Identifying Current Trends in the Urologic Oncology Workforce-Does Completion of Fellowship Significantly Change Future Practice?

摘要

Introduction: To assess fellowship impact on subsequent practice type and case mix, we compared urologists who completed a urologic oncology fellowship to urologists who did not complete a fellowship. Methods: Annualized case log data were obtained from the American Board of Urology from 2004 to 2016, including initial certification (C1) and recertifications 1 (R1) and 2 (R2). We evaluated trends in major urologic oncology case volume using relevant CPT codes. Surgeon specific data, including fellowship training, practice type and practice area population, were analyzed using chi-square and 2-sample t-tests. Results: Oncology fellows (338) were more likely than nonfellows (7,785) to practice in larger population areas (p <0.001) and practice in academics (p <0.001). Oncology fellows performed nearly 3 times as many major oncology cases as nonfellows at each certification cycle (C1-29.7 vs 12.5, R1-32.3 vs 13.5, R2-30.5 vs 11.5; p <0.001 for all) and maintained case volumes over time. Oncology fellows performed significantly more major cases in kidney, bladder and prostate cancer across all certification points than nonfellows, and continued to perform these cases at a similar frequency at all certification cycles. Moreover, during the period studied oncology fellows performed an increasing percentage of overall major oncologic cases (from 8.9% in 2004 to 13.3% by 2016). Conclusions: Completion of urologic oncology fellowship is associated with performing and maintaining a high volume of major oncology cases over recertification cycles, with academic practice and with practicing in large population centers. This information may be useful to urology residents considering oncology fellowship opportunities.