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Abstract
Purpose of ReviewSupporting struggling urology residents is an important yet challenging task. We describe strategies to assess resident performance, challenges in the clinical learning environment that contribute to resident remediation, and support mechanisms. This review highlights existing resources for positive outcomes in remediation and promotes exploration of innovative strategies to support future urology residents.Recent FindingsBurnout is associated with poor resident performance. Factors that promote burnout include unsatisfactory work-life balance, education or financial debt, access to mental health care, and identifying as a member of an underrepresented group. Competency-based assessment and tailored educational interventions can effectively address the needs of a struggling learner. Efforts to create standardized language, specialty-specific remediation programs, and robust mentorship infrastructure have been successful in other specialties.SummaryStudy of interventions and outcomes for struggling urology residents is somewhat limited; deeper understanding of prevailing remediations practices and individual needs of struggling residents will be critical to develop more robust support for trainees.
Highlights
Residency training is undeniably challenging professionally, personally, physically and emotionally
We focus on the current landscape of remediation and attrition in Urology residency training
Between the broad goals outlined in the Common Program Requirements (CPR) and specific limitations set out through institutional GME policies, programs directors must navigate the challenge of creating remediation plans that are tailored to the individual learner, sometimes with minimal resources or practical guidance
Summary
Residency training is undeniably challenging professionally, personally, physically and emotionally. The American Board of Internal Medicine previously used the term “problem” resident to describe a trainee who shows enough problem to require intervention by someone of authority, whereas another definition describes a “problem” resident as one who fails to meet at least 1 expectation on the Accreditation Council for Graduate Medical Education (ACGME) core competencies [5, 6] By these definitions, prevalence rates of struggling learners range between 9–28% [7–9]. Urology trainees report similar stressors: work-life balance dissatisfaction and working over 80 h a week is associated with burnout, while spending time with family is protective against burnout [28, 30, 31] Basic human care such as access to food, sleeping rooms, and the ability to attend medical and mental health appointments were among the biggest unmet needs for well-being [27, 28]. Similar findings have been described in general surgery residency, imposterism found to be an
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