the specialty of their current training without written MCSGME approval, except in emergency medicine where residents are permitted to moonlight in an emergency room and/or urgent care setting. Residents are not required to moonlight.

Time spent moonlighting must not interfere with your program requirements and academic performance at Mayo Clinic. Moonlighting must not interfere with or compromise patient care or the education of other learners. The program director must provide written approval for residents to moonlight.

Awards

Each year, the residents have an opportunity to submit papers to the Minnesota Urological Society's Kelalis Resident Essay Competition. There are first-, second-, and third-place winners, with cash prizes awarded.

The Mayo Clinic Urology Review meeting held every other year requests that residents submit manuscripts for a manuscript competition, with the winner presenting their research and attending the biennial meeting in Hawaii.

Urology residents are eligible for multiple awards provided by the Mayo Clinic School of Graduate Medical Education including the Mayo Brothers Distinguished Fellowship Award (recognizing excellence in clinical performance, scholarly productivity, and humanitarianism) and the Barbara Bush Distinguished Fellowship Award (recognizing similar qualities, with a particular emphasis on humanitarianism). Recipients of these prestigious awards receive funding up to $2,500 for an additional attendance trip.

The annual Joseph Weston Segura, M.D., Resident Essay Contest offers urology residents the opportunity to submit a full-length, unpublished manuscript on any urological topic in a format suitable for submission to a urologic journal. The first-, second-, and third-place winners present their research at the annual Essay Contest dinner and receive monetary prizes and a commemorative plaque honoring their achievements in the name of Dr. Joseph Weston Segura.

Various awards are available and have been received from the American Urological Association and its North Central Section, as well as the National Kidney Foundation of Minnesota.

Evaluation

To ensure that you acquire adequate knowledge and develop your technical skills, your performance is monitored carefully during the Urology Residency. You are evaluated formally by your supervising faculty member after each clinical rotation. In addition, you regularly evaluate the faculty to ensure that your education needs are being met.

In accordance with ACGME Urology Review Committee guidelines, you meet with your program director at least twice annually to review your evaluations and discuss any issues of concern (bi-annual review and self-reflection). In addition, you are evaluated by the program’s Clinical Competency Committee bi-annually to review your competence in the six essential core competencies and your progress in the program. Residents are surveyed annually by the ACGME and Mayo Clinic’s Graduate Education Committee to ensure that education, equity, and safety best practices are in place.

Residents are required to take the annual In-Service Examination sponsored by the American Urological Association to evaluate their strengths and weaknesses, performance and progress in their training program.

Career development

You meet periodically with your mentor, various faculty members, administrators, and the residency program director to discuss your individual career goals. Mayo Clinic recruits many of its staff physicians from its own training programs. Therefore, when you successfully complete the Urology Residency training program, job opportunities may be available at one of Mayo Clinic's regional teaching facilities or community practices.

Additional training

At the conclusion of the Urology Residency, you may wish to continue your graduate medical education at Mayo Clinic School of Graduate Medical Education.

Post-residency training fellowship positions are offered in subspecialty areas of urology. These fellowships emphasize clinical training in all aspects of a particular subspecialty, but can be tailored to your specific career requirements and interests.

Fellowships offered at Mayo Clinic include the:

• One-year Minimally Invasive Urologic Surgery Fellowship (Minnesota)
• One-year Andrology Fellowship (Minnesota)
• One-year Trauma and Genitourinary Reconstruction Fellowship (Minnesota)
• Two-year Urologic Oncology Fellowship (Minnesota)

If you are accepted for a fellowship, you continue to receive in-depth, daily, one-on-one training with a consulting physician. You also have the opportunity to increase your own supervisory and administrative skills. Contact your faculty adviser for more information about these opportunities.