114 Chapter 4 In order to provide a structured training program in robot-assisted surgery the European Robotic Urological Society developed a curriculum (CC-ERUS) focused on the performance of robot-assisted radical prostatectomy (RARP).5,6,15,16 After its initial conception in 2014, the program has evolved into a structured training curriculum. Indeed, it includes all the aspects of training, from the most basic ones as live case observation and table-side assistance, to the most advanced training facilities as virtual reality (VR), dry and wet lab with the most complex and advanced training models available today. Moreover, it provides six months of modular training at a certified host center, and the performance of a full RARP case with the video assessment by expert surgeons.15 Currently, this curriculum is available for fellows who train in CCERUS host centers. Since the implementation of training curricula for fellows is a step into the right direction, but, the training is demanding and expensive and therefore normally not available for residents. An increasing number of residents are allowed to train RAS on patients under the supervision of an experienced robotic surgeon during internship, however most of them do not have the possibility to receive a well-structured training and simulation before that. Thus, a structured curriculum during the residency program is also needed. For this reason, The Dutch and Belgian Association of Urology organize yearly a one-week training at ORSI Academy (https://www. orsi-online.com/en) in order to provide a structured and supervised training for residents. The question arises whether residents poses a sufficient background to effectively participate in the course and in order to meet educational goals. We therefore asked ourselves the following questions: (1) What is the current availability of training for robot assisted surgery and the possibility to perform robot assisted surgery during Dutch residency in urology curriculum? (2) Do residents show a significant increase in Simulation-based surgical skills following the curriculum? (3) Are residents able/allowed by their trainers to perform robot assisted surgery after the curriculum?
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