We attempted to quantitate the level of participation of urology residents and faculty in clinical renal transplantation in the United States and Canada at the present time.
All 123 urology residency program directors in the United States and all 13 in Canada were mailed a questionnaire requesting information about the participation of their residents and faculty in clinical renal transplantation at their institutions. All program directors (100%) returned the surveys.
In the United States 94% of residencies are affiliated with renal transplant programs and 81% provide a transplant rotation. In Canada each program provides a transplant experience. In the United States 22% and in Canada 85% of academic renal transplant programs are directed or codirected by urology. In the United States approximately 80% and in Canada more than 90% of residents are exposed to transplant surgery, although the majority have pre-urology or junior resident rotations. Approximately 50% of residents in each country receive training in immunosuppression. In the United States 25% of programs have urology faculty perform transplant surgery and administer immunosuppression, compared to more than 90 and only 15%, respectively, in Canada.
Urological participation in clinical renal transplantation at academic medical centers remains strong with approximately 25% of programs directed or codirected by urology departments in the United States--a figure that has not changed appreciably during the last 10 years. In the future the continued presence of urology in transplantation requires a commitment from urology program directors to support exposure for residents as well as promoting the training and development of young transplant surgeons within our own specialty.