Toronto Western Hospital (TWH) – Urology – Goals and Objectives
The Toronto Western Hospital rotation is 3 blocks in duration. Mid-level residents (PGY-3) rotate
through TWH as the sole resident. The focus of clinical activity at TWH is voiding dysfunction, urinary
incontinence, neuro-urology, reconstructive urology, men’s health, as well as general urology.
At TWH the PGY-3 assumes the role of chief resident for the site. The resident participates in ambulatory
clinics, manages the inpatients and the consult service and has extensive exposure in the OR. The
patient demographic at TWH allows the resident to develop skills in health advocacy for underprivileged
and immigrant populations. On this rotation there is particular emphasis on the development and
evaluation of the Medical Expert, Collaborator and Health Advocate CanMEDS roles.
Medical Expert
By the end of the rotation the senior urology resident will:
1) Demonstrate the basic scientific and clinical knowledge relevant to voiding dysfunction, urinary
incontinence, neuro-urology, reconstructive urology, men’s health, and relate it appropriately to
patient care
2) Complete accurate and well organized history and physical examinations and recognize all major
significant findings
3) Use all of the pertinent information to arrive at complete and accurate clinical decisions; order
appropriate investigations, and develop a therapeutic plan that reflects current standards of
practice
4) Select appropriate diagnostic tests and therapeutic interventions and make use of appropriate
consultative services.
5) Demonstrate proficiency in pre-operative and post-operative patient management. Generally
recognize and manage post-op complications.
6) Demonstrate an understanding of the concept, the goals and the approach to the operation as
well as the potential complications. Assists efficiently.
7) Demonstrate competence in procedural skills. Handle instruments and tissues carefully.
8) Demonstrate an understanding of the etiology, pathophysiology, classification, diagnosis, and
treatment of male and female voiding dysfunction and urinary incontinence
9) Demonstrate an understanding of the etiology, pathophysiology, classification, diagnosis, and
treatment of neurogenic bladder, including spinal cord injury and neuromodulation
10) Demonstrate transurethral surgical skills, including resection of prostate and bladder tumors
The urology resident will:
Demonstrate the ability to investigate and manage complex urologic problems, including:
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Neurogenic voiding dysfunction, including indications, techniques and interpretation of
urodynamic studies
Female urinary incontinence, including differential diagnosis and management options
Post-prostatectomy urinary incontinence and erectile dysfunction, including evaluation and
management options
Demonstrate fundamental skills, including:
 Endoscopic treatment of prostate hypertrophy and bladder cancer including transurethral
resection and laser vaporization of prostate and transurethral resection of bladder tumors
 Surgical skills for the treatment of urinary incontinence, including the placement of mid-urethral
slings and artificial urinary sphincters
 Introductory skills with sacral neuromodulation
 Facility with minor, open surgeries such as hydrocelectomy
 Introductory skills to penile prosthetic and other reconstructive surgery
Communicator
By the end of the rotation the urology resident will:
1) Exhibit effective and timely verbal and written communication skills, including: communicating
with patients and families, verbal presentations, documentation and consult letters.
2) Establish a therapeutic relationship with patients and communicate well with family.
3) Provide clear and thorough explanations of diagnosis, investigations and management in a
professional manner.
4) Demonstrate empathy and sensitivity to racial, gender and cultural issues.
5) Provide patients and families with sufficient information of the risks and benefits of treatment
alternatives
Collaborator
By the end of the rotation the urology resident will:
1)
2)
3)
4)
5)
6)
7)
Participate effectively and appropriately in an inter-professional health care team.
Collaborate with community agencies (as required) as well as other health care professionals
Demonstrate an understanding of role in hospital.
Contribute to team effectiveness.
Manage differences and resolves conflict.
Ask for assistance appropriately.
Share knowledge effectively to formulate health care plan.
8) Identify and implement strategies for safe handover and transfer of accountability for ongoing
patient care issues during periods of absence.
Manager
By the end of the rotation the urology resident will:
1) Demonstrate time management skills to reflect and balance the priorities for patient care,
sustainable practice and personal life.
Health Advocate
By the end of the rotation the senior urology resident will:
1) Support the health of patients/families by providing appropriate referrals, support and
information on health maintenance, as well as community/home resources.
2) Advocate effectively for the biopsychosocial needs of patients and their families within the
health care system and community.
3) Intervene on behalf of patients or the community with respect to the social, economic and
biologic factors that may impact on the patients’ health.
Scholar
By the end of the rotation the urology resident will:
1)
2)
3)
4)
Effectively use evidence in day to day clinical work.
Read around cases and is knowledgeable about own patients
Demonstrate awareness of personal limitations, seeking advice when necessary.
Accept advice graciously.
Professional
By the end of the rotation the urology resident will:
1) Demonstrate a commitment to excellence in clinical care and personal and ethical conduct.
2) Exhibit proper professional behavior.
3) Adhere to legal and ethical codes of practice.