Rotations during the clinical years provide exposure to all aspects of general urologic diagnosis and treatment and offer an unusually extensive experience in pediatric urology, endocrine and renovascular surgery, urologic oncology, endourology, ESWL, laparoscopy, impotence, infertility and reconstructive urology.
Residents rotate at hospitals other than the Brigham. The rotation at Brigham and Women’s Faulkner Hospital exposes residents to the management of urologic problems in a community hospital. Pediatric rotations at Boston Children's Hospital provide exposure to complex and common pediatric urologic problems. Lastly, the training program incorporates urology rotations at the VA Boston Healthcare System campuses in West Roxbury and Jamaica Plain. The West Roxbury campus has a full urologic service.
Dr. Steven Chang at Faulkner Hospital
The first year of residency training is equally divided between general surgery and urological training, with emphases on (a) teaching surgical interns how to care for surgical patients and (b) building a strong basic urologic foundation for the following years of training. While Urology interns learn to care for patients recovering on the floor and ICU, they are also afforded a significant amount of operative time and develop their endoscopic skillset early-on. Residents leave their internship very comfortable with basic urological workups and treatments.
Call: While on the BWH urology service, PGY-1 residents take in-house primary call (24 hours) once weekly.
PGY-2 (Junior Resident)
PGY-2 residents spend four months at BWH, where they balance their efforts primarily running the emergency department consult service and commencing their exposure to open and robotic surgery. Another four months are spent at the Brigham and Women’s Faulkner Hospital (BWFH), where residents cover the primary inpatient and ED/inpatient consult services and learn urological practice in a high-turnover, predominantly outpatient setting. PGY-2 residents also spend two months at the Boston Children’s Hospital (BCH). One month is spent on the ambulatory service, where residents accompany the faculty and actively participate in the outpatient clinical workup of urological disease. Lastly, another month is spent covering the Surgical Intensive Care Unit (SICU).
Call: PGY-2 residents take in-house primary call (24 hours) two to three times weekly on the BWH urological and ambulatory services. BWFH PGY-2 residents take home call and only cover the BWFH over a seven-day period every other week; they alternate weekly calls with the VAMC PGY-3 resident (discussed below).
PGY-3 (Junior Resident)
The third year of residency is divided into three four-month blocks. The research block allows residents to work closely with a mentor of their choosing to further their academic interests and credentials. Another block is spent at the main BWH campus, where PGY-3 residents primarily run the inpatient consult service and actively participate in a broad variety of robotic, open, and endoscopic cases. The third block is spent at the West Roxbury VAMC.
Call: During the research and BWH blocks, PGY-3 residents alternate between primary in-house call and home call (12- to 24-hour blocks for research PGY-3 residents, 24-hour blocks for BWH PGY-3 residents) two to three times weekly. For VAMC PGY-3 residents, weeklong home call shifts occur every other week in alternation with the BWFH PGY-2 residents.
PGY-4 (Senior Resident)
The PGY-4 year is also divided into three four-month blocks, two of which take place at the BWH and one of which takes place at the BCH. The BWH operative block allows the PGY-4 resident (PGY-4A) to focus exclusively on operating. They primarily participate in major open and robotic oncological cases and complex reconstruction cases but are also afforded numerous opportunities to further hone and develop their skills in endoscopy and men’s health. PGY-4 residents also spend four months as the BWH administrative chief resident (PGY-4B), overseeing the educational and conference programs at the BWH, overseeing the BWH consult service, and running the BWH Resident Clinic. The PGY-4B resident also serves as the primary resident surgeon in all consult cases involving urology; this is often in collaboration with gynecologic oncology, colorectal surgery, and surgical oncology. Finally, PGY-4 residents spend four months gaining further exposure to pediatric urology at the Boston Children’s Hospital.
Call: During the BWH operative block, the PGY-4A takes backup call two to four times every other week. During the BWH administrative block, the PGY-4B takes backup call one to three times every other week and takes primary in-house call (24 hours) sparingly on an as-needed basis.
PGY-5 (Chief Resident)
The chief residency year is the capstone year of the program. The chief resident spends four months running the BWH inpatient urology service, four months running the BWFH inpatient and consult urology services, and four months running the VAMC inpatient and consult urology services. Chief residents present at the monthly morbidity and mortality (M&M) and surgical indications conferences. While they participate on major urological cases, they also cultivate their skills in mentoring more junior residents through various open and endoscopic cases.
Call: During the BWH rotation, the PGY-5 takes backup call two to four times every other week. During the BWFH rotation, the PGY-5 takes backup call for weeklong segments every other week in conjunction with the BWFH PGY-2 resident. The VAMC PGY-5 takes backup call for weeklong segments every other week in conjunction with the VAMC PGY-3 resident.
After completion of training, approximately 2/3 of graduating seniors will pursue additional fellowship training. Our graduating residents have outstanding success in matching into highly-competitive fellowships and become leaders in their respective fields.