R-2 The first year of clinical urology training (R-2) is divided between the general urology services at the Veterans Administration Medical Center and at University Hospital. The R-2 residents spend two 3-month blocks at one institution and a six-month block at the other. This rotation schedule is designed to provide continuity of care on the urology services when the Chief Residents rotate on January 1 and to allow the R-2s to spend six months with each Chief Resident. The R-2 resident works closely with the R-6 residents on both services, fostering a close educational relationship between the chief and junior residents. The R-2 resident gains experience with endoscopic and other diagnostic procedures, performing inpatient and outpatient urologic work-ups, and select surgical procedures. The training objectives are to master urologic signs and symptoms, to become familiar with common adult urologic diseases, to learn the appropriate selection and interpretation of urologic imaging tests, and to achieve proficiency in the functional and anatomic evaluation of the urinary tract and genitalia.
R-3 The fourth year of postgraduate training is divided into three-month rotations, alternating between University Hospital and Kaiser Sunnyside Medical Center. At Kaiser, the resident has experience with patients in a prepaid health care plan. He or she actively participates in a variety of urologic procedures with 5 skilled urologic surgeons. The primary objectives of the Kaiser rotation are to learn skills and standard practice habits from community urologists, to expand and consolidate endoscopy skills, and to gain further experience with open surgical procedures and with postoperative care. An independent resident clinic with emphasis on the evaluation of infertility patients rounds out the Kaiser rotation. The remainder of the R-3 year is spent on the Urology Service at University Hospital, focusing on renal transplantation, voiding dysfunction, female urology, and erectile dysfunction, and minimally invasive urology including the treatment of stone disease and laparoscopic urology. About 130 renal transplants are performed each year and the resident has the responsibility for preoperative and post-operative care of these patients. There are frequent opportunities to deal with fluid and electrolyte problems, acute and chronic renal failure, immunosuppression, hypertension, infectious diseases, and other difficult medical problems. Sessions on the special problems of uremia and transplantation are conducted by Nephrology and Urology faculty members. The resident participates in the Renal Transplant Clinic, the Chairman's referral clinic, and the Endourology clinics. The resident participates in kidney transplants, laparoscopic and open donor and allograft nephrectomies, multiple organ procurements, and peritoneal dialysis access procedures. In addition, the R-3 resident assists the faculty in the outpatient evaluations and operations performed on selected general urology patients, gaining experience in the surgical management of impotence, Peyronie's disease, urethral strictures, cystic kidney disease, male and female voiding dysfunction, and other urologic disorders. Laparoscopic procedures including donor nephrectomy, radical nephrectomy, partial nephrectomy, and pyeloplasty are also a big part of the experience during this rotation.
R-4 The R-4 year is divided into six months of investigative urology and six months at University Hospital focusing on pediatric urology. The resident has freedom in designing feasible laboratory or clinical projects. Ongoing clinical projects can be completed during this time, and opportunities to develop special surgical skills or animal models for surgical problems can be arranged with the assistance of OHSU Animal Care. Participation in current clinical and laboratory research projects of the faculty are is encouraged. The research resident also performs male sterilization procedures for Planned Parenthood on a scheduled basis. The pediatric urology rotation consists of a busy six months of combined outpatient and operative experiences. Here the resident learns the orderly assessment of developmental, neurologic, and functional urologic problems, and learns appropriate management skills. The outpatient clinical experience includes pre- and postoperative care, but also emphasizes the long term evaluation and treatment of permanent or dynamic urologic disorders.
R-5 The Chief Resident year is divided into six month rotations on the general urology services at the Veterans Administration Medical Center and at University Hospital. The chief resident contributes to the teaching of junior residents and interns, as well as medical students who rotate on the urology services. He serves as a primary urologic consultant at either hospital, but continues to have essential support from the faculty. The chief resident has discretion over the assignment of surgical and clinical responsibilities to junior residents and interns. Additionally, he participates in the outpatient urology clinics, including urologic oncology. Administrative duties of the chief include call schedules, and all arrangements relevant to the care of his clinic patients. It is expected that the resident will emerge from the chief residency year as a thoughtful, knowledgeable, and technically proficient surgeon who is well prepared to enter the next phase of his or her career.
Some of our graduates choose to enter private practice upon completing the program, while others have gone on to additional fellowship training and academic careers. Our program is designed to provide you with the finest, comprehensive education in urology that will allow you to follow the career path of your choosing.
