Abstract The Coronavirus (COVID-19) pandemic, typified as such in March 2020 by the World Health Organization (WHO), has exceeded the capacity of health systems to aid victims, and triggered a radical change in medical research, and in the monitoring of the enrollment for clinical trials in urologic fields around the world. Last year, almost 90% of clinical sites closed patient enrollment, while at the same time, researchers around the world initiated almost 1000 COVID-19 clinical trials. This catastrophic pandemic has allowed us to expand our medical knowledge exponentially. The global urological community has created and published an infinity of scientific articles: establishing guideline reactions for diagnosis, treatment, and follow-up of the different urologic conditions across all areas of the field, reporting the experiences at urology services, and putting forward new strategies. The Confederación Americana de Urología (CAU) has promoted international collaborative projects that have led to gaining insight into how the Latin American Urology Services faced the pandemic, including the challenges, strengths, and the areas of opportunity for urologic care. It also allowed us to increase the number and quality of publications. Also, we have created new virtual platforms and international networks to exchange our knowledge. We have as well transformed this social, economic and health crisis brought upon us by COVID-19, into a source of opportunities for the growth and promotion of research in Latin America. Urologic patients, require researchers to work on favoring their goals. A collaborative network, the established and coordinated protocols, the safety of patients and researchers, assertive and constant communication, and effective technology use, are the essential tools to resume institutional investigation under these critical conditions.

Resumen La pandemia del coronavirus (COVID-19), tipificada como tal en marzo de 2020 por la Organización Mundial de la Salud (OMS), ha superado la capacidad de los sistemas de salud para ayudar a las víctimas y ha desencadenado un cambio radical en la investigación médica y en el seguimiento de los registros para ensayos clínicos en campos urológicos de todo el mundo. El año pasado, casi el 90 % de los sitios clínicos cerraron la inscripción de pacientes, mientras que, al mismo tiempo, investigadores de todo el mundo iniciaron casi 1000 ensayos clínicos de COVID-19. Esta pandemia catastrófica nos ha permitido ampliar exponencialmente nuestro conocimiento médico. La comunidad urológica mundial ha creado y publicado una infinidad de artículos científicos: estableciendo pautas de reacción para el diagnóstico, tratamiento y seguimiento de las diferentes condiciones urológicas en todas las áreas del campo, reportando las experiencias en los servicios de urología y proponiendo nuevas estrategias. La Confederación Americana de Urología (CAU) ha impulsado proyectos de colaboración internacional que han permitido conocer cómo los Servicios de Urología de América Latina enfrentaron la pandemia, incluidos los desafíos, las fortalezas y las áreas de oportunidad para la atención urológica. También nos permitió aumentar el número y la calidad de las publicaciones. Además, hemos creado nuevas plataformas virtuales y redes internacionales para intercambiar nuestro conocimiento. También hemos transformado esta crisis social, económica y de salud que nos ha traído el COVID-19, en una fuente de oportunidades para el crecimiento y fomento de la investigación en América Latina. Los pacientes urológicos, requieren que los investigadores trabajen en favor de sus objetivos. Una red colaborativa, los protocolos establecidos y coordinados, la seguridad de pacientes e investigadores, la comunicación asertiva y constante, y el uso efectivo de la tecnología, son las herramientas esenciales para retomar la investigación institucional en estas condiciones críticas.

Abstract Objective: The recently developed technological advances in urology are a challenge, both for the urologists responsible for training activities, as well as for residents. This has led to heterogeneous residency programs; in terms of training and access to these technologies, among the scientific societies of the countries that make up the American Confederation of Urology (CAU, by its Spanish initials). The aim of this study was to collect relevant information and to perform a situational analysis to promote the development of more homogeneous programs for the training of future professionals in urology. Methodology: A closed survey using the CAU EDUCACIÓN platform that included twenty-seven multiple-choice questions between September 2019 and September 2020. Results: The difference between programs was found, above all, in the duration of the residencies, accreditations, the possibility of publication in scientific journals, training modalities, access to technology and subsequent job opportunities. Limitations: The main limitation was the number of participants, which was much lower than the total number of active residents. Despite this, the number of participating countries, the distribution, and the results obtained, allowed us to assess the current training of CAU residents. Conclusion: It is important to gain more insight about residencies in Ibero-America, to establish a specific and uniform plan to ensure proper training, regardless of the unit in which the residency occurs.

Resumen Objetivo: Los nuevos aportes tecnológicos en urología que se han desarrollado en los últimos años suponen un reto, tanto para los urólogos responsables de las actividades formativas, como para los residentes. Esto hace que los programas de residencias en relación a la formación y al acceso a dichas tecnologías, entre los países y sociedades científicas que componen la Confederación Americana de Urología sean heterogéneos. El objetivo es recopilar dicha información, con el fin de obtener un análisis situacional para desarrollar programas de formación más homogéneas de los futuros profesionales en urología. Metodología: Encuesta cerrada utilizando la plataforma CAU EDUCACIÓN que incluyó veintisiete preguntas de opción múltiple en el período de septiembre de 2019 a septiembre de 2020. Resultados: Las diferencias entre los programas residenciales está relacionada, sobre todo, con la duración de las residencias, acreditaciones, posibilidad de publicación en revistas científicas, modalidades de formación, acceso a la tecnología y posteriores oportunidades laborales. Limitaciones: El número de participantes, que está lejos del número total de residentes activos. A pesar de ello, el número de países participantes, la distribución y los resultados obtenidos nos permiten acercarnos a la situación de la formación actual de los residentes de CAU. Conclusión: Es importante conocer más sobre la realidad de las residencias en Iberoamérica, con el fin de establecer un plan específico y uniforme que asegure una adecuada formación, independientemente del lugar donde se realice la residencia.

ABSTRACT Introduction: Since World Health Organization (WHO) declared COVID-19 as a global pandemic, urology services have developed strategies to prioritize and not to differ urgent and oncological patient's medical attention, in order to optimize resources and decrease infection probability among staff and patients. This unprecedented situation has generated a decrease in assistance and academic activities in most medical residences. The aim of this manuscript is to evaluate the impact of this health crisis on training programs through a survey addressed to urology medical residents. Materials and Methods: Cross sectional designed study, with multiple-choice non validated survey answered online by residents. Questionnaire was developed through the CAU EDUCACION platform. Results: A total of 148 responses from 18 countries coming from Latin America and Spain answering the survey. Of total, 82% answered that the activity of their urology department was significantly reduced, attending only urgent surgical pathologies, 15 % that, the urology activity has been closed completely and the staff was assigned to COVID-19 patients care, 3% continue with the regular clinic activity. Likewise, 75% stated that their surgical training has been completely affected, 93% receive urological information through tools such as Skype, ZOOM meeting, Cisco Webex, being Webinar modality the most used. Despite technological boom, 65% answered their academic training has been partially or completely affected. Most of the surveyed residents consider that period of residence should be extended to retrieve the educational targets. Conclusion: This unprecedented reality is negatively impacting the heterogeneous residency programs that American Confederation of Urology (CAU) nucleates. It is necessary to continue with technological innovation and allocate time and resources to easily generate accessible tools to favor the training of future urologists.