MDC7670
Sub-Internship in Urological Surgery

Sub-Internship in Urological Surgery
Clerkship Syllabus
2025-2026
Clerkship web page: link (Canvas)
Duration: 4 weeks

CLERKSHIP INFORMATION:

Clerkship Description

Fourth year medical students are invited to participate in a four-week sub-internship rotation designed to bridge the gap between medical school and residency, offering students an immersive experience that emphasizes the practical application of clinical knowledge and problem-solving, providing exposure to the process of being an intern on our busy urological surgery service. The goal is to provide students with experience for a smooth transition into their intern year. Students will focus on diagnosing and managing a wide spectrum of adult and pediatric urological conditions, gaining exposure to both outpatient and surgical care environments. The rotation prioritizes hands-on learning, active participation in patient care, and the development of autonomy under the guidance of residents and faculty. Students are encouraged to approach clinical problems with a critical and evidence-based mindset, preparing them to excel as interns.

Students will gain an understanding of the focused history, genitourinary examination, and assessment of uroradiological labs and imaging studies necessary to make thorough differential diagnoses, assessments, and management plans for patients with urological pathology. Students will additionally gain exposure to the subspecialities of urology: urogynecology, endourology, laparoscopic and robotic surgery, neurourology, genitourinary reconstruction, neurourology, urologic oncology, and men’s health/andrology, and infertility.

Throughout the rotation, sub-interns will work closely with residents and faculty in all patient care settings. Sub-interns are expected to participate in daily rounds for their assigned service(s), evaluate and present patients in clinic, and evaluate and present inpatient consultations in the emergency department and wards. In
some scenarios, sub-interns may report to residents, and in others they may work directly with faculty.

Though students will be supervised, faculty and residents expect sub-interns to take primary responsibility for the care of their patients (usually 3–4 at a time). This autonomy will involve direct communication with patients and their families, demonstration of efficient time management strategies in accomplishing tasks (e.g., calling consultations, arranging pharmacy needs, such as total parental nutrition orders, and communicating with nursing staff and case managers), and confirming assessment and plans with residents or
faculty. A critical part of the sub-internship is ensuring safe and effective transition of care from day to night housestaff.

Consistent with this mission of providing a learning experience for transition to internship, sub-interns will take weekday and weekend call coverage.

Learning Objectives

BOG Attestation Regarding Instructional Materials
Instructional materials for this course consist of materials reviewed, selected, and assigned by the instructor(s). The instructor(s) is only responsible for these instructional materials. Based on self-assessment of learning needs, students may identify other credible resources to augment the identification, analysis, and synthesis of relevant information.

Recommended Textbooks and Resources

1. American Urological Association (AUA) Medical Student Curriculum (Online Resource)
   • https://www.auanet.org/meetings-and-education/for-medical-students/medicalstudents-curriculum-x18427
2. AUA Guidelines (Online Resource)
   • https://www.auanet.org/guidelines-and-quality/guidelines
3. AUA Medical Student Resources (Online Resource)
   • https://www.auanet.org/meetings-and-education/for-medical-students/medicalstudent-resources
4. Pocket Guide to Urology
   • Author: Jeff A. Wieder
   • Year: 2021
   • Edition: Sixth Edition
   • ISBN: 978-0-9672845-7-6

Personal Laptops
Personal laptops can be utilized in clinical spaces and should meet the computer requirements laid out by the College of Medicine (https://osa.med.ufl.edu/support/policies-procedures/computer-requirement/). While desktops are typically available on all clinical rotation sites it is recommended that you bring a personal laptop in case a desktop is not available.

Mid-clerkship Formative Feedback

Students will receive weekly verbal feedback at the end of each subspecialty service line rotation. Faculty and residents will provide this feedback based on the student’s performance throughout the week, focusing on areas such as clinical knowledge, procedural skills, communication, and professionalism. This ongoing feedback should allow students to make timely improvements and address any identified areas of concern before their final evaluation. Students are encouraged to actively seek feedback from both faculty and residents with
whom they work closely.

At the end of the rotation, students will undergo a final summative clinical performance evaluation conducted by the Course Director. This evaluation will be based on the aggregate feedback gathered from residents, faculty, and other members of the healthcare team who had significant clinical contact with the student throughout the sub-internship. The final assessment will incorporate feedback on the student’s professionalism, clinical competency, patient care, and interpersonal communication, evaluated using a modified Chen 5-point scale rubric.

ASSESSMENT

Please refer to Table 1 for additional details regarding description of feedback/assessments by learning objectives. To help to prepare students for residency, the ACGME Core Competencies will also be assessed:

#1 Professionalism

• Understand basic bioethical principles and be able to identify ethical issues in urological surgery Demonstrate behavior that conveys caring, honesty, and interest in patients and families
• Act in a professional manner, with appropriate attire, and be punctual for clinical and educational assignments. Be prompt, honest, and courteous in interactions with others
  
  Method of Evaluation: The criteria with which the student will be evaluated will be based on the student’s daily interactions with patients, families, and other health care members while on the rotation. Student professionalism will be subjectively evaluated by residents and faculty. The modified Chen 5-point scale rubric will be applied.

