Alexander Beulens

152 Chapter 5 Discussion Although not all fellows responded to the survey, the results of this questionnaire give insights into the experiences of the respondents during and after the CC-ERUS fellowship. Many of the respondents were resident at the start of the CC-ERUS fellowship. Although almost two-thirds of the respondents participated in the video review at the end of the course not even half of them received a score on their video. All respondents recommend the CC-ERUS fellowship to their colleagues. Most of the respondents to this survey continue to practice robot assisted surgery, this is in line with earlier research on this subject which showed most of the participant still performed robot assisted surgery based on short term (14 months) and long term (up to 3 years post training) follow-up data.17,18 Even though the course was designed to train the fellows in RARP some respondents have gained experience in RAPN and RARC surgery during and after the fellowship. This endorses the need for specialized fellowship programs for both RAPN and RARC procedure in order to provide a structured training program for urologists. Remarkably results show almost two thirds of the respondents are unaware of the functional outcomes of their patients. One third of the respondents were unaware of the oncological outcomes of their surgeries. We recommend to have a more rigorous follow-up of trainees in surgical fellowship to improve elements of the fellowship program and monitor the need for continuous education after the fellowship. Conclusion Results of this survey show additional focus should be put on both functional and oncological outcomes during the fellowship. Most respondents are still practicing robot assisted surgery. Specialized fellowship programs for both RAPN and RARC procedure should be developed in order to provide structured training in these procedures.