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Goujon A, Kaulanjan K, Taha F, Gasmi A, Badet L, Bessede T, Boissier R, Boutin JM, Branchereau J, Culty T, Defortescu G, Drouin S, Kleinclauss F, Matillon X, Millet C, Prudhomme T, Sallusto F, Seizilles de Mazancourt E, Verhoest G, Timsit MO. Young urologists and kidney transplantation training: A survey designed by the French Transplantation Committee of the French Association of Urology (CTAFU) and the French Association of Urologists in training (AFUF). THE FRENCH JOURNAL OF UROLOGY 2024; 34:102611. [PMID: 38460937 DOI: 10.1016/j.fjurol.2024.102611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 01/12/2024] [Accepted: 03/04/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVE In France, kidney transplantations (KT) are mainly performed by urologist. Young urologists and residents are involved in this activity mostly performed in emergency. How do they feel about KT training? Is KT an attractive part of the urologist activity? METHODS This survey has been designed in the form of a questionnaire by the French Committee of Kidney Transplantation (CTAFU) and the French Association of Urologists in training (AFUF). It has been sent by e-mail to all the AFUF members. Interest in KT and performance of the training were evaluated. RESULTS In total, 126 members filed the form. Among the residents, 51.5% feel secure to perform KT at the end of their residency. KT is considered as an interesting surgery for 92.1% of the participants: 76.5% are willing to get involved in KT during their residency/fellowship. Among the participants, 44% are willing to continue a long-term involvement. Among the residents, 65.9% consider their practical training insufficient: 56.8% have been supervised for a KT performance during their residency and 86% declare a lack of practical training and had a patient-based learning. Among the residents, 92.1% declare an insufficient theorical training. Among the residents, 33.3% say the schedules of transplantation limit their interest in KT. Among the participants, 34.4% receive a transplant bonus in addition to the usual on-call salary. CONCLUSION Young urologists wish to continue their involvement in KT activity, but improved theoretical and practical training are essential. In addition, the conditions under which this activity is performed and remunerated are a matter of concern. LEVEL OF EVIDENCE: 3
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Affiliation(s)
- Anna Goujon
- Department of Urology, Rennes University Hospital, Rennes, France; Department of Nephrology, Rennes University Hospital, Rennes, France.
| | | | - Fayek Taha
- Department of Urology Reims University Hospital, Reims, France
| | - Anis Gasmi
- Department of Urology, Rennes University Hospital, Rennes, France
| | - Lionel Badet
- Department of Urology Hospices Civils de Lyon, Lyon, France
| | - Thomas Bessede
- Department of Urology Kremlin-Bicêtre Hospital, Paris, France
| | - Romain Boissier
- Department of Urology La Conception Hospital, Marseille, France
| | - Jean-Michel Boutin
- Department of Urology, Trousseau-Chambray University Hospital, Tours, France
| | | | - Thibaut Culty
- Department of Urology, Angers University Hospital, Angers, France
| | | | - Sarah Drouin
- Department of Urology La Pitié-Salpêtrière Hospital, Paris, France
| | | | | | - Clementine Millet
- Department of Urology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Thomas Prudhomme
- Department of Urology, Toulouse University Hospital, Toulouse, France
| | - Federico Sallusto
- Department of Urology, Toulouse University Hospital, Toulouse, France
| | | | - Gegory Verhoest
- Department of Urology, Rennes University Hospital, Rennes, France
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Pecoraro A, Territo A, Boissier R, Hevia V, Prudhomme T, Piana A, Banuelos B, Breda A, Serni S, Checcucci E, Campi R. Urologists and kidney transplantation: the residents' perspective. Minerva Urol Nephrol 2024; 76:131-133. [PMID: 38426428 DOI: 10.23736/s2724-6051.23.05606-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Affiliation(s)
- Alessio Pecoraro
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Angelo Territo
- Department of Urology, Puigvert Foundation, Autonomous University of Barcelona, Barcelona, Spain
| | - Romain Boissier
- Department of Urology and Renal Transplantation, La Conception University Hospital, Marseille, France
| | - Vital Hevia
- Department of Urology, Ramón y Cajal Hospital, IRYCIS, Alcalá University, Madrid, Spain
| | - Thomas Prudhomme
- Department of Urology, Kidney Transplantation and Andrology, Toulouse Rangueil University Hospital, Toulouse, France
| | - Alberto Piana
- Department of Urology, Romolo Hospital, Rocca di Neto, Crotone, Italy
| | - Beatriz Banuelos
- Division Renal Transplantation and Reconstructive Urology, Hospital Universitario El Clínico San Carlos, Madrid, Spain
| | - Alberto Breda
- Department of Urology, Puigvert Foundation, Autonomous University of Barcelona, Barcelona, Spain
| | - Sergio Serni
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Enrico Checcucci
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy -
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Territo A, Bañuelos Marco B, Breda A, Gómez Rivas J, Dönmez MI. What would be the ideal pathway for a young urologist interested in kidney transplantation? Actas Urol Esp 2023; 47:619-620. [PMID: 37094628 DOI: 10.1016/j.acuroe.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 04/26/2023]
Affiliation(s)
- A Territo
- Department of Urology, Autonoma University of Barcelona, Barcelona, Spain
| | - B Bañuelos Marco
- Department of Urology, Hospital Universitario Clinico San Carlos
| | - A Breda
- Department of Urology, Autonoma University of Barcelona, Barcelona, Spain
| | - J Gómez Rivas
- Department of Urology, Hospital Universitario Clinico San Carlos
| | - M I Dönmez
- Division of Pediatric Urology, Department of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.
