Paratesticular Fibrous Pseudotumor in 8-Year-Old Male Following Scrotal Trauma.

Fibrous pseudotumors are a rare type of benign paratesticular mass that normally present to patients in their 30s secondary to local trauma. Here, we describe an 8-year-old male patient that presented with several right testicular masses following an injury 2 years prior. The masses were successfully resected in a testicle-sparing operation. This report describes the unique finding of a reactive fibroinflammatory mass in a pediatric patient, and also highlights the uncertainty of pseudotumor diagnostic criteria that need to be recognized in order to avoid unnecessary orchiectomy.

Up and Away: Five Decades of Urologic Investigation in Microgravity.

A renewed global interest in manned space exploration has emerged, propelled by the challenge of reaching a new frontier: travel to the Red Planet, Mars. As the physiological changes induced by microgravity bear direct relevance to the safety and viability of these goals, we provide a historical narrative of the urologic investigations in space. We review the significant contributions to the understanding of the urologic consequences associated with exposure to microgravity, considerations for prolonged missions, and forward-looking efforts to manage emergent conditions remotely. Historical insights gleaned are poised to inform interplanetary travel, where urologic pathology will remain an important practical consideration.

The Current State of Urological Education for Medical Students.

INTRODUCTION: Providing medical students with a basic urological education is important as the geriatric population expands and the need for urological care increases. In the last decades there have been considerable changes to medical school curricula and graduation requirements that may impact medical student exposure to urology. We reviewed the literature pertaining to urological education for medical students in the United States. METHODS: We searched the PubMed® and Medline® databases to identify articles pertaining to medical student education in urology. We summarized these articles according to 4 themes, including 1) medical student electives in urology, 2) medical student career interest in urology, 3) new interventions in urology education and 4) the urology match. RESULTS: We identified 25 articles, which showed that 1) medical student exposure to urology has markedly declined, 2) medical students remain highly interested in pursuing a career in urology, 3) the AUA (American Urological Association) medical student curriculum has provided a key resource for medical school urological education and 4) applying for urology residency may be expensive and challenging. CONCLUSIONS: Medical school urological education has changed in the last decades. Although it appears that fewer medical students are required to rotate through urology, new materials are available to educate medical students in urology and many students are highly interested in pursing a career in the field.

The Current State of Urological Residency Education.

INTRODUCTION: We reviewed literature pertaining to the current state of urological education for residents in the United States. METHODS: A literature review was performed to identify relevant manuscripts using a key word search of the PubMed® and MEDLINE® databases. Central themes of the literature were identified and summarized for the purpose of this review. RESULTS: A literature search identified 23 articles related to urological residency education. Key themes identified in the available literature included surgical simulation, decreasing open experience, and improving the efficiency and quality of resident education and evaluation. With increasing limitations in available resident training hours as well as increasing utilization of minimally invasive approaches in the field of urology it is important to critically assess how urological residents are trained. CONCLUSIONS: As the scope and complexity of medical knowledge and surgical approaches evolve in the field of urology it is imperative to critically evaluate how urological residents are trained to ensure that graduating residents are prepared to provide outstanding patient care as independent surgeons.

Challenges Facing Program Directors in the Urology Match.

INTRODUCTION: We investigate urology residency program directors' perspectives on the current residency matching system. METHODS: A survey was emailed to Society of Urology Chairpersons and Program Directors members. The survey queried respondents' perspectives on the current residency matching system, with special attention to the recent surge in application volume and the usefulness of the Medical Student Performance Evaluation. Participants were also asked about their perspective on a possible application limit for students applying to urology residencies. RESULTS: A total of 70 members of the Society of Urology Chairpersons and Program Directors responded to the survey. The majority of respondents received more than 200 applications for their program's residency positions (77.1%) and used a Step 1 cutoff score to screen applications (81.4%). Approximately half of the respondents (51.4%) were in favor of imposing a limit to the number of applications that applicants are permitted to submit. The Medical Student Performance Evaluation was considered important or very important by 20% and 94.3% favored including an applicant's class rank in the evaluation. An applicant's projected likelihood of attending a respondent's program was considered by 76%, and 60% had previously not offered superior candidates interviews because they estimated the applicants were not truly interested in the program. CONCLUSIONS: Urology program directors exclude a large number of applications based on board scores and applicants' perceived levels of interest in the programs. A significant number of program directors favored an application limit as well as including class rank in the Medical Student Performance Evaluation.

Relationship Between the Number of Residency Applications and the Yearly Match Rate: Time to Start Thinking About an Application Limit?

BACKGROUND: There has been an increase in the number of applications medical students have submitted for the National Residency Matching Program (NRMP). These additional applications are associated with significant costs and may contribute to match inefficiency. OBJECTIVE: We explored if match rates improved in years when an increased number of applications were submitted. METHODS: We analyzed yearly published data from the NRMP and the Electronic Residency Application Service for 13 specialties. A generalized linear model was used to assess the relationship between the annual match rate and the mean number of applications submitted per applicant, while controlling for the number of positions available and the number of applicants in the given year. RESULTS: Over the last 13 years there has been an increase in the mean number of applications submitted per applicant (P < .001). For the 13 assessed medical specialties, there was no statistically significant relationship between the mean number of applications per applicant per year submitted to the NRMP, and the annual match rate (odds ratios near 1.00 and nonsignificant, P values > .05). CONCLUSIONS: There was no improvement in the match rate in years when medical students submitted an increased number of applications. Therefore, it would appear that the applicants do not benefit from the larger number of applications submitted. Further study is required to assess the cost and benefit of these additional applications.

Program directors' criteria for selection into urology residency.

OBJECTIVE: To investigate urology residency program directors' criteria for resident selection. METHODS: In 2014, the urology residency program directors were surveyed using an email questionnaire. The generated questionnaire included the following 3 components: (1) assessing the factors used in selecting applicants for interviewing and matching, (2) rating the factors resulting in a negative decision for applicants for interviewing and matching, and (3) investigating the factors that gave applicants special attention or consideration from program directors. Analysis of variance testing and post hoc Student t tests were used to assess for differences in the mean importance score of the factors. RESULTS: Urology reference letters and United States Medical Licensing Examination (USMLE) scores were ranked as the most important factors for applicant selection. A USMLE Step 1 score ≤220 and a USMLE Step 2 score ≤220 were the most deleterious factors to applicants, with a previous match failure being no less deleterious to an applicant than a USMLE Step 1 or 2 score ≤220. Program directors gave special attention or consideration to gender (25%), minority status (36.8%), being from the same medical school as the program director (61.8%), completing an away rotation at the program director's institution (86.8%), being a child of an academic urologist (47.4%), and being a child of an academic nonurologic physician (15.8%). CONCLUSION: Although program directors consider a variety of factors during the residency selection process, USMLE performance, urology references, and completing an away rotation at the program directors' institution appear to be the most important factors to program directors during the residency selection process.