creased urological teaching to students to maintain thequality of our specialty. As physicians, we need it tomaintain the quality of care of the elderly population byour profession.

APPENDIX

Medical Student Teaching Questionnaire

Urological Teaching of Medical Students, 2007

1. a) Do students at your medical school get any formal exposure tourology (didactic lectures or required clinical rotations) duringtheir 4 years in medical school?Yes No

b) If yes, is it duringAnatomy _____Embryology _____Reproductive medicine _____Clinical rotations_____Other _____

2. a) In the preclinical years, are there any lectures to the studentsby members of the urology faculty?Yes No

b) If yes, the number of lecture hours is:12–45 or more

3. Is there a urology lecture during the physical diagnosis course?Yes No

4. Is there a required urology rotation (exposure) during the generalsurgery rotation?Yes No

5. a) Is there a urology rotation available in the third or fourth year?Yes No

b) Is it required?Yes No

6. a) Is there any opportunity to do urological research for a medicalstudent at your medical school?Yes No

b) If so, is the opportunity in:Basic science _____Clinical _____Either _____

7. a) Roughly, how many of your medical students (number andpercent) at your school, actually do a urology rotation and/orelective during their 3rd or 4th year?Number _____Percent _____%

b) Compared to a decade ago, would you estimate that exposure tourology is:Increased ______Decreased ______About the same ______

8. Is it possible for a student to graduate from your medical schoolwithout any clinical exposure to urology?Yes No

9. What percent of your graduating students choose urology as acareer?_____________%

10. Any other comments are welcome.11. Name

Medical school/institution

REFERENCES

1. The present status of undergraduate urologic training. Com-mittee to Study Status of Urology in Medical Schools. J Urol1956; 76: 309.

2. Rous SN and Mendelsohn M: A report on the present status ofundergraduate urologic teaching in medical schools andsome resulting recommendations. J Urol 1978; 119: 303.

3. Rous SN and Teitelbaum H: To determine educational objec-tives for undergraduate teaching. Results of a comprehen-sive study. Urology 1974; 3: 107.

4. Benson GS: The decline of urological education in UnitedStates medical schools. J Urol 1994; 152: 169.

5. McCullough DL: Factors relating to residency training and med-ical student career choices in urology. J Urol 2005; 174: 1725.

6. Litwin MS, Saigal CS and Beerbohm EM: The burden of uro-logic diseases in America. J Urol 2005; 173: 1065.

7. Thom DH, Nyguard IE and Calhoun EA: Urologic Diseases inAmerica Project: urinary incontinence in women-nationaltrends in hospitalizations, office visits, treatment and eco-nomic impact. J Urol 2005; 173: 1295.

8. Stothers L, Thom D and Calhoun E: Urologic Diseases inAmerica Project: urinary incontinence in males-demo-graphics and economic burden. J Urol 2005; 173: 1302.

9. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ andMcKinlay JB: Impotence. and its medical and psychosocialcorrelates: results of the Massachusetts Male Aging Study.J Urol 1994; 151: 54.

10. Kerfoot BP, Baker H, Jackson TL, Hulbert WC, Federman DD,Oates RD et al: A multi-institutional randomized controlledtrial of adjuvant Web-based teaching to medical students.Acad Med 2006; 81: 224.

EDITORIAL COMMENTS

This questionnaire survey study has reaffirmed similar find-ings by Kerfoot et al that there has been a dramatic declinein the formal urological education of medical students in theUnited States during the last 1 to 2 decades.1 However,neither of these reports determined whether this trend hasbeen detrimental to the overall education and skills of thesestudents in their subsequent medical practice after medicalschool.

In a recent report presented to the American UrologicalAssociation Education Council Meeting Turek and Kerfootidentified important areas of medical student learning bysurvey in urology for emergency medicine, pediatric medi-cine, family medicine and palliative medicine.2 With thisdirective the American Urological Association is developinga Medical Student Website and a Urology Curriculum forMedical Students. It is not sufficient to berate the schools ofmedicine for the decrease in formal urology training at themedical student level. We must undertake effective curric-ulum development to delineate the critical cognitive objec-tives, skills objectives and educational strategies for medicalstudent urological training. It is constructive development ofeducational programs that will help medical schools incor-porate appropriate urological training into their programs.The development of this curriculum will involve discussionand deliberative inquiry by the Education Council and theOffice of Education of the American Urological Association.

The development of an American Urological AssociationMedical Student Website will provide a format to introducethe recommended curriculum and assist urology departmentchairs in presenting these educational programs to thedeans of their medical schools. In addition, this will be avenue to entice and encourage medical students to selecturology as an area of career development. The website willexplain what urology is and what medical students mustknow about urology, and provide Web based teaching, in-cluding references for reading, videos on residency trainingand guidelines for applying to residency training programs.

Therefore, the findings of the current study should notgive rise to despair and criticism, but rather to enthusiasmthat will assist our subspecialty create a robust medicalstudent curriculum in urology and present new and excitingopportunities for learning about the rewarding and stimu-lating career that urology can offer. The American Urologi-

CURRENT STATUS OF MEDICAL STUDENT UROLOGICAL EDUCATION1090

cal Association Education Council is eagerly taking up thegauntlet to address these 2 challenges for our subspecialty.

Elspeth M. McDougallDepartment of Urology

Astellas Surgical Education CenterUniversity of California-Irvine

Irvine, California

1. Kerfoot BP, Masser BA and DeWolf WC: The continued declineof formal urological education of medical students in theUnited States: does it matter? J Urol 2006; 175: 2243.

2. Turek PJ and Kerfoot BP: American Urological AssociationUrology Curriculum for Medical Students. Presented atAmerican Urological Association Education Council Meet-ing, May 21, 2007.

This special communication brings forth the latest genera-tion of data on the status of urological teaching in medicalschools. Despite tremendous growth, change and technolog-ical advancement in urological care in the last decade as wellas evidence of the graying of society there has not been acorresponding increase in required exposure to urologicaleducation. Like other studies of its kind before it, this studypoints out the trend but the reason for this remains unclear.The findings of this study support the need for researchfocused on urological education at the undergraduate andgraduate medical education levels. Academic urologists in-terested in this topic must work with each other and leaders

in medical education research to critically examine andhopefully improve urological education for all physicians.

Harriette ScarperoDepartment of Urologic Surgery

Vanderbilt University Medical CenterNashville, Tennessee

REPLY BY AUTHORS

I think we are all in agreement about medical student uro-logical education. The American Urological Association Ed-ucation Council is to be applauded for its efforts regarding amedical student web site and curriculum. These will cer-tainly be valuable tools for introducing medical students tourology. However, students applying for urological residencyinvariably mention the urology rotation and/or a urologymentor as instrumental in the selection of urology as acareer choice. It would seem that the web site and curricu-lum should serve as valuable adjuncts to, but not substitutesfor, medical student exposure to clinical urological practiceand research.

In an era when many constituencies believe that theirspecialty is critical to medical student education, those of usin academic urology need to actively approach our respectivedeans with the AUA web site and curriculum in hand toargue for greater medical student exposure to urology.

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