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Ghayda RA, Carrion DM, Gomez Rivas J, Esperto F, Mantica G, Rodriguez-Socarras ME, Mattigk A, Kathrins M, O'Leary M, Niederberger C. Knowledge gap across continents: the andrology and male infertility exposure among urology residents in the United States and Europe. Int J Impot Res 2020; 33:603-610. [PMID: 32826968 DOI: 10.1038/s41443-020-00342-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 06/19/2020] [Accepted: 08/06/2020] [Indexed: 11/09/2022]
Abstract
It is well established that resident's exposure and training are of primary importance and positively correlated with patient and health quality outcomes. We aimed to compare and contrast urology residents' self-reported perspectives and attitudes toward exposure and education of andrology and male infertility during residency in both the United States and Europe. We performed a cross-sectional design study using a survey that was distributed to a representative sample of American and European urology residents. The survey included questions regarding demographics, and the residents' perception and description of their training in this specific subspecialty. Response data were analyzed using Chi-square tests. Sixty-five percent of European and thirty-five percent American urology residents reported feeling uncomfortable in a new consultation evaluating an infertile patient and interpreting semen analyses. Surprisingly, more than half of responders replied that they would not go to their own training institutions seeking for male fertility care (78% US and 58% Europeans). In the comparative analysis, although no differences were observed in the very low number (18%) of hospitals that offer formal microsurgical training for urology residents between the US and Europe, more US institutions were reported to have an operating microscope for urology (68% vs. 41%), and more US residents replied reported participating in at least one urologic surgery using the microscope (65% vs. 34%). In conclusion, both American and European residents shared the same frustration regarding their education and exposure to andrology and male infertility during residency training. Collaborative efforts between stakeholders are needed to establish a clear and focused curriculum and training objectives to eliminate this educational gap.
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Affiliation(s)
- Ramy Abou Ghayda
- Division of Urology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Diego M Carrion
- Department of Urology, La Paz University Hospital, Madrid, Spain.,European Society of Residents in Urology (ESRU), Arnhem, The Netherlands
| | - Juan Gomez Rivas
- Department of Urology, La Paz University Hospital, Madrid, Spain.,European Society of Residents in Urology (ESRU), Arnhem, The Netherlands
| | - Francesco Esperto
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, Campus Biomedico, University of Rome, Rome, Italy
| | - Guglielmo Mantica
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova, Italy
| | - Moises E Rodriguez-Socarras
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, Instituto de Cirugia Urologica Avanzada (ICUA), Madrid, Spain
| | - Angelika Mattigk
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands.,Department of Urology, Ulm University Medical Center, Ulm, Germany
| | - Martin Kathrins
- Division of Urology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Michael O'Leary
- Division of Urology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Craig Niederberger
- Department of Urology, University of Illinois at Chicago, Chicago, USA. .,Department of Bioengineering, College of Engineering, University of Illinois at Chicago, Chicago, USA. .,University of Illinois at Chicago Innovation Center, Chicago, USA.
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Coloma L, Cabello R, González C, Quicios C, Bueno G, García JV, Arribas AB, Clascá F. Cadaveric Models for Renal Transplant Surgery Education: a Comprehensive Review. Curr Urol Rep 2020; 21:10. [PMID: 32166557 DOI: 10.1007/s11934-020-0961-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW To evaluate the utility of cadaveric models for kidney transplant (KT) surgery training. RECENT FINDINGS Medline® and PubMed® databases were searched for English and Spanish language articles published describing different learning models used in KT formation. We evaluated the use of cadavers preserved by Thiel's embalming method (TEM) as KT simulation models. Students were divided in groups of 4 people: four trainees mentored by an expert in KT surgery. Among the trainees were surgical residents and low-experience surgeons. A total of 39 TEM preserved bodies were used, of which 75 viable renal grafts were obtained. In each cadaver, two complete transplantation processes were performed, each consisting of en bloc nephrectomy with the trunk of aorta and inferior vena cava, bench surgery and perfusion with saline of the organ, and KT surgery. As with any surgical procedure, learning KT surgery is a stepwise process that requires years of dedication. The models available for the surgical simulation of KT surgery allow to practice and achieve dexterity in performing the procedure in a safe and reproducible way. Training on TEM-preserved corpses offers a highly realistic model for the surgical simulation of KT surgery.
