Residents Corner

"I was overcome by the sinking notion that my career ambitions were regressing from thriving to surviving-a sentiment I know isn’t unique to my training. What may be unique, however, is how my program responded to increasingly evident signs of resident burnout," says James Anaissie, MD.

"If you’re already in training or are considering joining the field and think you will be able to be a full-time urologist, full-time father/mother, world-class athlete, and writer, and still spend 3 hours a day watching TV or hanging out with your buddies, you’re wrong," writes Henry Rosevear, MD.

"Like most doctors, the majority of my day is spent handholding, counseling, relieving anxiety, and otherwise dealing with problems that aren’t necessarily medical," writes urologist Scott Donaldson, MD.

"When almost 80% of practicing urologists report that there is much more administrative workload in practice versus training and yet only 23% of residents expect this, that is a problem," writes Henry Rosevear, MD.

"It is imperative that APPs are active in advocacy for issues that remove barriers and ensure direct access to patients for their services," writes Adele M. Caruso, DNP, CRNP.

Igor Sorokin, MD, presents the case of a 36-year-old female in whom two proximal stones are seen on KUB, but intraoperatively, only one stone is seen.

"There is tremendous diversity within urology, enabling clinicians to practice in a variety of ways and settings, and there is clearly a huge demand for female providers," says Mara R. Holton, MD.

"We need to change not medicine but the delivery of medicine before the current system changes us anymore," writes Henry Rosevear, MD.

A 63-year-old African-American male presents to the emergency department with sudden onset of painless gross hematuria for one day. He reports dark red urine with clots causing occasional dysuria, difficulty emptying, and light-headedness.

This article illustrates the content of the six apps that are available from AUA.

Injury stemming from awkward maneuvers and equipment can and should be prevented, says Henry Rosevear, MD.

This quiz focuses on a 40-year-old female who presents with a history of right flank pain and first urinary tract infection (UTI). After treatment of the UTI, she noted her right flank pain continued.

"Fresh out of medical school, I had lofty plans for intern year... Fast forward through orientation, and the ACGME-approved 80-hour work week was quick to remind me of the alternate meaning of the word ‘intern’: to be held prisoner," writes Kiran Sury, MD.

"As surgeons, our first step toward improving the situation is to become significantly better at controlling postoperative pain using opioid-sparing protocols," writes Henry Rosevear, MD.

"Restoring form and function to my patients with my care and interventions is both intellectually challenging and rewarding," says Elodi Joy Dielubanza, MD.

"In the short to medium term, many urology practices are facing a tidal wave of increasing costs and decreasing revenue, which unless appropriate steps are taken, could cause significant financial problems in the future," writes Henry Rosevear, MD.

Ownership has advantages, but debt levels and contracts are considerations, according to Jeff Witz, CFP.

A 35-year-old male from Sudan was hospitalized with a right obstructing 1-cm ureteral stone seen on KUB. The KUB also revealed curvilinear calcification in the bladder wall. The patient was taken to the operating room for ureteroscopy and laser lithotripsy. During cystoscopy, a rim of calcification was seen along the right ureteric ridge. What is the diagnosis?

Spyridon P. Basourakos, MD, and Alexis E. Te, MD, review the Dip.io app.

"I have worked in some fantastic urology departments where I've been supported by an amazing group of faculty and colleagues," says Leslie M. Rickey, MD, MPH.

"Just like I’ve learned that the grass really isn’t any greener on the other side, I am learning that life in the trenches of urology, as a small-town urologist, isn't exactly what I thought it would be when I was a resident," writes Dr. Rosevear.

The author’s career shortcomings are lessons in academic pursuit, leadership, and more.

In the first installment in a new series, Spyridon Basourakos, MD, and Alexis E. Te, MD, review the UpToDate app.

"I think the future is very bright for women in urology," says Stacy Loeb, MD, MSc.

To help the modern urologist, we list and briefly review the best apps to get urologists at all levels of expertise through their day.

A 24-year-old male is seen in the emergency room for complaints of bilateral testicular pain for the past several weeks.

“After more than 10 years in urology (including 5 in residency), I thought I was reaching the point where I have at least heard of all things urologic… Once again, life proved me wrong,” writes Henry Rosevear, MD.

Henry Rosevear, MD, shares what he learned from reducing time spent on his smartphone.

The authors discuss the case of a 57-year-old man who initially presents to a general surgeon with a chief complaint of right lower back and posterior neck pain, with associated soft tissue swelling. On presentation to the authors' institution, he had experienced regrowth of the masses with "ticking" in the right lumbar area that he correlated with his heartbeat. He also reported unintentional weight loss of 15 pounds over the previous 3 months.

Several strategies are available, each with their own pros and cons.