Objective: To determine the views of urology trainees regarding training checkpoints/waypoints, and challenges to achieving a Certificate of Completion of Training (CCT). Methods: A novel survey was devised and distributed to evaluate urology trainee perceptions of the challenges in achieving the current CCT requirements as well as their views on the ST4 waypoint, indicative numbers (INs), workplace-based assessments (WBAs) and critical condition case-based discussions. Results: Of 347 trainees, 59 (17.0%) returned completed surveys from 13 of 19 training regions. The most significant challenges in achieving CCT as perceived by all trainees were, from highest to lowest: publication requirements, paediatric urology experience, achieving FRCS (Urol), INs and WBAs. All questions relating to ST4 waypoints were answered positively by a majority of respondents. Conclusions: The findings of this survey suggest that trainees will approve of the forthcoming changes in training assessment and outcomes embedded within the 2021 curriculum. The ST5 checkpoint, in particular, is an opportunity to better match trainees and placements and will underpin successful ‘phasing’ of training. A future study will inform the success of ‘embedding’ the 2021 curriculum and subsequently play a crucial part in the continuous improvement of urological training. Level of evidence: Not applicable for this multicentre audit.

The Plastics Division of ICI employs some 10 000 men and women in the development, manufacture and marketing of raw materials used by the plastics industry. Many changes have taken place in our markets and our ways of managing our human resources over the last few years, and the division decided to investigate the potential contributions of different methods of management training as aids to the further development of the organisation.

Objective: To synthesise all available data to determine the best management for urolithiasis-related renal forniceal rupture (RFR), with particular reference to the National Institute for Health and Care Excellence (NICE) 2019 Renal and Ureteric Stone Guidelines. Methods: PubMed search to March 2020 using permutations of renal, forniceal, fornix, calyceal, calyx and rupture. Non-English abstracts, editorial comments, letters to the editor and abstracts of conference proceedings were excluded. Results: An initial PubMed search retrieved 126 titles which were screened for relevance and five further titles were added from associated references. 64 abstracts were subsequently assessed, with 25 articles proceeding to full paper review. Conclusions: In cases of RFR secondary to ureteric calculi, management options, including conservative management, for the stone should be considered without the decision being influenced by the presence of the rupture. Perirenal abscesses secondary to RFR are rare, occurring in less than 0.25% of cases. Evidence supports restricting antibiotic prophylaxis to patients with a history of recurrent urinary tract infections or a positive urine culture, in line with the European Association of Urology’s antibiotic stewardship general management principle. RFR is not inherently a contraindication to primary ureteroscopy, which has particularly relevance with the drive to meet the 2019 NICE recommendations. Level of evidence: Not applicable to this literature review.

A new urology curriculum has been approved by the General Medical Council and will be rolled out from August 2021. Major changes include phasing of training with a hard checkpoint at ST5 that facilitates focussed development on core skills during phase 2 (ST3–5) and the development of a special interest during phase 3 (ST6–7). While the syllabus remains unchanged, supervision levels will replace many of the workplace-based assessments currently used in wider clinical practice, learning agreements will transition from placement to placement, and indicative numbers have been replaced with index procedures, in a move from box-ticking to a professional assessment of competency and totality of practice. While change can be daunting, the 2021 urology curriculum can be viewed positively as a move away from the arbitrary collection of records of workplace-based assessments and exposure to indicative numbers, and towards the holistic professional judgements of competency that are more in keeping with lifelong consultant practice. Level of evidence: Not applicable.