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The author discusses a study conducted by the Canadian Upper Tract Collaboration (CUTC) on the surgical treatment of upper tract urothelial carcinoma (UTUC). He critisizes the lack of categorization of patients according to the exposure to disease, socioeconomic status and ethnicity. He highlights the reports regarding the outcomes of nephroureterectomy. He talks about the practices for management of distal ureter and lymphadenectomy which is linked to survival.

Introduction: Many factors impact the performance of graduating residents on certification exams. It is thought that most factors are related to the individual candidate's ability, motivation, and work ethic. Less understood, however, is whether a training program has any impact on the preparation and performance of its graduates on certification exams. We present 20 years of results of a national preparatory exam that all graduating residents complete about three months before the Royal College of Physicians and Surgeons of Canada (RCPSC) qualifying urology exam. This exam, known colloquially as QUEST, aims to simulate the RCPSC exam with written and oral components. We aimed to analyze the impact of a training program on the performance of its residents. Methods: A retrospective review of exam results from 1997-2016 was conducted. During that time, 495 candidates from all 12 Canadian urology training programs undertook the exam. The performance of graduating residents from each individual program was grouped together for any given year. The different programs were anonymized, as the aim of this study is to assess the impact of a training program and not to rate the different programs. Statistical analysis using one-way ANOVA was conducted. Results: All training programs fall within one standard deviation of the mean for the written component, the oral component, and the overall score. The residents of four training programs had statistically better scores than the overall mean of the written component. The residents of three out of these four training programs also had statistically better scores than the overall mean of the oral component and the overall results of the exam. Conclusions: Most Canadian training programs prepare their residents adequately for this simulated certification exam in urology. However, there are some training programs that consistently prepare graduating residents to outperform their peers. [ABSTRACT FROM AUTHOR]