For a study, researchers sought to perform a statewide review of the opinions of students and program directors (PD) on virtual sub-internships that occurred during the COVID-19 epidemic. To assess virtual sub-internships, they provided anonymous surveys to all 534 urology residency candidates and 161 urology PDs at academic medical facilities across the United States in December 2020. Curriculum content, goals, satisfaction, impediments, and future reusability were all evaluated through surveys. On a 5-point Likert scale, the key result was overall satisfaction with the sub-internship.

The survey was completed by 174 students (33%), 82 PDs (51%), 81 students (47%), and 32 PDs (41%), who participated in virtual sub-internships at 29 institutions. Overall, 77% of students and 78% of PDs assessed the electives as “outstanding” or “very good.” Higher student evaluations were linked with a length of ≥3 weeks (odds ratio [OR] 4.64, P=.003) and a class size of ≤4 students (OR 3.33, P=.015) in ordinal logistic regression. Higher PD evaluations were linked with full-time electives (OR 11.18, P=.019), class size of ≤4 students (OR 13.99, P=.042), and use of the Society of Academic Urologists’ standardized Guidebook (OR 11.89, P=.038). The most often mentioned barrier to the effectiveness of the sub-internship was a lack of hands-on learning (87% of students and 81% of PDs). In the future, 45% of students and 66%of PDs suggested introducing virtual components into electives.

During a pandemic, the virtual sub-internship was a concerted countrywide endeavor to deliver urologic instruction to medical students. The most effective courses had longer durations, full-time commitments, and small class sizes.