Publications by authors named "Byron D Joyner"
Objective: To investigate whether interview travel cost and time differed for urology residency applicants from medical schools with higher vs lower proportions of students from groups underrepresented in medicine (URiMs).
Methods: We identified 22 medical schools, 11 with <15% and 11 with >20% URiM students, and 17 "highly ranked" urology residency programs. We contacted the residency programs and requested interview dates, preferred lodging options, and institution-based cost-savings.
Introduction: Despite the competitiveness and high stakes of the urology residency match little research has focused on the application process from the applicants' perspective.
Methods: In April 2018 we e-mailed a 23-question multiple-choice survey to all applicants to the 2018 urology residency match.
Results: Of the 436 applicants 186 (42.
Background: With increasing public awareness of and greater coverage for gender-confirming surgery by insurers, more transgender patients are likely to seek surgical transition. The degree to which plastic surgery and urology trainees are prepared to treat transgender patients is unknown.
Objective: We assessed the number of hours dedicated to transgender-oriented education in plastic surgery and urology residencies, and the impact of program director (PD) attitudes on provision of such training.
Aligning institutional priorities: engaging house staff in a quality improvement and safety initiative to fulfill Clinical Learning Environment Review objectives and electronic medical record Meaningful Use requirements.
Am J Surg
February 2016
Background: House staff quality improvement projects are often not aligned with training institution priorities. House staff are the primary users of inpatient problem lists in academic medical centers, and list maintenance has significant patient safety and financial implications. Improvement of the problem list is an important objective for hospitals with electronic health records under the Meaningful Use program.
View Article and Find Full Text PDFPurpose: To assess the extent and types of publication misrepresentation among medical students applying to the urology residency program at the University of Washington. Research experience and publications are the selection criteria used to judge and rank urology residency applicants.
Methods: Electronic Residency Application Service (ERAS) applications submitted for the incoming class of 2011 for urology residency at the University of Washington were reviewed.
Purpose: We determined whether the presence or absence of dextranomer-hyaluronic acid copolymer mounds on bladder ultrasound coincides with voiding cystourethrogram results after injection therapy in children with primary vesicoureteral reflux.
Materials And Methods: We retrospectively reviewed consecutive cases of dextranomer-hyaluronic acid copolymer injection for primary vesicoureteral reflux. The primary outcome investigated was the appearance of dextranomer-hyaluronic acid copolymer mounds on ultrasound and their association with voiding cystourethrogram results postoperatively.
Purpose: Since 1989, we have used the complete primary repair of exstrophy surgical technique to reconstruct the genitourinary system of children born with the exstrophy-epispadias complex based on the assumption that this complex represents a malformation. We initially reported using this technique in 1999. We now report a longer term followup of this initial group as well as surgical outcomes in a larger group of children who have undergone this repair for classic bladder exstrophy.
View Article and Find Full Text PDFPurpose: Although laparoscopic pyeloplasty has gained popularity, to our knowledge no multi-institutional study has evaluated the prevalence of this approach in children. We used a multicenter database to determine trends in the treatment of congenital ureteropelvic junction obstruction.
Materials And Methods: The Pediatric Health Information System database contains data on 37 freestanding hospitals for children across the United States.
Purpose: The American population continues to increase in ethnic diversity. However, the medical work force has lagged behind these population trends. We evaluated the extent of diversity and perceived barriers to multicultural training in American urology programs.
View Article and Find Full Text PDFPurpose: Augmentation gastrocystoplasty has been proposed as an alternative to enterocystoplasty because of potential benefits, including decreased risk of mucus production, stone formation and urinary tract infections. Although cancer has rarely been reported in this patient population, it is a well recognized potential risk of all augmentation cystoplasties. To define better the risk of malignancy associated with gastric augmentation and the appropriate surveillance protocol for these patients, we describe our experience in 2 patients with metastatic adenocarcinoma following gastrocystoplasty.
View Article and Find Full Text PDFPurpose: Professionalism is one of the most challenging of the Accreditation Council for Graduate Medical Education Competencies to define, teach and evaluate. At University of Washington we assessed whether defining professionalism, and training faculty and residents in the evaluation process would improve professional behavior.
Materials And Methods: In 2003 the Accreditation Council for Graduate Medical Education Global Resident Competency Rating Form was distributed to faculty after each rotation to evaluate residents.
Purpose: Since Food and Drug Administration approval of Deflux, injection therapy for vesicoureteral reflux has increased. Little data exist on the effect that injection therapy has had on the incidence of ureteral reimplantation and total vesicoureteral reflux procedures. We used the Pediatric Health Information System database to define practice trends for vesicoureteral reflux therapy.
View Article and Find Full Text PDFPurpose: We identified augmentation cystoplasty rates in children with spina bifida at children's hospitals enrolled in the Pediatric Health Information System database.
Materials And Methods: The Pediatric Health Information System database tabulates demographic and diagnostic patient data from 35 children's hospital centers in the United States. Between October 1999 and September 2004 we extracted data on 0 to 19-year-old patients with International Classification of Diseases-9 diagnosis codes for spina bifida.
Purpose: The Accreditation Council for Graduate Medical Education requires that each residency program must demonstrate and document actual accomplishments through objective measures. At University of Washington we identified deficiencies in resident medical knowledge and designed interventions that would assist in improving resident AUA IS scores, using this as a metric to document the outcomes.
Materials And Methods: In 2001 the University of Washington syllabus and faculty precepted chapter review sessions were formally established.
Purpose: Residency programs in the United States are held accountable for achieving outcomes based on the new Accreditation Council for Graduate Medical Education (ACGME) regulations for improving resident fatigue and education. A national survey of Urology Program Directors was conducted to determine the attitudes toward the new regulations and the actions taken to implement them.
Materials And Methods: A national survey was developed by an ad hoc committee and distributed electronically.
Background And Purpose: Laparoscopic dismembered pyeloplasty is an acceptable option for ureteropelvic junction (UPS) obstruction in the pediatric population. We compared our results with dismembered and nondismembered laparoscopic pyeloplasty.
Patients And Methods: A series of 26 children between the ages of 8 months and 15 years (mean age 5 years) underwent transperitoneal laparoscopic pyeloplasty for an obstruction not caused by a crossing vessel.
Purpose: To describe the laparoscopic management of anterior caliceal diverticula in pediatric patients and to emphasize the importance of intraoperative retrograde pyelography for the diagnosis of symptomatic lesions when preoperative radiologic evaluation is inconclusive.
Patients And Methods: We performed laparoscopic transperitoneal excision of a large symptomatic caliceal diverticulum in three patients. Ultrasonography was consistent with a cyst, and a CT scan did not show layering on delayed images.
Purpose: We hypothesize that residual ureteral stumps following nephroureterectomy (NU) or heminephroureterectomy (HNU) are associated with an increased risk of urinary tract infection (UTI) that is decreased by distal ureterectomy.
Materials And Methods: We performed a retrospective review of 71 patients who underwent NU or HNU for reflux into a nonfunctioning system between 1990 and 2003. The indications for all renal surgery included recurrent UTIs in 44 patients, hypertension in 8 and a combination of these conditions in 19.