For a study, researchers sought to conduct the first countrywide assessment of clinical learning environments in American urology training programs. After obtaining each program coordinator’s email address, a survey was distributed to program directors (PD) at American Urological Association-accredited urological training programs. The 21-question survey was meant to elicit critical aspects of each training set, including demographics, training methodology, clinic organization, and resident perception.

The program coordinator for 113 of the 131 American Urological Association-accredited training programs got an email inviting them to participate. The poll received 60/113 (53%) responses from PDs. Residents attended clinics at the following hospitals: Children’s 51 (85%), County/Indigent 23 (38%), Private 29 (48%), University 56 (93%), and Veterans Administration 38 (63%). PDs estimated that their residents spent 2.6 half days per week in the clinic on average (1-6). About 13 programs (22%) reported a “clinic only” rotation lasting between one and six months. Time constraints and schedules were recognized as the most significant barriers to teaching in clinics by PDs, and 40% of residents saw clinic as a vital aspect of their training, while 30% saw clinic as a required exercise with limited learning possibilities. The first characterization of resident engagement in the clinical learning environment is presented. The structure is very varied, and a concerted effort is required to enhance resident competency evaluation and monitoring in the clinic.