Objective: To report our experience of a 3-year Fellowship in reconstructive urology for its content and duration, with particular reference to what can be achieved each year.
Methods: Over the 3-year period October 2004 to October 2007 the Fellow worked full-time in a specialist reconstructive urological centre as principal assistant to the trainer in the care of outpatients and inpatients, and in the performance of the various surgical procedures. Using a prospectively constructed logbook it was possible to compare the developing surgical experience of the Fellow in terms of both the frequency and complexity of the cases undertaken and the surgical outcomes, compared with similar data for the trainer.
Results: Over the 3-year period the Fellow progressively took on more cases and of increasing complexity, and the trainer progressively adopted the role of assistant, except for particularly complex cases. Throughout this period the complication rate of the trainer and the Fellow remained the same.
Conclusions: Even at the end of 3 years the Fellow was still limited in what she could deal with as an independent practitioner. Fellowship training should be goal directed in content and duration, and based around hands-on experience.