Introducing the Canadian Urology Student Interest Group (CUSIG)

INTRODUCTION

The Canadian Residency Matching Service (CaRMS ) has undergone significant changes with the Association of Faculties of Medicine of Canada (AFMC) electives diversification policy and restriction of visiting electives due to the COVID-19 pandemic.^1–4 These changes are significant considering that visiting electives play an essential role in the urology match process.⁵ During this time, many residency programs increased their online presence through websites or social media platforms and began hosting virtual events to increase interaction with applicants.^6,7 Student interest groups have also leveraged this increased online presence to build national medical student specialty interest groups in ophthalmology, neurosurgery, and radiology.^8–10 These student-led nationwide interest groups foster a sense of community among medical students, enabling them to connect with co-applicants and residency programs.^5–7 For these reasons, the Canadian Urology Student Interest Group (CUSIG) was created to serve as a national hub for Canadian medical students interested in urology.

To launch the CUSIG, a nationwide, virtual, post-match talk with recently matched urology residents was organized for medical students. This is the first event of its kind for Canadian medical students interested in urology.⁸ The goals of this event were to: 1) enable medical students to gain insight from matched residents about the unique CaRMS 2022 process and; 2) understand the current student perspective on urology and the matching process. Participants were sent a survey following the event to meet the second goal. We report the survey findings of this first event and introduce the CUSIG.

METHODS

This study was granted exemption from ethics approval from the Ethics Office at the University of Saskatchewan.

Event description

The CUSIG hosted a post-CaRMS match event on July 28, 2022. Five incoming residents from different Canadian medical schools (the University of Toronto, Western University, Dalhousie University, Sherbrooke University, and the University of Montreal) were recruited by the CUSIG executives to share their perspectives on the CaRMS 2022 process. They also discussed a unique topic specific to their application experience, including going unmatched, parallel planning, taking a gap year, applying to French universities, and matching without a home program.

To attend the event, participants were required to fill out a registration form promoted from July 13 to July 28, 2022, through the CUSIG Twitter social media platform. In addition, local urology interest group and surgical interest group representatives from 13 Canadian medical schools promoted the event on their respective platforms. No predefined prerequisites were required to sign up for the event but all attendees were medical students based on how the event was advertised.

The event started with a large group session with a brief introduction to CUSIG and its future goals and an evidence-based overview of the CaRMS urology match using the CaRMS publicly available data and studies evaluating the Canadian urology match.^1,2 The large group session ended with each resident introducing themselves and their brief impression of the CaRMS process. Students were then invited to join individual breakout rooms with one of the resident physicians to discuss their specific topics and perspectives in further detail. Students were able to circulate among the different breakout rooms freely.

Questionnaire

Following the event, students were asked to complete an online survey that consisted of 25 questions with short-answer and five-point Likert scale items (Appendix A; available at cuaj.ca). The survey is based on the one developed by the Canadian Ophthalmology Student Interest Group (COSIG) but refined with consultation from experts in urology medical education.⁸

RESULTS

Student attendance, responses, and demographics

As depicted in Table 1, 57 people registered for the event, 33 attended, and 16 filled out the post-seminar questionnaire, leading to a response rate of 48%. The respondents ranged from 20–29 years of age and are expected to graduate between 2022 and 2026. There was an even distribution between female (50%) and male attendees (50%). Most respondents attended schools in Eastern Canada, with over 50% of the attendees from schools in Quebec (the University of Montreal, University of Laval, McGill University, and the University of Sherbrooke).

Table 1.

CUSIG panel event student participation and demographics

Category	Number of responses	Percentage of survey response
Number of students
Registered for event	57
Attended event	33
Answered survey	16
Gender identity
Male	8	50%
Female	8	50%
School representation
Université de Montréal	3	19%
Université Laval	1	6.3%
McGill University	7	44%
Université de Sherbrooke	1	6.3%
Western University	1	6.3%
University of Saskatchewan	1	6.3%
University of Ottawa	1	6.3%
International medical graduate	1	6.3%
Age distribution
20	1	6.3%
21	0
22	2	13%
23	5	31%
24	0
25	2	13%
26	1	6.3%
27	1	6.3%
28	0
29	2	13%
Graduation date
2022 or before	3	19%
2023	5	31%
2024	1	6.3%
2025	4	25%
2026	3	19%

CaRMS knowledge

The mean of all survey answers regarding CaRMS knowledge was close to 3.5 (±0.1), with students rating their knowledge as “neutral” (Figure 1). Specifically, students rated their understanding of the following aspects of CaRMS as “neutral”: personal letters (mean 3.3±0.99), research/publications (3.7±1.0), reference letters (3.6±1.0), elective choices (3.7±1.1), and options if they were to go unmatched (3.4±1.2). The participants were least knowledgeable regarding the interview process (3.1±1.1).

