Introduction: The introduction of a second ACGME-accredited year to Society for Pediatric Urology (SPU) fellowships allows greater curricular flexibility and has modified attending-fellow oversight. New restrictions on clinical independence and duty hours necessitate the identification of the most germane components of the fellowship experience. We sought to determine the self-assessed surgical capabilities of SPU fellowship graduates and the most relevant factors contributing to those abilities. Methods: A survey was designed in collaborative fashion with input from all listed authors. It was alpha-tested by two potential SPU fellowship applicants to confirm clarity. It was distributed by email to 2016-2021 SPU fellowship graduates. Descriptive deidentified response data are reported. Results: We invited 109 graduates, and 53 (49%) completed the survey. 42/53 (79%) practice in an academic setting. Clinical FTE exceeds 0.7 for 35/41 (85%) of respondents. 35/53 (66%) have at least three partners and 6/53 (11%) are in solo practice. Respondents reported increased confidence from graduation to the present day for all index procedures queried (Table 1). 51% of respondents served as a credentialed attending during fellowship, of whom 93% found this “very” or “extremely” helpful for achieving surgical independence. Other highly valued experiences were operating with only a resident (96%) or scrub technician (78%) without the attending scrubbed. Key contributors to graduates’ confidence and self-perceived independence were fellowship case volume (96% rated it a “strong” or “very strong” contributor), general surgical ability gained during fellowship (96%), technical experience in early practice cases (87%), case volume in early practice (81%), and outcomes of early practice cases (79%). Only 62% gave a high rating to general surgical ability gained during residency. Conclusions: High case volume during training is critical for developing surgical independence in SPU fellows, and highly autonomous operative experiences are an important scaffold. Confidence and skill continue to progress dramatically in the first years of practice, and therefore active mentorship from senior colleagues early in a pediatric urologist’s career can be of profound value. SOURCE OF Funding: None
