Urology

Duration: 4 weeks

Distribution of student's time:
30% inpatient care/operating room
50% outpatient care
20% conferences/lectures

Enrollment/Period: 3 maximum, upon availability

Average number of patients seen each week: 20

Prerequisites: Completion of core clerkship in Surgery

Sub-Internship Student Rotation Objectives:

Attend scheduled conferences and other assigned lectures: Grand rounds, didactics, tumor board, journal club, specialty conferences.

• Operative experience: Students should have broad exposure of operative experience, including robotic and laparoscopic, endoscopic, general urology, and microsurgery, if applicable. Office and outpatient procedure should also be part of the exposure.
• Clinic and outpatient experience. Clinic exposure to allow the opportunity to evaluate, diagnose, and develop an outpatient treatment plan for different urologic conditions. Call and weekend rounds that will mirror an intern schedule. Over the course of the rotation students are expected to be on call and demonstrate inpatient management of patients. Focus areas should be sign-out and communication regarding transition of care, post-op patients, and triage calls.
• Rounds: round with consult service and exposure to triaging and evaluating inpatient and emergency room consults, including patient calls. Write a medical student note for consults, follow up notes, sign off, and any procedures (student note) for patients they see.
• Presenting patient on rounds: Expectation to present patients to residents and rounding staff, including a full history and physical and assessment and plan.
  Grand Rounds Presentation: Expectation to present during grand rounds.

Rotation Structure

We want you to have a comprehensive and diverse experience during your rotation. Generally, your rotation with us will be split into four separate week-long blocks, each with a different service—the services are listed below

• Robotics/Oncology—genitourinary oncology (prostate, kidney, bladder, penile, testicular), robotics for benign pathology including BPH, upper/lower tract reconstruction, etc.
• Female/Neurourology—pelvic organ prolapse, incontinence, urodynamics, etc.
• Pediatrics—all things pediatric, from hydronephrosis to hypospadias to intersex/DSD, etc.
• General/Endourology/Men's Health—benign prostatic disease, nephrolithiasis, prosthetics and implants, hydroceles, men’s health, etc.

Please note, if you are interested in working with a specific staff member, please speak with the chief/senior residents early in your rotation so that we can try to make that happen.

Conferences/Meetings

In general, you will be expected to attend all conferences and meetings.

Grand Rounds conference on Wednesday mornings from 7:00-9:00 am. These are more formal conferences, and topics vary widely. The first Wednesday of every month is M&M, and the final Wednesday of the month is generally reserved for medical student presentations. You are expected to dress in clinical attire for this conference (no scrubs). This conference takes place in our conference room on K9 at Henry Ford Main Hospital.

Every Friday morning from 7:00-8:00 am, our faculty will give a lecture to the rotating medical students on various urologic topics. You are expected to attend these lectures regardless of the clinical site at which you are rotating. This conference takes place in our conference room on K9 at Henry Ford Main Hospital.

Multidisciplinary tumor board is every Thursday from 7:00-8:00 am. This is staffed by urological oncology staff, medical oncologist, radiation oncologists, radiologists, and pathologists. Residents/students are expected to attend if available.

At Children’s Hospital of Michigan, there is a radiology conference every Thursday morning from 7:30-8:30. Only the residents/students assigned to CHM for any given week are expected to attend.

Men's Health Conference once a month on a Friday in the Afternoon. Women's Health Conference every Thursday in the Morning.

Journal Club

Scheduled every 4 months part of Grand rounds or part of the visiting professor’s series This conference is attended by the residents, senior staff, and scientific staff (Ph.D.). Articles for review are chosen by the senior resident with input from the senior staff. Many of the articles are selected from The Journal of Urology, Urology, and European Urology. In addition, any article pertaining to a urological topic in JAMA, NEJM, and Lancet are discussed. Each article is presented on PowerPoint by one of the residents with emphasis on study design, validity of interpretation of results, and its relevance to patient care.

Rotation Expectations

We want this rotation to be of high educational value—we want you to see and do as much as possible—if we can get you functioning like a first-year resident, then we have all achieved our goals—you will learn an immense amount and have the opportunities to distinguish yourself.

• Prepare for clinic and OR cases. If you are scheduled to be in the OR, please read about the cases ahead of time. The more you can demonstrate your knowledge/interest, the easier it is to get you involved.
• You should attend all academic educational sessions.
• Every morning, you will be expected to present patients on rounds—you should pre-round on this patient, so that you can deliver an informed, comprehensive presentation. In turn, the residents will be responsible for giving you feedback on your presentations. This feedback may take place either on rounds, or after rounds at a later time. Also you will have the opportunity to present those patient to the senior staff when they round.
• You will be expected to work one weekend of your choice (both Saturday and Sunday during the day). Please coordinate with the other medical students to minimize double coverage and ensure there is a student each weekend.
• You will be expected to take overnight call one weeknight during your time with us; please coordinate with the other medical students to ensure that no two students are on the same night.
• You will be expected to deliver an approximately 15 minutes presentation on the final week of your rotation—this can be on any urologic topic you find interesting and can be related to research you have done. Early on in your rotation, please talk with the chiefs and senior residents about your presentation. They will be able to direct you to a staff member who can help provide mentorship.
• You are expected to wear clinical attire for clinic days, as well as all (eliminate Monday, Tuesday and Wednesday) conferences
• Do NOT wear your scrubs into and out of the hospital
• Be prompt and on time.

