Further training curriculum for specialists in urology

1 Introduction

1.1 Legal basis
The further training concept is based on the further training regulations of the Baden-Württemberg Medical Association (WBO) and the contents of the associated guideline.

 

1.2 Duration of the authorisation for further training

The Clinic Director Prof. Bolenz has full authorisation for further training in urology (60 months) and additional authorisation for further training in drug tumour therapy (12 months).

 

1.3 Aim and purpose of further training

The aim of structured further training is to ensure that the further training assistant continuously and purposefully deals with the contents of further training. The aim of further training in the field of urology is to achieve specialist competence after completing the prescribed training period and training content.

 

2 Structure/focal points of the clinic

2.1 Structure

The Department of Urology and Paediatric Urology offers a wide and modern range of treatments and is a competent partner for all urological diseases. The aim of the clinic is to offer patients comprehensive medical advice and the highest level of medical expertise. High-tech surgical medicine is just as much a part of the clinic's offering as the caring and committed care of the patients entrusted to it. A close dialogue is maintained with other specialist disciplines and the urologists in private practice or referring physicians.

 

2.2 Focal points/research topics

In addition to open surgery, the clinic offers the option of minimally invasive robot-assisted surgery with the daVinci SI system for function-preserving prostate cancer surgery. In the Prostate Cancer Centre, which is certified by the German Cancer Society, the optimal treatment plan for patients with prostate cancer is determined for each stage of the disease in regular interdisciplinary conferences together with oncologists, radiotherapists, radiologists and pathologists. The urologists providing further treatment are also involved in these tumour boards.
Clinical and basic scientific research for the benefit of patients is an important part of the Department of Urology.
Tumour diseases of the bladder, prostate, kidneys and testicles are clinical and research priorities.
Some scientific projects are realised through national and international collaborations.

 

3. persons responsible for further training/contact persons

Ltd. medical director and specialists/senior physicians responsible for further training.

 

4 Course of further training

4.1 Rotation

During the five years of specialist training, the trainee will work on the two urology wards, the urology intermediate care ward, in the operating theatre and in the urology outpatient clinic. The youngest inpatients are treated in the adjacent paediatric clinic and cared for by a paediatric urology team.

Intravascular chemotherapy and drug-based targeted tumour therapies are carried out in the specialised and recently renovated Interdisciplinary Oncology Day Clinic (IOT), so that sufficient experience in drug-based tumour therapy can be gained within a specialised team. As a certified prostate cancer centre, the implementation of the latest and guideline-compliant therapy standards is ensured by extensive quality measures.

In the university outpatient clinic, assistant physicians work together with a specialist or senior physician to ensure close supervision during consultation hours and for emergency patients.

Rotation into the paediatric urology team is possible for 12 months.

The development of internal clinic standards and structured process organisations in the form of SOPs (standard operating procedures) is seen as an important prerequisite for optimal patient care and quality management. Participation in the development of these standards is possible and desirable as part of specialist training.

Contents of the further training curriculum

The content and timing of the curricular further training programme is listed below as an example and is intended to provide doctors in further training with guidance on training objectives. Deviations from this model curriculum may occur and are coordinated by the clinic management.

From 1st year

Field of activity

 Training objectives

- Wards

- University outpatient clinic

  • Ward procedures and organisation
  • Examination techniques (sonography, transrectal ultrasound, duplex sonography, urodynamics)
  • Interpretation of radiological findings (CT/MRI, urethrogram, excretory urogram)
  • Conducting dialogue with patients
  • Emergency situations
  • Basics of pharmacotherapy
  • Basic pain therapy concepts, wound care, wound treatment and dressing theory

- Surgical
Training objectives

  • Urethrocystoscopy
  • DJ insertion
  • Transurethral catheterisation techniques
  • Catheter exchange (including suprapubic, nephrostomy (PCN))
  • Suturing techniques
  • External genital surgery, including circumcision, scrotal testicular excision
  • Assisting with open operations
  • Shock wave lithotripsy (ESWL)

 

From 2nd year

Field of activity

 Training objectives

- Wards

- University outpatient clinic

  • Infusion, transfusion and blood replacement therapy, enteral and parenteral nutrition
  • Preparation of simple urological expert reports
  • Taking paediatric urological anamneses and performing paediatric urological examinations
  • Knowledge of specialised urological pain therapy
  • Recognising and treating erectile dysfunction, including recognising andrological disorders and determining indications for further treatment
  • Specialised andrological diagnostics / therapy (hormones, SKAT)
  • Knowledge of the health economic effects of medical action

