Special article
Urology at the European university: Adaptations to the Bologna Plan. The model of the Autonomous University of Madrid
Urología en la universidad europea: Adaptaciones a Bolonia. El modelo de la Universidad Autónoma de Madrid
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El modelo de la Universidad Autónoma de Madrid" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">With the meeting of the European Ministers of Education in Bologna on June 19, 1999, in the framework of the European Higher Education Area (EHEA), began, in the case of medicine, the so-called Pact of Convergence of Bologna.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">1</span></a> The fundamental objectives of the Convergence Pact referred to the need to normalize, harmonize, standardize the teaching of medicine in all European Medical Schools, imposing a similar curriculum to all medicine students, whether they studied in Palermo, Warsaw, Edinburgh, Seville, or Bucharest. A second objective was that medicine students finished their degree being excellent general practitioners, so practical teaching should dominate over theoretical one, just the opposite of what apparently happened in most European medical schools. Achieving these goals has required substantial changes to the curricular itinerary of the student, with greater exposure in the classroom engagement, proximity to the patient, with the greatest active participation of the faculty in tutoring, greater availability of human and educational resources, and other aspects that have been and are debated by the Conference of Deans of the different countries.<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">2–5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The discipline of Urology has been outlined more clearly throughout the development and implementation of the Pact of Bologna:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1.</span><p id="par0015" class="elsevierStylePara elsevierViewall">The subject of Urology, as such independent discipline, was non-existent in many European Schools of Medicine. Therefore, Bologna has been of great benefit to European Urology, its teaching being incorporated in many medical schools.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">6</span></a></p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2.</span><p id="par0020" class="elsevierStylePara elsevierViewall">Adapting to the proposals and postulates of Bologna has not been a special effort in other European Medical Schools, which were already conducting similar programs and teaching methods to those proposed, as it was the case of the Autonomous University of Madrid (UAM) and many other Spanish and EU faculties of medicine.<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">7,8</span></a></p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3.</span><p id="par0025" class="elsevierStylePara elsevierViewall">The aim of training excellent doctors necessarily involves a significant increase in clinical teaching scenarios over surgical ones, so the overall teaching load of the Department of Surgery has been reduced in favor of the Department of Medicine, but the content of the subject remains intact.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4.</span><p id="par0030" class="elsevierStylePara elsevierViewall">In the surgical specialties that have their medical counterpart, this problem has been the subject of more controversy than in Urology, which has no medical alternative, as some mistakenly might suspect, but it is an inclusive and comprehensive medical-surgical specialty.</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5.</span><p id="par0035" class="elsevierStylePara elsevierViewall">Most disputes motivated by Bologna, their proposals and application, refer to structural issues that will increasingly find adaptations and solutions in the hands of the respective conferences of deans and other institutions, according to the different countries.</p></li></ul></p><p id="par0040" class="elsevierStylePara elsevierViewall">The Bologna teaching proposals can be summarized as follows:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">1.</span><p id="par0045" class="elsevierStylePara elsevierViewall">Change in the approach and the teaching methodology, focusing teaching on student learning, based on active student participation in the acquisition of knowledge, skills, attitudes, and competences.</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">2.</span><p id="par0050" class="elsevierStylePara elsevierViewall">Activation and increased number of clinical scenarios of participatory learning over traditional lectures.</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">3.</span><p id="par0055" class="elsevierStylePara elsevierViewall">Orientation of the activity of the professor to student mentoring, increasing seminars and supervised practice, i.e. diverting the classroom teaching effort to the proximity of the patient in the company of the student.</p></li></ul></p><p id="par0060" class="elsevierStylePara elsevierViewall">We will analyze, then, specific aspects of the subject of Urology, along with the many motivated discussions to reach some consensus.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Content and program: what to teach?</span><p id="par0065" class="elsevierStylePara elsevierViewall">Bologna has not changed the content of urological discipline. Therefore, any of the traditional programs that define Urology as a medical-surgical specialty remain. During the consultative process of the Pact of Bologna, specific proposals of the minimum content of the discipline were made from the European Association of Urology.<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">9,10</span></a> There have been changes as to the way of stating the content, recommending the titles relating to the main syndromes.</p><p id="par0070" class="elsevierStylePara elsevierViewall">The titles of our program of 12 lectures and 6 seminars are briefly presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>, which are to be explained during the current academic year. This thematic synthesis is intended to include in a few words the entire content of Urology as medical-surgical specialty. Each lesson contains detailed specification of all processes that it treats, so that there are no omissions or mistakes. This detailed program is delivered to students at the beginning of the course.