• Hendrik Borgmann, Hannah K Arnold, Christian P Meyer, Johannes Bründl, Justus König, Tim Nestler, Christian Ruf, Julian Struck, and Johannes Salem.
• Department of Urology, University Hospital Mainz, Mainz, Germany. Electronic address: borgmann.hendrik@gmail.com.
• Eur Urol Focus. 2018 Apr 1; 4 (3): 455-460.

BackgroundExcellent uniform training of urology residents is crucial to secure both high-quality patient care and the future of our specialty. Residency training has come under scrutiny following the demands of subspecialized care, economical aspects, and working hour regulations.ObjectiveTo comprehensively assess the surgical training, research opportunities, and working conditions among urology residents in Germany.Design, Setting, And ParticipantsWe sent a 29-item online survey via email to 721 members of the German Society of Residents in Urology.Outcome Measurements And Statistical AnalysisDescriptive analyses were conducted to describe the surveys' four domains: (1) baseline characteristics, (2) surgical training (cumulative completed case volume for all minor-, medium-, and major-complexity surgeries), (3) research opportunities, and (4) working conditions.Results And LimitationsFour hundred and seventy-two residents completed the online survey (response rate 65%). Surgical training: the median number of cumulative completed cases for postgraduate yr (PGY)-5 residents was 113 (interquartile range: 76-178). Minor surgeries comprised 57% of all surgeries and were performed by residents in all PGYs. Medium-complexity surgeries comprised 39% of all surgeries and were mostly performed by residents in PGYs 2-5. Major surgeries comprised 4% of all surgeries and were occasionally performed by residents in PGYs 3-5. Research opportunities: some 44% have attained a medical thesis (Dr. med.), and 39% are currently pursuing research. Working conditions: psychosocial work-related stress was high and for 82% of residents their effort exceeded their rewards. Some 44% were satisfied, 32% were undecided, and 24% were dissatisfied with their current working situation. Limitations include self-reported survey answers and a lack of validated assessment tools.ConclusionsSurgical exposure among German urology residents is low and comprises minor and medium-complex surgeries. Psychosocial work-related stress is high for the vast majority of residents indicating the need for structural improvements in German urology residency training.Patient SummaryIn this study, we evaluated the surgical training, research opportunities, and working conditions among urology residents in Germany. We found low surgical exposure and high rates for psychosocial work-related stress, indicating the need for structural improvements in German urology residency training.Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

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