- Operative
Training objectives

  • Puncture and catheterisation techniques (suprapubic inserts and DJ inserts; percutaneous nephrostomy)
  • Techniques of urological local anaesthesia
  • Simple operations of the external genitalia
  • Basic principles of complicated wound care with wound revision
  • Assistance with major (1st hand) and laparoscopic (robot-assisted) procedures
  • Transurethral procedures (TUR-B, Sachse urethrotomy)
  • Punctures (e.g. renal cysts)
  • Prostate biopsies
  • Evacuation of bladder tamponades

 

From 3rd year

Field of activity

 Training objectives

- Wards

- University outpatient clinic

  • Fundamentals of urological tumour therapy including the indication of urological radiotherapy
  • Preparation and monitoring of simple chemotherapy plans
  • Participation in the interdisciplinary oncological day clinic (IOT)
  • Dealing with patients in life-threatening conditions, as well as sensitive communication with relatives of these patients
  • Basic principles of intermediate care for urological patients

- Operative
Training objectives

  • Ureterorenoscopies
  • Varicocele sclerotherapy
  • Bladder stone lithotripsy
  • Assistance and partial steps in major tumour operations
  • Partial steps in pelvic lymphadenectomy

 

From 4th year

Field of activity

Training objectives

- Wards

- University outpatient clinic

  • Early detection, treatment and aftercare of urological tumour diseases
  • Care of patients requiring palliative medical care
  • Family planning and sexual counselling for men and couples
  • Fundamentals of nutritional counselling and dietetics for urological diseases, including urinary stone metaphylaxis

- Surgical
Training objectives

  • Assistance and partial steps of radical nephrectomy
  • Assistance with endoscopic and minimally invasive surgical procedures
  • TUR prostate, TUR bladder
  • MRI/TRUS fusion biopsies of the prostate
  • Assistance with incontinence operations

From 5th year

Field of activity

 Training objectives

- Wards

- Outpatient clinic/polyclinic

  • Carrying out interdisciplinary case discussions
  • Preparation of complex urological expert reports
  • Intraoperative radiological examination of findings in consideration of radiation protection

- Operative
Training objectives

  • Sterilisation and (re-)fertilisation of men
  • TUR prostate independently
  • Assistance and partial steps in reconstructive operations
  • Assistance and partial steps in tumour operations (including radical prostatectomy and radical cystectomy)
  • Assistance and partial steps in percutaneous nephrolitholapaxy

 

4.2 Training periods

The training period comprises 60 months, of which up to 12 months in inpatient patient care in the field of surgery, 6 months in another field and up to 12 months in the outpatient sector can be credited.

 

4.3 Specialist discussions

Staff appraisals are held and documented at least once a year, in which the current status of further training, objectives and further training measures are discussed. In addition to clinical training, academic career paths are also specifically promoted and research and habilitation topics are planned and intensively supervised.

 

4.4 Participation in congresses, seminars, colloquia, etc.

Internal training opportunities are provided by the daily radiological conference and the weekly interdisciplinary tumour boards, in which complex uro-oncological cases are discussed in detail. The Comprehensive Cancer Center Ulm (CCCU), which is funded by German Cancer Aid as an oncological centre of excellence, organises regular training series on all oncological topics.

 

4.5 Documentation

The documentation of individual training objectives is standardised as part of the staff appraisals with the clinic director. This includes both the documentation of the work situation by the employee and the manager, as well as specific, individual further training measures. The employee is responsible for documenting the interventions carried out, but these can be retrieved from the clinic's internal IT system.

 

4.6 Opportunities for scientific work/structured research funding

The Department of Urology and Paediatric Urology offers a wide range of opportunities to work on clinical, translational and basic scientific research topics. The focus is on uro-oncological topics with a special focus on bladder cancer. In addition, projects in the fields of urotechnology, reconstructive urology and paediatric urology are also carried out.
The urological research laboratory is equipped with modern facilities and offers all the prerequisites for carrying out experimental research projects. There is also close networking with other research groups and the Core Facility, which ensures interdisciplinary exchange and access to highly specialised technologies.
Medical staff are encouraged to engage in scientific work if they are interested and are introduced to the projects. Habilitation topics and specific research projects are discussed and documented in staff meetings (see above). Assistance in applying for research grants and third-party funding is guaranteed. If possible, employees can be temporarily released from clinical work for scientific work.

 

5. key competences

None

 

6. additional training

Drug tumour therapy