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">For those who consider that this list represents a poor statement of urological issues during the curricular itinerary, we remind them that there are currently many medical schools in Europe and the United States where Urology is non-existent as individualized academic discipline. In the particular case of the United States, the American Urological Association (AUA) offered the Core Urology program, a very reduced program, with the request that at least these issues were explained in the American medical schools.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">11</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">The initiative of the AUA has raised an interesting debate: can professional associations suggest or propose teaching subjects of their specialty to universities? To understand this attitude, it is enough to remember that in medical schools in the United States and in some European ones, urological issues are explained by professors of surgical or medical pathology, not specifically by professors of Urology, and in some schools they are not even mentioned. One of the works denouncing this situation states: “50 years ago, all medicine students in the United States received training in Urology. Currently, only 17% of students receive it. However, it is still urgently important that medicine students learn, for good training, the essence of Urology before their graduation”.<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">12,13</span></a> Undoubtedly, training is a powerful argument, but there are other reasons explored by the European Association of Urology (EAU) that show the clear relationship between the presence of Urology in university and the health care and professional dimension that Urology occupies in national health systems of different European countries.<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">14,15</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">To insist on clinical training of medicine students, future general practitioners, Bologna claims statements closer to major clinical syndromes than to scientific or nosological ones, also inviting the reporting dynamics to begin with a clinical scenario, particular and common and, from there, the rest of the teaching discourse develops. An alternative program which includes the above comments is presented in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>. Finally, it is claimed that in each process it is clearly indicated what the student must master compulsorily or just know.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Pedagogy. Teaching techniques. How to teach?</span><p id="par0090" class="elsevierStylePara elsevierViewall">Bologna calls for greater interaction between professors and students in the teaching and learning process; that practical, classroom, and supervised teaching at least compares to that provided in the classrooms. Traditionally, the teaching load of the discipline was measured by the number of given lectures (10<span class="elsevierStyleHsp" style=""></span>h of class<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1 credit). The lecture, the foundation of the teaching strategy, was, as such, theoretical. Many medical schools lacked “rotations” by the Department of Urology, and even by the corresponding university hospital, frequently resorting to massive “practical lessons”. On the other hand, when the rotating period was possible, the student was allowed only for a passive attitude, as a listener.</p><p id="par0095" class="elsevierStylePara elsevierViewall">The teaching load proposed by Bologna now refers to the European Transfer Credit System (ETCS) credits, which are the result, as a whole, of the sum of the tutoring of professors and the effort that the student puts in the effort to master the discipline, both the theoretical and practical aspects (1 ECTS<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>25<span class="elsevierStyleHsp" style=""></span>h with 50% attendance). Consequently, the image of the student closer to textbooks than to contact with the sick and the professor more interested in the excellence of the lecture than in visiting the sick with the student, must change.</p><p id="par0100" class="elsevierStylePara elsevierViewall">The effort by the students should be to learn, making the appropriate consultations on a particular topic in more than in the textbook, which still has consultative value. They must be prepared for their lifelong commitment: “continuing medical education”. Therefore, the professor, rather than recommending textbooks, should recommend updated information sources.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Accordingly, the “subject guidelines” are now proposed<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">14</span></a> for the student, whose preamble clearly states what the student should master, know, or just hear of that particular subject. The AUA, on its website (<a href="http://www.auanet.org/">http://www.auanet.org</a>) in the Education section (AUA UNIVERSITY-Educational programs), in the section on Education for medical students, presents several subjects for teaching purposes, with other teaching materials. The EAU did the same in a project, Guide to Urology for medical students, started years ago, but still not on the web. These guidelines, in the case of Europe, provide the added benefit that the whole European faculty has uniform thematic reference for the discipline of Urology.</p><p id="par0110" class="elsevierStylePara elsevierViewall">The aspect of most difficult application for professors is that which corresponds to the active tutoring of students. There are several factors in this educational commitment that deserve to be analyzed individually and have been and are matters of debate. If this commitment has to be met effectively, it is necessary to increase the number of professors significantly, at the discretion of some. On the other hand, the university hospital has changed its healthcare dynamics significantly in recent years, especially in those where there are new models of management or private management,<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">16–21</span></a> so that the oppressive occupation of professors in their daily work can limit, and even prevent, their dedication to teaching. This is a problem that must be regulated under the direction of the dean of the Faculty, and certainly individually, if the Faculty has several hospitals, as in the UAM.