Page 12 - CUA2019 Abstracts - Miscellaneous/Other

Poster session 8: Community Urology and Management

male predominance could have an impact on the physician work force, MP-8.11
mentorship opportunities for females pursuing surgery, and on medical Is it time to rethink how we page physicians? Understanding
student attraction to urology as a specialty. Research conducted in the paging patterns in a tertiary care hospital
United States has shown that although fewer females enter the field of Luke Witherspoon , Emily Nham , Hamidreza (Hamid) Abdi , Ali
1
1
2
urology, acceptance rates between the two genders are similar. This study Dergham , Thomas A. Skinner , J. Stuart Oake , James D. Watterson ,
1
1
3
1
aims to identify if a trend towards gender-specific acceptance into urology Luke T. Lavallee 1
residency exists within Canada. 1 Urology, The University of Ottawa/The Ottawa Hospital, Ottawa, ON,
Methods: Canadian Residency Matching Services (CARMS) data from Canada; Medicine, The University of Ottawa, Ottawa, ON, Canada;
2
the previous 10 years was analyzed. Logistic regression analyses were 3 Medicine, Queen’s University, Kingston, ON, Canada
used to assess if any significant difference exists between the rates of Introduction: Frequent pages can disrupt workflow, interrupt patient care,
female and male applicant acceptance into urology. These rates were and may contribute to physician burnout. The purpose of this study was
then compared to the rates of female and male acceptance into surgical to determine the volume and temporal relationship of pages received by
residency as a whole. three surgical services and one medical service at one tertiary care centre.
Results: Within urology applicants, there is no evidence that the success Methods: We conducted a retrospective review of paging data collected
rate over time between males and females differs (p=0.47). Within surgi- from four services at The Ottawa Hospital. Using the hospital paging
cal residency applicants, there is no evidence that the success rate over system database, resident paging data from April 1 to July 31, 2018 were
time differs between male and female applicants (p=0.84). In compar- collected from orthopedic surgery, general surgery, neurology, and neu-
ing these two rates, there is also no significant difference between rates rosurgery. We then examined the trends in paging volume during the
of acceptance to urology vs. surgery in general for female applicants four-month period.
(p=0.45). General surgery has a higher growth of females entering into Results: Between April 1 and July 31, 2018, 25 797 pages were received
the specialty compared to urology (p=0.026). by the services, averaging 211.45 (± standard deviation [SD] 12.17) calls
Conclusions: Our data identifies that there is no significant trend toward per day; 19 371 (75.10%) were calls from in-hospital units, while 6426
male acceptance into urology over female applicants. There is no signifi- (24.90%) were pages from the emergency room. The median interval
cant difference related to female acceptance specifically into urology or between pages across all specialties was 22:30 minutes. In-hospital units
any difference between rates of females accepted into urology as com- peaked between 5:30 pm and 6:30 pm (Fig. 1a), while emergency room
pared to all other surgical subspecialties combined. pages peaked between 4:30 pm and 8:00 pm (Fig. 1b).
References Conclusions: All specialties experienced frequent paging with similar
1. Halpern JA, Lee UJ, Wolff EM, et al. Women in urology residency, patterns of marked increases at specific times. This study thus identifies
1978–2013: A critical look at gender representation in our specialty. areas for future study about what the factors are that contribute to the
Urology 2016;92:20. https://doi.org/10.1016/j.urology.2015.12.092 paging patterns observed.
2. Association of Canadian Medical Colleges. Canadian medical This paper has figures, which may be viewed online at:
education statistics. Statistiques relatives à l’enseignement médical https://2019.cua.events/webapp/lecture/205
au Canada. 2017. Available at: https://afmc.ca/sites/default/files/
CMES2017-Complete.pdf. Accessed Oct. 15, 2018
3. Canadian Institute for Health Information. Physicians in Canada, MP-8.12
2016: Summary report. 2017. Available at: https://www.cihi.ca/en/ Urological conditions in nonagenarians
1
1
access-data-reports/. Accessed Oct. 15, 2018. Anjali Lobo , Tarek Lawen , Ashley R. Cox 1
4. Canadian Medical Association. Number of physicians by specialty 1 Urology, Dalhousie University, Halifax, NS, Canada
and age, Canada, 2017. CMA Masterfile. 2017. Available at: https:// Introduction: Nonagenarians represent a growing population of challeng-
www.cma.ca/En/Pages/physician-historical-data.aspx. Accessed Oct. ing patients in North America. Limited data exists on urological health
15, 2018. in this population. This study’s objectives were to: 1) assess the current
5. Canadian Medical Association. Urology profile. CMA masterfile. pattern of urological referrals for nonagenarians; 2) identify investiga-
2018. Available at: https://www.cma.ca/Assets/assets-library/docu- tions and treatment modalities being used; and 3) identify how frequently
ment/en/advocacy/profiles/urology-e.pdf. Accessed Nov. 25, 2018. management was being altered due to patient age.
6. American Urological Association. The state of urology workforce Methods: A retrospective chart review of urological referrals in patients
and Ppractice in the United States 2016. Linthicum, Maryland, above 90 years was done. Referrals to 11 academic urologists from 2007–
U.S.A. 2017. Available at: https://www.auanet.org/research/research- 2017 were reviewed. Data was collected via electronic health records
resources/aua-census/census-results. Accessed Oct. 15, 2018. and was analyzed using descriptive statistics.
7. Anderson K, Tennankore K, Cox A. Trends in the training of female Results: One hundred and seventeen charts were reviewed to date (77%
urology residents in Canada. Can Urol Assoc J 2018;12:E105-11. male). Mean age at the time of consultation was 92.2 years. Referrals were
https://doi.org/10.5489/cuaj.4697 received from family doctors (58%), specialists (22%), and emergency
8. Kim S, Farrokhyar F, Braga LH. Survey on the perception of urology room physicians (15%). The top three reasons for referral were hematuria
as a specialty by medical students. Can Urol Assoc J 2016;10:349- (27%), lower urinary tract symptoms (21%), and retention (13%). The most
54. https://doi.org/10.5489/cuaj.3621. common investigations were cystoscopy (56%), uroflow and post-void
9. Mayer KL, Perez RV, Ho HS. Factors affecting choice of surgical residual (23%), and ultrasound (21%). Digital rectal exam was performed
residency training program. J Surg Res 2001;98:71-5. https://doi. in 21% of men. The top three diagnoses in this population were benign
org/10.1006/jsre.2001.6143. prostatic hypertrophy, prostate cancer, and bladder cancer. Conservative
10. Baxter N, Cohen R, McLeod R. The impact of gender on the choice management was used in 52% of cases. Only 13% of patients underwent
of surgery as a career. Am J Surg 1996;172: 373-6. https://doi. a surgical intervention (53% transurethral resection of prostate, 27% trans-
org/10.1016/S0002-9610(96)00185-7. urethral resection of bladder tumour). There were 37 (32%) documented
11. Buddeberg-Fischer B, Klaghofer R, Abel T, et al. The influence of instances where management was altered due to age; in 43% of these
gender and personality traits on the career planning of Swiss medi- instances, the patient refused care.
cal students. Swiss Med Wkly 2003;133:535-40. https://dx.doi. Conclusions: This is the first study to describe urological issues in nona-
org/10.1186%2F1472-6963-6-137. genarians in North America. Nonagenarians are referred to urology for
common symptoms and are often managed conservatively. Management
plans may vary due to their advanced age and comorbidities. In order to
prepare our specialty for the provision of excellent care, it is imperative
to gain an understanding into the urological issues arising in this patient
population.
CUAJ • June 2019 • Volume 13, Issue 6(Suppl5) S139