#2 Medical Knowledge

• Display thorough understanding of the anatomic and physiologic principles underlying care of urological surgery patients
• Articulate clinical plans, develop differential diagnoses, and order tests that are based on
  understanding of the conditions treated in urological surgery
• Understand basic concepts of urological conditions and principles
• Demonstrate basic understanding of uroradiological imaging study (e.g., plain film, fluoroscopy, CT,
  MRI, nuclear renography) interpretation
• Understand and recount the sequence of basic Foley and ureteral stent placement
• Be able to discuss the basic concepts of postoperative management of urological patients
• Manage several uncomplicated patients and complicated cases, with assistance
• Gather and categorize information
  
  Method of Evaluation: Urological surgery teams will evaluate the student based on daily interactions related to patient care and core knowledge and problem solving will also be assessed based on admission notes and progress notes. The modified Chen 5-point scale rubric will be applied.

# 3 Patient Care

• Perform history and physical examination of variety of urological surgery patients
• Assist with operations and performs routine procedures (e.g., Foley catheter placement, ureteral stent
  placement, surgical drain removal, continuous bladder irrigation)
• Independently perform basic techniques in the care of the urological surgery patients (e.g., suturing,
  and wound closure, knot tying, wound care)
• Display appropriate tissue handling skills and application of different techniques of closure
• Identify various pathologies and develop appropriate treatment plans and strategies
• Provide routine pre- and post-operative care
  
  Method of Evaluation: Urological surgery teams will evaluate students based on direct observation. Students will be assessed in the operating room for these skills and be questioned by faculty and residents in these settings regarding techniques and choice of procedures, etc. The modified Chen 5-point scale rubric will be applied. Students will also submit written admission notes, discharge notes, progress notes, and documentation regarding exam skills and oral presentations which will be assessed by the course director.

#4 Practice-Based Learning

• Demonstrate cognizance of one’s own level of knowledge and expertise and solicit feedback from teachers, colleagues, and patients
• Identify and utilize learning resources
  
  Method of Evaluation: Urological surgery teams will evaluate students based on observation of student’s application of learned information to patient care and dissemination of learned information to the team. The modified Chen 5-point scale rubric will be applied.

#5 Interpersonal and Communication Skills

• Develop a positive relationship with patients and teams, in uncomplicated situations, and identify and be able to resolve communication conflicts
• Understand the patient’s and their family’s perspective while engaging in communication
• Utilize interpreters as needed
• Appreciate effective communication to prevent medical error
• Participate in effective transitions of care
• Uses photographic documentation with safeguards for privacy
  
  Method of Evaluation: Urological surgery teams will evaluate students based on direct observation. Student’s ability to communicate and complete tasks will be evaluated by faculty and residents. The modified Chen 5-point scale rubric will be applied.

#6 Systems-Based Practice

• Understand the differences between medical errors, near misses, and sentinel events
• Understand the roles of care team members
• Describe practical variations in resource consumption, such as the utilization of diagnostic tests
• Understand basic health payment systems, including uninsured care
• Understands different practice models
  
  Method of Evaluation: Urological surgery teams will evaluate students based on direct observation and daily interactions. The modified Chen 5-point scale rubric will be applied. Students will additionally submit discharge notes. Attendance at Morbidity and Mortality conference will be recorded.

Final Grades

The Sub-Internship in Urological Surgery will evaluate students at the completion of their rotation in keeping with the UFCOM policy of Pass-Fail grading for sub-internships. The following grading rubric will be used to evaluate students’ performance during the rotation with a final grade as “Pass” or “Fail.” Any student given a “fail” grade will be given an opportunity to meet with the course director(s) to discuss specific reasons for their graded evaluation and discuss opportunities for possible remediation.

To earn a grade of “Pass,” students must be evaluated as performing ≥7 elements with no deficiencies.

Required clinical presentations, skills, and procedures

The clerkship is designed to expose you to the following core presentations, skills, and/or procedures, which are clerkship requirements. If you have difficulty meeting any of these, an alternate method is listed in the table below.

Clerkship requirements:

• 15 minute Grand Rounds (see Table 1, Objective 10)
  • Students unable to complete the Grand Rounds presentation must complete an alternative
    assignment arranged with the course director.

Policy on student evaluations

• Each student must complete at least 75% of all assigned faculty, resident, and small group leader evaluation forms associated with a course/clerkship in each year of enrollment. There is an expectation of 100% completion on overall course and clerkship evaluations.
• Every student is expected to respond in a professional manner to each item which she/he feels qualified to answer.
• Strict confidentiality of responses is assured. Evaluation data (numerical ratings and student comments) is de-identified. However, the completion of evaluations will be tracked.

College of Medicine Policies and Procedures Handbook
The following topics are covered in the College of Medicine Policies and Procedures Handbook (which can be downloaded from https://osa.med.ufl.edu/policies-procedures/). Individual policies are hyperlinked in the table below.