Figure 1.

Knowledge about various aspects involved in the CaRMS application and results process.

Interest in urology

Most attendants agreed or strongly agreed that they were interested in urology (mean 4.4±0.9) (Figure 2). When asked if they have easy access to mentors, the average answer was “neutral” (3.4±1.2), and so was their access to networking opportunities (3.4±1.2) and resources in the field of urology (3.5±1.0). When asked if the respondents felt that they had received a thorough education in urology throughout their medical training, the students disagreed (2.5±1.2).

Figure 2.

Interest and access to resources in urology.

Event feedback

All of the respondents supported the creation of a countrywide CUSIG (mean 4.8±0.3) (Figure 3). The students’ stress levels did not change when comparing levels before (2.4±1.2) and after the event (2.4±1.2). There was a wide distribution of students willing to attend a similar event in the following year (2.9±1.7).

Figure 3.

Event-specific feedback.

DISCUSSION

To overcome the challenges created by limiting time in single-entry specialties and the suspension of visiting electives, numerous initiatives were undertaken to pivot toward fostering virtual connections between applicants and programs.^1,2,6–10 This is the underpinning for the start of the CUSIG as a means to connect students to different virtual events in urology with the hope that having one primary source of communication would enable more participation, connection, and benefit for students and Canadian urology programs.

National Canadian specialty interest groups are a novel concept. In the last two years, many initiatives were founded and launched by Canadian groups in ophthalmology (COSIG) and neurosurgery (CAMSIGN) that aim to unite medical students interested in particular subspecialties.^5,9 COSIG and CAMSIGN have reimagined the traditional local subspecialty interest group by providing robust online platforms to promote education, research, advocacy, and mentorship in neurosurgery and ophthalmology, respectively. In addition, they have organized dozens of successful events, ranging from educational topics (i.e., neuroanatomy sessions, annual meetings, and the Virtual Introductory Summer Course in Ophthalmology) to diversity training (with CAMSIGN’s Women in Neurosurgery series and COSIG’s Canadian Ophthalmology Mentorship Program).^8,9 These initiatives have been shown to benefit students by providing a greater sense of connection through events and programs.⁶

While subcommittees of the Canadian Urological Association (CUA) provide high-quality undergraduate medical education curriculum in urology, organize national conferences wherein medical students can participate, and advocate for equity, diversity, and inclusivity within urology, the success of COSIG and CAMSIGN highlight the value in trainee-led initiatives for undergraduate trainees. In collaboration with existing groups, such as the Canadian Undergraduate Urology Committee of the CUA (CanUUC), CUSIG hopes to augment and advance these initiatives at the trainee level. Future initiatives include Canada-wide mentorship programs for trainees similar to the framework designed by COSIG and CAMSIGN.^9,11

To ensure that CUSIG can support students in ways that will assist the navigation of their pathway towards a career in urology, the first event to launch our network shared matched urology residents’ knowledge with medical students. We leveraged this event to collect data on the current knowledge base of the medical students interested in urology as a career.

Although the implications of this study are limited by the small number of respondents (n=16), the participants all support the creation of CUSIG and highlight areas for future initiatives, such as urology mentorship, education, and increasing knowledge on the CaRMS process. It also highlighted that students feel undersupported regarding their urology knowledge and training at the medical school level, which is something CUSIG can advocate for.

This study is limited by the number of students that attended and responded to our survey. If this study were to be repeated, it might have more responses if it were not hosted during summer break and may be able to increase the Western Canadian presence by including panelists from schools in Saskatchewan, Alberta, and British Columbia. The results of this study should also be taken in the context that the students that attended and responded to this event are likely motivated for a career in urology and may not reflect the needs of all medical students.

KEY MESSAGES.

• ■ The creation of a student-led Canadian urology student interest group (CUSIG) is well-received among medical students interested in urology.

• ■ The first event launched by CUSIG was a nationwide, virtual, post-match talk with recently matched urology residents to: 1) enable medical students to gain insight from matched residents about the unique CaRMS 2022 process and; 2) understand the current student perspective on urology and the matching process.

• ■ The participants all support the creation of CUSIG and highlight areas for future initiatives, such as urology mentorship, education, and increasing knowledge on the CaRMS process.