The URO-4 resident is the primary physician for these patients. All patients are either seen or discussed with an attending staff member. Surgical procedures are performed by the residents with attending supervision. Private patients are admitted to the same service as the non-private patients.
Residents have primary responsibility for their in-hospital care.
Most operations on the private patients are performed by the resident staff with attending supervision. However, the attending staff has primary responsibility for deciding the treatment regimen both preoperatively and in the postoperative clinic. This is not always possible, however, because of the residents' other duties. At the VA, basically all patients are considered the primary responsibility of the URO-4 resident. His decisions are discussed with the attending staff, but he is viewed as the primary urologist within the institution.