M3 Urology Clerkship
The Division of Urology at VCU School of Medicine provides direct exposure to our subspecialty for medical students during their surgical rotations. Medical students who choose urology as their subspecialty elective spend two weeks functioning as members of the urology team at either the MCV campus or the McGuire VA hospital campus.
Exposure to pediatric urology is only available at the MCV campus. Students with a known interest in pediatric urology should therefore make a specific request for this rotation. However, depending on student volume and interest, we may not be able to accommodate every student request. Students will be contacted prior to the start of their rotation with details and instructions.
We strive to diversify our workplace at all levels including staff, faculty, and trainees. The clinical, hospital, and academic environment will be a safe place for all people to feel comfortable and able to receive the expert level care that our urologists provide.
Students are expected to “pick-up” patients who are admitted to the service through the emergency department or in the post-operative period. Students should follow at least one patient at all times but should not follow more than three. They should familiarize themselves with all aspects of the patient’s history and physical exam findings either through chart review or preferably through direct interaction with the patient/family members. Students should present patients on morning and afternoon rounds in a formal fashion using the “SOAP” system. However, a full presentation of the history and physical is required when the patient is initially “picked-up” or admitted.
Students should check with the chief resident in charge of their service to determine the upcoming surgical cases. Reading ahead of time on surgical cases is required. Students will be expected to have read ahead of time and should be well prepared for all surgical cases including preoperative indications, surgical steps, and surgical anatomy.
Presentations:
Students are also asked to present a short (approximately 5-10 minute), informal presentation on a relevant urologic topic. The presentation should include a brief (approx. 1-2 page) handout which lists the student’s name, date, and references of any sources utilized. The topic may be chosen from the cases the student participated in while on service or it may simply be a topic that has peaked the student’s interest. Scope of topics should be extremely narrow and detailed enough that all participants will obtain new information.
Students should review the topic with Dr. Roseman or, in Dr. Roseman’s absence, Dr. Hampton prior to beginning work on the presentation.
Presentation topics must be pre-approved and IF NOT — will not be accepted. Topics should be chosen by Monday of week two and the presentation should occur on the final day of the rotation unless otherwise requested.
It is the responsibility of the student to ensure that the presentation is given.
Students are encouraged to interact directly with faculty members in clinics and the operating room.
John D. Edmondson, MD
Assistant Professor
Sub-specialization: Pediatric Urology
Email: john.edmondson@vcuhealth.org
B. Mayer Grob, MD
Professor
Chief of Service, McGuire VA Medical Center
Residency Program Director
Sub-specialization: Urologic Oncology
Email: baruch.grob@vcuhealth.org
Georgi Guruli, MD, PhD
Professor
Director of Urologic Oncology
Sub-specialization: Urologic Oncology
Email: georgi.guruli@vcuhealth.org
Lance Hampton, MD
Chair, VCU Division of Urology, Professor, and Urology MIV Internship Director
Director of Robotic Urology
Sub-specialization: Robotics and Minimally Invasive Urology
Email: lance.hampton@vcuhealth.org
C.D. Anthony Herndon, MD
Professor
Director, Pediatric Urology
Email: claude.herndon@vcuhealth.org
Adam P. Klausner, MD
Professor & Warren Koontz Professor of Urologic Research
Director of Neurourology and Voiding Dysfunction
Sub-specialization: Neurourology, female urology, voiding dysfunction
Email: adam.klausner@vcuhealth.org
Sarah Krzastek, MD
Assistant Clinical Professor
Sub-specialization: Male infertility
Email: sarah.krzastek@vcuhealth.org
Eric D. Nelson, MD
Assistant Professor
Sub-specialization: Pediatric urology, voiding dysfunction
Email: eric.nelson@vcuhealth.org
J. Tyler Roseman, MD
Associate Professor
M3 Clerkship Director
Sub-specialization: Genitourinary reconstructive surgery
Email: john.rosemanii@vcuhealth.org
Luriel Smith-Harrison, MD
Assistant Professor
Sub-specialization: Complete and advanced reproductive care
Email: luriel.smithharrison@vcuhealth.org
Rebecca Zee, MD, PhD
Assistant Professor
Sub-specialization: Pediatric urology
Email: rebecca.zee@vcuhealth.org
During the two-week urology rotation, students will spend their time observing urologic surgical procedures, out-patient urologic clinics, in-patient and emergency urologic care. Day-to-day participation in these activities should be arranged and coordinated with the current chief resident at the VCU or VA campus. Conferences are held on Thursday and Friday mornings at 7:00am.
All students are required to attend these conferences unless otherwise directed. Students who take surgery “call” during their rotation should alert the chief resident in advance. Students are required to go home early post-call, if staying at work would cause them to exceed 30 continuous hours on duty. Students are also required to attend general surgery lectures and should make every effort to be on time for these events.
The AUA has provided a “National Medical Student Core Curriculum” in urology on the AUA website. This document, written by urologic experts, provides a basic comprehensive overview of urology. The student is expected to read this document and be prepared to be tested on the material therein.
At the conclusion of each 2-week urology rotation, students should able to answer the following questions:
A) Hematuria
- What is the definition of microscopic vs. gross hematuria?
- What is the differential diagnosis of hematuria?
- What is the work-up for hematuria?
- How is gross hematuria treated?
B) Benigh Prostatic Hyperplasia (BPH)
- What are “LUTS?”
- What is the AUA symptom score?
- What are medical therapies for BPH?
- What are surgical therapies for BPH?
C) Urolithiasis
- What stones are not visible on abdominal xray?
- What are “infection” stones and what causes them?
- What is standard medical therapy for calcium stones?
- What are surgical options for stones?
D) Uro-Oncology
- What is PSA and who should be screened?
- How is prostate cancer diagnosed?
- What is the Gleason Score?
- What are the treatment options for prostate cancer?
- What are the treatment options for bladder cancer?
- What are treatment options for kidney cancer?
E) Incontinence
- What are the different types of urinary incontinence
- What are medical therapies for incontinence
- What are surgical therapies for incontinence
F) Erectile Dysfunction
- What are the causes of organic impotence?
- What are the available non-surgical treatments for ED?
- What are the surgical treatments for ED?
G) Pediatric Urology
- What is the differential diagnosis for acute scrotal pain in a child?
- What is the work-up for acute scrotal pain in a child?
- How is testicular torsion treated?
- What is the differential diagnosis for hydronephrosis in a neonate?
- What is the differential diagnosis for ambiguous genitalia in a neonate?
- What is the work-up for urinary tract infection in a child?
At the conclusion of their two-week rotation, students should have been given the opportunity to practice the following skills:
A) Placement of a foley catheter
B) Manipulation of a cystoscope
C) Digital Rectal Exam to evaluate prostate size and texture
D) Scrotal and penile examination
E) Interpretation of a KUB and an Intravenous Pyelogram (IVP)
F) Interpretation of a “renal colic” CT scan
Grading:
Students will be evaluated on six core competencies as stipulated by the ACGME including: patient care, medical knowledge, practice-based learning, interpersonal and communication skills, professionalism, and systems based practice. Grades will be assigned based on a composite evaluation provided by urology chief residents and faculty as well as the final quiz score.
Issues regarding grading (other than appeals) should be directed to Dr. Hampton lance.hampton@vcuhealth.org. Appeals should be submitted directly to Dr. Eric Nelson, M3 Clerkship Director, eric.nelson1@vcuhealth.org within the specified time frame, as noted in the appeals policy.
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Lauren Simonetti
Program Coordinator
804-828-3039
Lauren.Simonetti1@vcuhealth.org