Vol.:(0123456789) 1 3
World Journal of Urology
https://doi.org/10.1007/s00345-019-02763-1
ORIGINAL ARTICLE
Current status of urology surgical training in Europe:
an ESRU–ESU–ESUT collaborative study
Diego M. Carrion
1,2,3
· Moises E. Rodriguez‑Socarrás
3,4
· Guglielmo Mantica
3,4
· Francesco Esperto
3,5
·
Angelika Cebulla
3,6
· Diederick Duijvesz
3,7
· Giulio Patruno
8
· Juan L. Vásquez
3,9
· Domenico Veneziano
10,11,12,13
·
Jesús Díez‑Sebastian
2,14
· Ali S. Gozen
13,15
· Joan Palou
16,17,18
· Juan Gómez Rivas
1,2,3,13,18
Received: 30 January 2019 / Accepted: 4 April 2019
© Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract
Purpose To determine the current status of surgical training amongst European Urology Residents, including their satisfac-
tion with training and their confdence in performing procedures.
Methods A 23-item survey was distributed to the 15th European Urology Residents Education Programme (EUREP) 2017
participants. An analysis of demographics, workload, training resources, surgical exposure, surgical caseload, satisfaction
and confdence in performing each procedure was performed.
Results A total of 152/350 participants completed the survey (response rate 43%), of which 14% think they perform enough
surgeries during their training, and 83% would like to continue training with a fellowship. Confdence in performing pro-
cedures without supervision and satisfaction with training was associated with higher surgical caseloads. Confdence in all
laparoscopic/robotic procedures (except for laparoscopic/robotic partial nephrectomy) was associated with laparoscopic and
robotics training, participation in practical courses and having training resources in hospitals. Satisfaction with surgical train-
ing was statistically associated with working ≤ 50 h per week, laparoscopic training and having laparoscopic training boxes.
Conclusions Surgical exposure of European Urology residents for major/minimally invasive procedures, confdence in
performing these procedures, and overall satisfaction with training is low. A higher volume of cases, as well as resources for
training are associated with higher individual confdence and satisfaction with training.
Keywords Confdence · Education · Europe · Residency · Satisfaction · Simulation · Surgical training · Urology
Introduction
Urology residency programmes in Europe are heterogene-
ous in their content and structure. The fnal requirements
of clinical and surgical exposure are not standardized, even
within the same country [1]. The new generation of Urol-
ogy residents are prone to more drawbacks from the operat-
ing room than ever before, as more complex and minimally
invasive procedures are being introduced, working hours
are restricted and heavy administrative work tasks with
electronic medical records and insurance paperwork are
occupying a signifcant proportion of training time [2]. A
complete Urology training embraces the multiple require-
ments and experience needed to produce competent, skilled
and trained surgeons/consultants [1, 3].
The European School of Urology (ESU) started the Euro-
pean Urology Residents Education Programme (EUREP)
to provide harmonized and standardized Urology training
in Europe and to facilitate National societies in ofering
curriculum-based learning for residents. This educational
efort directed to fnal year residents consists of an annual
5-day course, which has recently received excellent feed-
back from participants [4]. Initially, the theoretical part of
the course was aimed at obtaining the European Board of
Urology (EBU) certifcate, which is a mark of excellence of
clinical knowledge [5].
It is well known that self-confdence and competency
are fundamental in the routine practice of a specialist and
may infuence surgical outcomes [6]. This topic is gaining
Electronic supplementary material The online version of this
article (https://doi.org/10.1007/s00345-019-02763-1) contains
supplementary material, which is available to authorized users.
* Diego M. Carrion
diegocarrionm@hotmail.com
Extended author information available on the last page of the article