Locations

Henry Ford Hospital
2799 W. Grand Blvd
Detroit, MI 48202

Our flagship hospital, located in a neighborhood of Detroit called New Center, ~2.5 miles north of downtown. As an inner city tertiary referral center, this hospital serves an ethnically and socioeconomically diverse population. The majority of our clinical volume is at this location, including most of our oncology cases and robotics. Additionally, most of our female urology cases, reconstructive cases, and our infertility cases, are here.

The Vattikuti Urology Institute (VUI) is located on the 9th floor of the K clinical tower (K-9)—that is where we meet in the mornings before/for rounds. The OR is located on the fourth floor. The scrub machine is located on the 4th floor in the back hallway outside of the operating rooms and the locker room.

Henry Ford West Bloomfield
6777 W Maple Road
West Bloomfield, MI 48322

Our second largest clinical site located ~25 minutes from Henry Ford Main Hospital in one of the northwestern Detroit suburbs.

There are two urology clinics here—the larger is on the 3rd floor in the East Clinic Wing, and the other is on the 1st floor in the West Clinic Wing. The OR is located on the 2nd floor of the hospital, reached via the main elevators beyond the cafeteria. Scrubs are located in the hallway reached through the back door of the locker rooms.

Children’s Hospital of Michigan
3901 Beaubien Boulevard
Detroit, MI 48201

Our pediatric center, located in the Midtown neighborhood of Detroit, near the Detroit Medical Center and Wayne State University, and ~1.5 miles south of Henry Ford Hospital. We currently have 3 pediatric urologists who manage the full spectrum of pediatric urologic disease. Students need specific credentials to have access to Children's Hospital.

The urology department is located on the 2nd floor of the Carl’s Building.

Henry Ford Medical Center - Fairlane
19401 Hubbard Dr
Dearborn, MI 48126

One of our regional clinic locations, also equipped with an outpatient surgical center. We do a number of outpatient cases here every week, and the clinic is staffed daily by our urologists.

The urology clinic is located in the west wing of the building.

Henry Ford Medical Center - Lakeside
14500 Hall Rd
Sterling Heights, MI 48313

One of our regional clinic locations, and one at which we are rapidly expanding. It is also equipped with an outpatient surgical center. We also do a number of outpatient cases here every week, and the clinic is staffed daily by our urologists.

The urology clinic is located on the 2nd floor of the building

Useful Clinical Resources

The following resources are recommended. With the exception of Weider’s Pocket Guide to Urology, the rest are available through Henry Ford’s Sladen library, or your AUA account, for free

• Campbell’s Urology: The definitive urologic textbook.
• Pocket Guide to Urology—Jeff A. Weider: An all-around excellent introduction to urology, including the basics of managing numerous urologic conditions
• Hinman’s Atlas of Urologic Surgery:Great step-by-step guide to multiple procedures, including pertinent anatomy. A good resource for preparing for cases.
• PubMed:  Nothing like going straight to the source to find primary research to support your theory/opinion, or prove the residents wrong.
• AUA University/AUA Guidelines: If you are a member of the AUA, download these apps—they contain A TON of great information—most of our SASP questions come straight from these resources.
• AUA Medical Student Curriculum: An easy resource with basic urology knowledge that students should know. The format is easy to follow.
• Washington Manual of Surgery
• Mont Reid Surgical Handbook: Useful for core curriculum general surgery topics that are always useful: shock, fluids and electrolytes, sutures and instruments, peri-op troubleshooting/issues etc.
• Henry Ford Medical Student Rotation Handbook: A booklet of lecture slides with useful urologic information; you will all receive a copy when you begin the rotation.

Electronic Medical Record

We use Epic for our EMR system—you should get access to it through your onboarding process. You can access Epic from home. When you do your Epic Training, be sure to ask them how to set up your home Epic access.

Contact Information

Urology on Call—ASK for this number on DAY ONE

Always carried by one of the residents—if you need to get ahold of someone and you aren’t able to, call this number. If we don’t answer, we may be in a procedure or seeing a consult—don’t leave a voicemail—instead, text the phone with your question and then call the phone back in a while. We recommend putting this number in your phone for use during your time at Henry Ford.

Michelle Nickel
Residency Coordinator
Phone: (313) 916-9375

Dr. Ali A. Dabaja
Residency Program Director
Email: adabaja2@hfhs.org

For contact information for each of the faculty, please feel free to ask them. They are very welcoming and will be happy to speak and meet with you.