</p><p id="par0115" class="elsevierStylePara elsevierViewall">A new model of University Hospital chaired by former teaching and research convictions, as those promoted by Carlos Jiménez Díaz more than 50 years ago, will be necessary, if the demands of Bologna want to be met.<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">22</span></a> The university hospital must be fully committed (classrooms, study rooms, IT offering, library, etc.) with its teaching function and it must be led by the concept of totality: nothing must be done in the university hospital that has no teaching character, the very stimulus that raises the quality of health care work. No member of the university hospital remains out, voluntarily or involuntarily, of the teacher commitment, with or without official recognition. The role of the entire staff and residents in the teaching of medicine students must be regulated.<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">23</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Tutoring requires identification of the tutor and a list of procedures, mainly diagnostic, which students should know at the end of their rotation. The process must necessarily be interactive and subjected to continuous and controlled assessment.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">8</span></a> Each group of students will have a tutor chosen from the staff members by the head of the department, depending on their availability. To facilitate the work of professors, in addition to the forced contact with the patient, they can expect some videos on elementary and frequent urological procedures (male urethral catheterization and types of probes, female catheterization, etc.). Some educational videos can already be found on the website of the AUA. Various types of simulators have been proposed to facilitate the practice and they have been incorporated to the teaching program in some faculties.</p><p id="par0125" class="elsevierStylePara elsevierViewall">Traditionally, the longest and most frequent contact of the student with the patient takes place in examination rooms. The externalization of the examination rooms in the new hospital laws can recommend that both the student and their tutor have to travel to outpatients clinics dependent of the hospital which, as it has been noted, must be educational in its entirety. The recent issue of what part of the hospital should receive the student during their clinical training, for greater and more efficient training and tutoring can vary from one center to another.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Student engagement: how to learn?</span><p id="par0130" class="elsevierStylePara elsevierViewall">Tradition has shown that the best way to learn medicine is to progressively assume greater responsibilities, under the tutoring of the professor. Bologna, therefore, places the student in the vicinity of the patient and the tutor in a permanent interactivity that progressively gets skills (knowledge), competences (they can do it), and aptitudes (demonstrated that they can do it). The student obligatorily has to meet compliance of the activities listed in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>, which is given at the beginning of the rotation by the department.</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">Bologna insists that the last year of the degree, that is, the 6th, is for the student a true “boarding school”, with the privilege of being able to choose, at least partially, the departments that they want to rotate.<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">24</span></a> If the quality of what was learned and lived during their rotation in Urology in the 5th year encouraged them to choose this specialty for a new rotation during the internship, they will be able not only to improve their knowledge of urological problems but also guide their vocation for the specialty. The proposal for this 6th year at the UAM is that, at least, they are in the hospital in the mornings from 8 to 15, leaving their other academic and library commitments for the evenings.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">When to teach Urology?</span><p id="par0140" class="elsevierStylePara elsevierViewall">According to the law of teaching by organs and systems, the subject of Urology is explained in the UAM in the 5th year, as mandatory training with the time distribution for the student as follows (number of hours and percentages): lectures: 12<span class="elsevierStyleHsp" style=""></span>h (14.3%); seminars: 5<span class="elsevierStyleHsp" style=""></span>h (6.7%); authorized work: 3<span class="elsevierStyleHsp" style=""></span>h (4%); clinical practice: 20<span class="elsevierStyleHsp" style=""></span>h (26.7%); tutorials: 2<span class="elsevierStyleHsp" style=""></span>h (2.7%); assessments: 2<span class="elsevierStyleHsp" style=""></span>h (2.7%); attendance: 56<span class="elsevierStyleHsp" style=""></span>h (46%).</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Assessment</span><p id="par0145" class="elsevierStylePara elsevierViewall">The UAM has rules of academic assessment with general provisions relating to the rights and duties of professors and students.<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">25</span></a> Among the duties of information are: how the assessment tests, their registration and custody must be developed; on the timetable agreed, type of call; publication of grades, review, claims, plus some additional provisions. Following these guidelines, the teaching unit of Urology carries out the assessment of the student at the end of the course, consisting of 50 multiple choice questions and 3 written subjects on various clinical scenarios. The student has 90<span class="elsevierStyleHsp" style=""></span>min to complete the test, with a short break in between. In the future, there may be three exclusive questions which, if not answered correctly, the student will fail. The students who have not completed the classroom engagement will not be able to sit this assessment.