Dr. George Koch

I don't think they necessarily say we have to be subspecialty trained.

So I'm rambling a little bit, but I'd love your thoughts on like where residents factor into the more of these complex cases and if urethral reconstruction is something that they should be exposed to or should they be working towards competency or is it somewhere in the middle?

I'd love your thoughts on it.

Yeah, that's a good point and kind of,

Being able to troubleshoot, I think, is the difference between doing a straightforward case and maybe like outkicking your coverage is like, you know, all of a sudden this case ended up being very different than what I thought it was going to be.

And I've already passed a point where we now have to complete the anastomosis.

You know, like this has to be done.

Yeah, yeah, three in just the last 18 months for us.

Yeah, it's incredible.

It is certainly growing.

And the increase in fellowships, I mean, that certainly has helped.

But that is the thought that I kind of always have when I'm looking at the resident that's operating with me is like, do I think I can get this person to the point where they could do what we're doing today?

As you're doing that, you know, and your practice is obviously different than mine, both in your experience and you have a fellow kind of taking on, I'm sure, some of the teaching burden, even while they're also learning.

But are you... I wonder, like...

Do you have a curriculum that you follow?

Do you have a kind of a or just a sense for kind of who should be doing what at what level?

That's one thing that I'm trying to look into and would love to look into on a national level.

But kind of understanding for someone who's been teaching urethral reconstruction for a long time, like when you get a PGY-2 versus a PGY-5,

Do you have specific things where you're like, I never let X person do this, or you should definitely be doing that, that kind of thing.

there are still academic programs who don't have a reconstructionist.