Baseline urologic surgical skills among medical students: Differentiating trainees

Abstract

INTRODUCTION: Urology training programs seek to identify ideal candidates with the potential to become competent urologic surgeons. It is unclear whether innate technical ability has a role in this selection process. We aimed to determine whether there are any innate differences in baseline urologic technical skills among medical students. METHODS: Second-year medical students from the University of Toronto were recruited for this study and stratified into surgical and non-surgical cohorts based on their reported career aspirations. After a pre-test questionnaire, subjects were tested on several urologic surgical skills: laparoscopy, cystoscopy and robotic surgery. Statistical analysis was performed using chi-squared test, student t-tests and Spearman's correlation where appropriate. RESULTS: A total of 29 students participated in the study and no significant baseline differences were found between cohorts with respect to demographics and prior surgical experience. For laparoscopic skills, the surgical cohort outperformed the non-surgical cohort on several exercises: Lap Beans Missed (4.9 vs. 9.3, p < 0.01), Lap Bean Rating (3.8 vs. 3.1, p = 0.01), Lap Rings Error (0.2 vs. 1.22, p < 0.01), Lap Rings Rating (3.9 vs. 2.9, p < 0.01) and LapSim Grasping Score (64.3 vs. 46.4, p = 0.01). For cystoscopic skills, there were no significant differences between cohorts on any of the performance metrics. The surgical cohort also outperformed the non-surgical cohort on all measured robotic surgery performance metrics: Task Time (50.6 vs. 76.3, p < 0.01), Task Errors (0.2 vs. 3.1, p < 0.01), and Task Score (89.5 vs. 72.6, p < 0.01). DISCUSSION: Objective innate technical ability in urological skills, particularly laparoscopy and robotics, may differ between early trainees interested in a surgical career compared to those interested in a non-surgical career. Further studies are required to illicit what impact such differences have on future performance and competence.