Introduction: Despite advances in medicine, and perhaps because of it, access to specialized healthcare is sometimes increasingly difficult both in urban, and mainly in rural regions. The training time required and residency programs available for certain specialties make this even a bigger challenge.
We present a Novel program for a hybrid family-medicine Urology fellowship, to help provide access to basic urologic counselling and urgent procedures, that can be expanded to other disciplines in the future.
Methods: A Novel Program has been running for 4 years now at a busy urologic service with multiple hospitals, both centralized and rural. Candidates are family medicine Doctors, this is an internal program, part of our own network, and with no outside regulation, during its 18 months the fellows have both office and operating room rotations in uro-oncology, endourology, andrology, and female urology. The fellows are expected to actively participate in all resident educational meetings and journal clubs, including a minimum of 3-4 presentations in grand rounds each year. The fellows participate in the resident call schedule, with initial supervision. Fellows are expected to have proficiency in simple and urgent procedures including: stent insertion, cystoscopy, bladder biopsy, and others.
Results: Three graduates have already finished the program and are employed, two in our own system, and one at a different state where he helped start a similar program with similar goals. All graduates are capable of basic urologic evaluation with appropriate diagnostics and referrals as needed, including taking call for urgent cases.
Conclusions: We present an evolving Novel Fellowship program that can help bridge the gap for healthcare access in urology. We are constantly updating our program, requirements from candidates, and level of proficiency expected at the end of program. We see great benefit for this both in busy urban centers, and underserved rural areas.