Surgical competencies in Urology: Agreement between the perceptions of trainees and practicing professionals in a Latin American country

Abstract

Introduction

Consensus remains lacking on which surgeries should be deemed essential for general urologists and which should be reserved for subspecialists. This study aims to compare the perceptions of urology trainees (Trainees) and practicing urologists (PractUrol) regarding the relevance of surgeries for independent practice and subspecialist training.

Methods

Cross-sectional comparative study on Trainees and PractUrol from a Latin-American country. Participants completed a Google Forms® questionnaire on 56 urological surgeries in September–October 2023, categorizing each as Essential Index (E-index), Supervised Index (Sup-index), or Subspecialty (Subspec). Statistical comparisons were performed using Chi-square or Fisher’s exact tests with Bonferroni correction.

Results

Among 138 participants (109 PractUrol, 29 Trainees), 78.6% (44/56) of surgeries showed agreement between groups, with 13 surgeries achieving over 75% concordance. Disagreements were noted for 21.4% (12/56) of surgeries: (1) Microvaricocelectomy, penectomy, DVIU, ureteral reimplantation, and vesicovaginal fistula repair were more often classified as Subspec by Trainees but as E-index by PractUrol. (2) Radical cystectomy with orthotopic diversion and Boari Flap were classified as Subspec by Trainees but as Sup-index by PractUrol. (3) Partial cystectomy, pelvic, and inguinal lymphadenectomy were more frequently deemed Subspec by Trainees. (4) Flexible ureteroscopy was considered E-index by Trainees but Sup-index by PractUrol. (5) Artificial urinary sphincter placement was more often classified as Sup-index by PractUrol.

Conclusion

There is substantial agreement on the relevance of urological surgeries between PractUrol and Trainees, including 13 surgeries deemed essential by over 75% of participants. However, differing opinions on 12 surgeries highlight areas for further discussion.