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusions</span><p id="par0150" class="elsevierStylePara elsevierViewall">In the UAM, the subject of Urology, a mandatory training subject, is on the general program of degree with three ECTS. It is explained during the 5th year in the first or second semesters. Its content covers the entire Urology care commitment as medical-surgical specialty, which is exposed concisely and hierarchically to students in 12 lectures, oriented primarily on clinical scenarios and 6 seminars, also with a highly practical content.</p><p id="par0155" class="elsevierStylePara elsevierViewall">The professors, in addition to this specific classroom work, do the task of tutoring and tutorials for 2<span class="elsevierStyleHsp" style=""></span>h daily from Monday to Friday, during the 8 days when students rotate in the Department of Urology. Thus, it is achieved that the exposure of students to the teaching, court, and classroom work is comparable, in a distribution close to 50%. Furthermore, the student will, in addition to attending classes and seminars and active and tutored presence during the rotation, have to do supervised works and concrete presentations that promote commitment to active learning, information management, and interpersonal relationships.</p><p id="par0160" class="elsevierStylePara elsevierViewall">The dedication of the professors during the rotational period to student groups (maximum 4) is organized, so that there is no interference with care work, according to each Department of Urology of the four hospitals that make the urologic teaching unit of the UAM. There is a tutorial action plan that allows all students to have an academic reference to turn to when they need guidance regarding their training. These tutors, who will do not only individual tutoring but also group tutoring, depend on the Vice-deanship of Clinical Teaching.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interest</span><p id="par0165" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres547426" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec565305" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres547427" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec565304" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Content and program: what to teach?" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Pedagogy. Teaching techniques. How to teach?" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Student engagement: how to learn?" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "When to teach Urology?" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Assessment" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Conclusions" ] 11 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflict of interest" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-12-24" "fechaAceptado" => "2015-01-13" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec565305" "palabras" => array:3 [ 0 => "Urology university discipline" 1 => "Bologna" 2 => "European medical schools" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec565304" "palabras" => array:3 [ 0 => "Urología disciplina universitaria" 1 => "Bolonia" 2 => "Escuelas médicas europeas" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The fundamental objective of the Convergence Plan of Bologna is to normalize, harmonize and standardize the teaching of medicine in European medical schools by implementing a similar curriculum. This objective assumes the presence of Urology as a university discipline in all European medical schools. At the same time, the teaching techniques and subject distributions have been modified, emphasizing practical teaching and active participation of the student in the acquisition of expertise and skills. This approach enhances the curricular presence of Urology and requires increased dedication from the teaching staff. These staff members, with limited face-to-face and classroom time, must inform and educate medical students on the broad healthcare commitment of Urology as a surgical/medical specialty. The adaptation of the numerous European medical schools to the Bologna Plan raises a number of problems that can be easily overcome, as can be seen in the plan designed by the Faculty of Medicine at the Universidad Autonoma de Madrid.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El Plan de Convergencia de Bolonia tiene como objetivo fundamental normalizar, armonizar y estandarizar la enseñanza de Medicina en las facultades médicas europeas, imponiendo un curriculum similar. Esto ha supuesto la presencia de la Urología como disciplina universitaria en todas las escuelas médicas europeas. Simultáneamente ha modificado las técnicas pedagógicas y las distribuciones temáticas, insistiendo en la enseñanza práctica y en la activa participación del estudiante en la adquisición de conocimientos y habilidades. Todo ello realza la presencia curricular de la Urología y obliga a una mayor dedicación del profesorado que ahora, en un tiempo limitado presencial y de aulas, tiene que informar y formar al estudiante de Medicina sobre el amplísimo compromiso asistencial de la Urología como especialidad médico-quirúrgica. La adaptación a Bolonia de las numerosas escuelas médicas europeas plantea ciertas dificultades que pueden ser fácilmente superadas, como puede verse en el plan diseñado en la Facultad de Medicina en la Universidad Autónoma de Madrid.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Vela-Navarrete R, Carballido J, Gonzalez-Enguita C, Gómez CO, de Betancourt FR. Urología en la universidad europea: Adaptaciones a Bolonia. El modelo de la Universidad Autónoma de Madrid. Actas Urol Esp. 2015;39:399–404.