The Accreditation Council for Graduate Medical Education requires that each residency program must demonstrate and document actual accomplishments through objective measures. At University of Washington we identified deficiencies in resident medical knowledge and designed interventions that would assist in improving resident AUA IS scores, using this as a metric to document the outcomes. In 2001 the University of Washington syllabus and faculty precepted chapter review sessions were formally established. The national AUA IS was used as an objective standardized examination to determine an annual group percentile score. We noted a gradual and consistent increase in the average percentile group score on the national annual AUA IS examinations of our residents. A generalized estimating equation model demonstrated a significant difference between pre-intervention and post-intervention average percentile resident AUA IS scores (p <0.001). Average resident percentile rankings in 2001 to 2004 were 25.6 points higher than the average rankings of residents tested in 1997 to 2000. We developed and evaluated a cohesive core curriculum designed to improve resident knowledge in urology, as measured by the AUA IS metric. With the active participation of faculty the curriculum enhanced resident education.