Abstract

We aimed to compare objective structured clinical examinations (OSCE) performance of residents from four Canadian urology programs, based on resident and station characteristics. We also aimed to evaluate OSCE contents by station type and subspecialty. Scores of 109 postgraduate year (PGY)-3 to PGY-5 residents were retrospectively reviewed from 19 OSCEs from May 2008 to February 2019. Scores were grouped by station type/subspecialty, PGY level, medical graduate type (Canadian medical graduate [CMG], international medical graduate [IMG]), sex, and choice of fellowship/practice. Linear mixed modelling was performed to obtain least square means to account for repeated measures. Score increases from PGY-3 to PGY-5 were significant for all station types and subspecialties (p≤0.001). Scores were similar between male and female residents, and between CMGs and IMGs, except in visual recognition examinations (VREs) (males: 44.3±1.0, females: 39.0±1.6, p=0.005; IMG: 47.3±1.7, CMG: 41.6±0.9, p=0.004). Relative to uro-oncology stations, scores were lower in andrology (p=0.010) and functional urology (p<0.001). More female residents chose pediatric (14.3% vs. 1.5%, p=0.024) and functional urology fellowships (17.9% vs. 2.9%, p=0.021). More male residents chose endourology/robotic fellowships (30.9% vs. 10.7%, p=0.042). No associations between subspecialty scores and choice of fellowship/practice were found. Oral stations and VREs were more frequent than telephone stations. Uro-oncology and pediatric urology were more frequent than other subspecialties. Scores improved with higher PGY level. IMGs and male residents scored better in VREs. Scores were lower in functional urology. There was no correlation between subspecialty score and choice of fellowship/practice. Subspecialties and forms of evaluation were not equally represented.

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