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Affiliation(s)
- Lidia Coloma
- Urology Department, Hospital Universitario Fundación Jiménez Díaz/Universidad Autónoma de Madrid, Madrid, Spain
| | - Ramiro Cabello
- Urology Department, Hospital Universitario Fundación Jiménez Díaz/Universidad Autónoma de Madrid, Madrid, Spain.
| | - Carmen González
- Urology Department, Hospital Universitario Fundación Jiménez Díaz/Universidad Autónoma de Madrid, Madrid, Spain
| | - Cristina Quicios
- Urology Department, Hospital Universitario Fundación Jiménez Díaz/Universidad Autónoma de Madrid, Madrid, Spain
| | - Gonzalo Bueno
- Urology Department, Hospital Universitario Fundación Jiménez Díaz/Universidad Autónoma de Madrid, Madrid, Spain
| | - Juan Vicente García
- Urology Department, Hospital Universitario Fundación Jiménez Díaz/Universidad Autónoma de Madrid, Madrid, Spain
| | - Ana Begoña Arribas
- Vascular Surgery Department, Hospital Universitario Fundación Jiménez Díaz/Universidad Autónoma de Madrid, Madrid, Spain
| | - Francisco Clascá
- Anatomy, Histology and Neuroscience Department, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
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Rodríguez-Socarrás M, Gómez Rivas J, García-Sanz M, Pesquera L, Tortolero-Blanco L, Ciappara M, Melnick A, Colombo J, Patruno G, Serrano-Pascual Á, Bachiller-Burgos J, Cozar-Olmo J. Medical-surgical activity and the current state of training of urology residents in Spain: Results of a national survey. Actas Urol Esp 2017; 41:391-399. [PMID: 28336202 DOI: 10.1016/j.acuro.2016.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To determine the actual state of medical-surgical activity and training for urology residents in Spain. MATERIAL AND METHOD We designed 2 anonymous surveys, which were uploaded with the Google Docs© tool so that the respondents could answer the surveys online. The online collection period was September 2015 to January 2016. The collected data were processing using the statistical programme IBM SPSS for Windows, Version 21.0 and the programme R version 3.2.3. RESULTS The total number of responders was 163. In reference to the number of physically present on-call residents, the majority conducted between 4 and 6 shifts a month. Eighty-four of those surveyed indicated that they were in the operating room less than 20hours a week, and 43 of these even less than 10hours. Thirty percent of those surveyed had not performed any transurethral resection. The majority had performed at least one prostatic adenomectomy, but had not performed any major oncologic procedure, either laparoscopically or openly. In the questions concerning training and training courses, we found that most of the residents trained in laparoscopy at the hospital or at home. The overall satisfaction for the residence was assessed at 2.6. Based on this score, the overall satisfaction could be considered moderate. CONCLUSIONS Efforts should be directed towards standardising the acquisition of surgical and nonsurgical skills, ensuring access to training courses, establishing a minimum of required operations per year and achieving an objective assessment of the specialty.
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Cienfuegos-Belmonte I, León-Dueñas E, Román-Martín A, Olmo-Ruíz M, González-Roncero F, Medina-López R. Evaluation of the Spanish Urological Association quality care indicators in a kidney transplantation programme. Actas Urol Esp 2016; 40:523-8. [PMID: 26992850 DOI: 10.1016/j.acuro.2016.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 02/10/2016] [Accepted: 02/11/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Indicators show the presence of a phenomenon and its intensity. They assess the level of quality care and identify potential situations for improvement. Our objective is to assess the 2013 and 2014 quality care indicators of our department's kidney transplantation area. MATERIAL AND METHOD For 2013 and 2014, we reviewed 88 and 106 kidney transplants and 47 and 66 extractions. We evaluated the quality care indicators developed by the Spanish Urological Association, analysing the results with the SPSS v 21.0 programme. RESULTS The mean cold ischaemia time (CIT) was 14.96hours in 2013 and 18.07hours in 2014. The CIT was ≤18h in 53% and 56% of cadaveric donor kidneys in 2013 and 2014, respectively. The rate of relevant early onset urinary fistulae was 1.14% and 2.83% for each year. The rate of early transplantectomy due to a vascular complication was 3.41% and 2.83% for 2013 and 2014, respectively. Overall patient survival at 1 year was 100% for both periods, and graft survival at 1 year was 95% and 94.34% for 2013 and 2014, respectively. The rate of living-donor transplantation was 14.77% and 17.92%, and 92.31% and 68.42% of the living-donor extractions were laparoscopic for 2013 and 2014, respectively. Resident medical interns were the first surgeon in 6.67% and 12.64% of the transplantations and in 55.88% and 19.14% of the cadaveric extractions during 2013 and 2014, respectively. CONCLUSIONS During the evaluated period, all quality care standards in kidney transplantation were met, except for CIT in both years and resident medical intern participation in kidney implantation in 2013. This analysis promotes improvements in quality care, highlighting weak spots that need work.
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