Separating Fact from Fiction: Misconceptions About Urology Amongst Medical Students
Priyanka Shindgikar, MS1, Lara S. MacLachlan, MD2.
1Tufts University School of Medicine, Boston, MA, USA, 2Lahey Hospital & Medical Center, Boston, MA, USA.
Background: The United States has an aging population with a changing burden of urologic diseases that affects both male and female patients. These trends make early exposure to urologic pathologies and a better understanding of urology imperative for physicians-in-training. This study aims to understand medical students' perspectives on their exposure to urology during medical school and potential strategies to increase that exposure.
Methods: An anonymous 16-question survey was administered via an online platform (REDCap 12.0.13) from January 8 2022 to February 25 2022 following approval by the Institutional Review Board. Eligible subjects were currently enrolled medical students in MD programs in the United States. A survey link was distributed via email. No incentive was provided for the completion of the survey.
Results:178 medical students participated in the survey. Of the entire cohort, 30.3% could not explain what a urologist does. More than half of those surveyed (58.4%) learned about urology through medical school-related exposure, primarily interest-based groups. Free-text responses provided insights into students' understanding of the field and the need to increase exposure. Comments about the specialty and the role of a urologist included: “I may not know the exact line drawn between nephrologists and urologists”, “my exposure to urology has been through renal and urogyn”, “my school included no education on prostate health [what]soever, and I will graduate from medical school never been taught how to do a prostate exam”, “urologists teaching some of our lectures during the 1st and 2nd-year curriculum would have been helpful, I never thought of it as a distinct field”. Comments regarding the need for women in urology included: “I am wondering why we are concerned by a lack of female urologist/why there is a need when [the] majority of urology patients are male”, “having an all-male patient population is [a] major turnoff for me”. Comments regarding strategies to increase exposure to urology included: “urology is an under-emphasized topic in medical school”, “increasing awareness of the specific examples/areas where women are needed in urology may help to increase recruitment. I think it's typically thought of as a specialty pertaining to the male reproductive system. Examples of cases in female patients that need urologists can help to increase awareness”. Of the 87 students that responded to the free-text questions, 52.3% suggested ways to learn about a career in urology, 22.1% suggested including educational material in preclinical years, and 33.7% suggested clinical exposure.
Conclusions: A surprisingly high proportion of medical students (1 in 3) are unclear about the role of a urologist as a surgeon and how it is distinguished from other fields such as nephrology. In addition, free-text responses provided insights into students' misconceptions that urology is a medical field that only treats male patients and pathologies. Based on these perspectives, medical schools can address gaps in knowledge about urology by including more urology cases in the preclinical years, providing shadowing opportunities, offering a urology elective, and increasing opportunities to connect with a urologist during the surgery core clerkship.
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