AF Form 2818-6: Clinical Privileges – Urologic Surgeon

AF Form 2818-6: Clinical Privileges – Urologic Surgeon – AF Form 2818-6: Clinical Privileges – Urologic Surgeon is the official U.S. Air Force form used to request, verify, and grant clinical privileges to urologic surgeons practicing in Air Force Medical Treatment Facilities (MTFs). This specialized document ensures that board-certified or board-eligible urologists meet rigorous standards for performing a wide range of genitourinary surgical procedures, from minimally invasive endoscopic interventions to complex open and laparoscopic surgeries.

What Is AF Form 2818-6?

AF Form 2818-6, titled Clinical Privileges – Urologic Surgeon, belongs to the AF Form 2818 series of privilege lists for surgical specialties. It documents the specific scope of practice for urologic surgeons under Air Force Medical Service (AFMS) guidelines, governed primarily by AFI 44-119, Medical Quality Operations (which implements DoD clinical quality management policies).

Purpose of the form:

  • Defines the limits of clinical practice for individual providers.
  • Ensures privileges are granted based on verified credentials, training, experience, and demonstrated competency.
  • Supports patient safety and quality care in military treatment facilities.

The form is completed in ink and includes sections for the applicant to request privileges, the clinical supervisor to recommend approval (or modifications), and the credentials function to verify them using the facility’s master privileges list. Codes are assigned as follows:

  • 1 — Fully competent within defined scope.
  • 2 — Supervision required (e.g., for those lacking current experience or certification).
  • 3 — Not approved due to lack of facility support.
  • 4 — Not requested or not approved due to lack of expertise, proficiency, or physical limitations.

Any changes to approved privileges must follow the processes outlined in AFI 44-119.

Download the official form here: AF Form 2818-6 PDF

Scope of Clinical Privileges for Urologic Surgeons

The form provides a detailed list of privileges organized by anatomical area and procedure type. Urologic surgeons in the Air Force are authorized to evaluate, diagnose, treat (medically and surgically), and consult on patients of all ages with congenital or acquired conditions of the genitourinary system, contiguous structures, and the adrenal gland. This includes pre-, intra-, and post-operative management, admission of patients, and care in intensive settings per MTF policy.

Key categories of privileges typically listed on AF Form 2818-6 include:

  • Kidney: Percutaneous nephrolithotomy, nephrectomy (various approaches, including laparoscopic and donor), partial nephrectomy, pyeloplasty, renal biopsy, and management of renal cysts or abscesses.
  • Ureter: Ureterolithotomy, ureteroplasty, ureteroneocystostomy, transureteroureterostomy, and various repairs or diversions.
  • Bladder: Cystectomy (partial or complete), cystolithotomy, enterocystoplasty, vesicovaginal fistula repair, and insertion of artificial urinary sphincter.
  • Endoscopic Procedures: Diagnostic and therapeutic cystourethroscopy, ureteroscopy, transurethral resection of prostate (TURP) or bladder tumor (TURBT), litholapaxy, laser applications, and percutaneous nephrostomy.
  • Prostate: Prostatectomy (perineal, retropubic, suprapubic), biopsy, and brachytherapy.
  • Genitalia and Reproductive Structures: Procedures involving penis (prosthesis insertion, hypospadias repair, Peyronie’s disease correction), testis (orchiectomy, orchiopexy), epididymis, vas deferens (vasectomy, vasovasostomy), and scrotum.
  • Adrenal and Lymphatic: Adrenalectomy (open or laparoscopic), retroperitoneal and pelvic lymphadenectomy.
  • Additional/Special Procedures: Laparoscopic approaches to pelvic/retroperitoneal organs, extracorporeal shock wave lithotripsy (ESWL), and management of trauma or congenital anomalies (e.g., exstrophy repair).

Privileges also often encompass ultrasound interpretation of the genitourinary tract, urodynamic studies, male infertility and family planning procedures, stone disease management, and hernia repairs related to the genitourinary system.

Modern Air Force urology privilege lists (DODMPL for Urology) emphasize competency in minimally invasive techniques, robotics where available, and comprehensive stone disease and oncology management.

Qualifications and Requirements for Urologic Surgeons in the Air Force

To request privileges via AF Form 2818-6, providers must typically meet these criteria (aligned with DoD and AFMS standards):

  • Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) from an approved school.
  • Successful completion of an ACGME- or AOA-accredited residency in urology.
  • Current board certification (or active pursuit of certification) by the American Board of Urology (ABU) or equivalent.
  • Active, unrestricted medical license (with portability considerations under DoDI 6025.16).
  • Demonstrated recent clinical experience and ongoing competency through proctoring, case logs, continuing medical education (CME), and performance evaluations.

For initial granting or renewal of privileges, the Air Force evaluates education, postgraduate training, current competence, and facility-specific capabilities. Civilian-trained applicants follow specific instructions from the Air Force Credentials Verification Office (AFCCVO) and submit the form alongside DHA Form 367.

Renewal of privileges generally requires evidence of ongoing practice, CME, and satisfactory clinical performance within the privileging cycle.

How the Privileging Process Works in Air Force Medicine?

  1. Applicant completes Part I, requesting privileges with appropriate codes.
  2. Clinical Supervisor reviews and recommends approval, modification, or disapproval in Part II.
  3. Credentials Function verifies against the master list and processes through the credentials committee and medical staff.
  4. Final approval rests with the privileging authority (typically the MTF Commander or designated official).

This process aligns with broader DoD and Air Force policies for clinical quality management, risk management, and performance improvement.

Why This Matters for Air Force Medical Professionals

Accurate completion of AF Form 2818-6 ensures urologic surgeons can deliver high-quality, specialized care to active-duty service members, retirees, and their families. It supports mission readiness by maintaining a skilled surgical workforce capable of managing complex genitourinary conditions, including trauma, oncology, reconstructive surgery, and stone disease.

For current or prospective Air Force urologists, understanding this form is essential during credentialing, transition from residency, or moves between MTFs.

Official Resources:

Note: Always use the most current version of the form and consult your local credentials office or AFCCVO for facility-specific guidance, as privilege lists and requirements can be updated.

This article provides general information based on publicly available official U.S. Air Force and DoD sources. For personalized advice on privileging, contact your military treatment facility’s credentials office.