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Lessons</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1. – Introduction to Urology. Medical history, semiology, and physical examination of patients with genitourinary disease \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2. – Functional Urology. Voiding dysfunctions. Urinary incontinence. Female Urology \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3. – Urinary tract obstructive uropathy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4. – Congenital malformations of the urinary system \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5. – Infectious and inflammatory disorders of the urinary tract. Infectious diseases of the male genital system \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>6. – Lithiasic disease \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>7. – Benign and malignant disease of the adrenal glands and retroperitoneum \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>8. – Urothelial and renal tumor disease \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>9. – Benign and malignant testicular and appendages disease \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>10. – Benign and malignant disease of the urethra and penis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>11. – Benign and malignant disease of the prostate \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>12. – Sexual medicine. Male sexual dysfunction. Androgen deficiency. Infertility in subfertility \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Seminars</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1. – Non-invasive diagnostic techniques in Urology \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2. – Invasive diagnostic techniques. The world of Urology \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3. – Great syndromes in Urology. Pain of urological origin. Hematuria. Urinary incontinence \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4. – Surgical treatment of chronic renal failure. Renal transplant \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5. – Emergencies in Urology. Genitourinary trauma \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>6. – Aging and overall health of the man. Prevention in Urology and sexual medicine \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab884200.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Urology lessons and seminars.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Lessons</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1. – Introduction to Urology. System of urological examination (clinical history, semiology, physical examination). Urology at the NHS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2. – Upper urinary tract: large obstructive syndromes: anuria, hydronephrosis, megaureter, acute obstruction \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3. – Lower urinary tract: urinary disorders: acute and chronic retention of urine. Urinary incontinence. Neurogenic voiding dysfunctions \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4. – Female Urology. Incontinence and genital prolapses. Micturition painful syndromes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5. – Male urinary tract and genital infection. Cystitis, pyelonephritis, prostatitis. Sexually transmitted diseases. Genitourinary tuberculosis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>6. – Renal colic and renal lithiasis. Etiological varieties (metabolic, infectious): current therapeutic strategies \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>7. – Benign and malignant tumors of the renal parenchyma. Renal cysts. Renal cancer \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>8. – Benign and malignant diseases of the bladder: cystopaties. Urothelial bladder and pyeloureteral cancer \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>9. – Benign and malignant prostate diseases: benign prostatic hyperplasia (BPH). Prostate cancer \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>10. – Benign and malignant diseases of urethra and penis: urethral strictures: penile cancer \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>11. – Male sexual dysfunctions: erectile dysfunction. Premature ejaculation. Anorgasmia \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>12. – Benign and malignant diseases of the testis, adrenal glands, and retroperitoneum. Testicular cancer. Pheochromocytoma \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Seminars</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1. – Non-invasive diagnostic techniques in Urology \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2. – Invasive diagnostic techniques in Urology \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3. – Urological emergencies: hematuria. Acute scrotum. Urological pain. Genitourinary trauma \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4. – Renal failure: obstructive, vascular, and renal. Kidney transplant \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5. – Pediatric Urology: phimosis, cryptorchidism, genitourinary malformations \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>6. – Male reproductive system: fertility, infertility, family planning, and vasectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab884201.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Urology lessons and seminars (alternative program).</p>" ] ] 2 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Categories: 1: only see; 2: perform; 3: master.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">1. – Clinical histories (2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">2. – Examination of external genitalia in males (2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">3. – DRE (2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">4. – Analytical interpretation of urine and urinary sediment (3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">5. – Interpretation of imaging techniques: plain abdominal radiography, intravenous urography, abdominal ultrasound, CT urography (2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">6. – Prostate biopsy (1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">7. – Urethrocystoscopy (1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">8. – Bladder catheterization and types of probe (3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">9. – Assessing the patient with renal colic (3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">10. – Assessing the patient with hematuria (3) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab884199.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Students of Urology. 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|---|---|---|---|
| 2018 May | 1 | 0 | 1 |
| 2018 March | 2 | 0 | 2 |
| 2018 February | 10 | 2 | 12 |
| 2017 December | 6 | 1 | 7 |
| 2017 November | 8 | 0 | 8 |
| 2017 October | 7 | 2 | 9 |
| 2017 September | 9 | 1 | 10 |
| 2017 May | 1 | 1 | 2 |
| 2015 November | 3 | 2 | 5 |
| 2015 October | 1 | 0 | 1 |
